PMC7310607_01
Erythematous and violaceous papules and nodules, some of them with exulcerated surface on the limbs.
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PMC7310607_01_1678-9946-rimtsp-62-S1678-9946202062042-gf01.jpg
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Subsequently, they progressed to ulcerated plaques with a blood-draining s discharge (Figure 1).
- Microculture showing macroconidia of Arthroderma gypseum and Macroculture on Agar Sabouraud displaying the Arthroderma gypseum growth.
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PMC7310607_01_1678-9946-rimtsp-62-S1678-9946202062042-gf02.jpg
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The confirmation of deep mycosis by M. gypseum (N. gypsea) was made through a direct mycological examination, culture in Agar Sabouraud (Figure 2) and a cutaneous biopsy, however, the molecular identification of the strain was not performed.
- Top image: intense mixed inflammatory infiltrate with suppuration in the dermis and the hypodermis. HE, OM: x 40 magnification; Bottom image: granulomatous and suppurative inflammation with epithelioid and giant multinucleated histiocytes and neutrophils in the dermis. HE, OM: x 400 magnification.
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The histopathology demonstrated acanthosis and spongiosis of epidermis, a granulomatous and suppurative intense inflammation of the dermis and hypodermis (Figure 3) along with the presence of fungal septate hyphae in Grocott' staining (Figure 4).
Histopathology: Grocott's staining disclosing fungal hyphae in the dermis. OM: x 400 magnification.
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PMC7310607_01_1678-9946-rimtsp-62-S1678-9946202062042-gf04.jpg
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The histopathology demonstrated acanthosis and spongiosis of epidermis, a granulomatous and suppurative intense inflammation of the dermis and hypodermis (Figure 3) along with the presence of fungal septate hyphae in Grocott' staining (Figure 4).