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Superficial phaeohyphomycosis of the scrotum in a patient with the acquired immunodeficiency syndrome.

To the Editor.— Patients with the acquired immunodeficiency syndrome (AIDS) often have exotic opportunistic infections or unusual presentations of common infections. Report of a Case.— A 28-year-old male homosexual with AIDS, manifested by Kaposi's sarcoma and cytomegalovirus retinitis, presented to Dermatology Clinic with "tiny brown spots on the scrotum over the last three weeks." He had been undergoing chemotherapy for Kaposi's sarcoma and had a white blood cell count of 6 × 109/L (600/mm3). Examination revealed flat, rough 1- to 3-mm papules with variegated pigmentation on the scrotum (Fig 1). Some resembled small follicular seborrheic keratoses. However, examination of one lesion with potassium hydroxide showed a mass of mycelia. Two separate lesions removed with a sterile scalpel were directly inoculated onto fungal culture slants and were evaluated by different mycology laboratories. The initial slants yielded a dull black-brown mycelia, which, on subculture, yielded two organisms: a fluffy