PMC3504245_01
Infiltrating plaques, with a verrucoid appearance, occupying the back of hands (a) and forearms (b).
CRIM.DM2011-385803.001.jpg
PMC3504245_01_CRIM.DM2011-385803.001.jpg
fig1
A 76-year-old woman, resident in a rural area, came to our observation with multiple slowly growing, painless, erythematous infiltrating plaques, with a verrucoid appearance, occupying the back of hands, forearms, and the distal 2/3 of the arms (Figures 1(a) and 1(b)).
Segmented hyphae and spherical spore-like bodies in the dermis (PAS: (a) 10x; (b) 40x).
CRIM.DM2011-385803.002.jpg
PMC3504245_01_CRIM.DM2011-385803.002.jpg
fig2
Histopathological examination revealed an intense inflammatory process in the dermis, and several septate hyphae and round or oval spore-like structures that stained positively with periodic acid Schiff stain (Figures 2(a) and 2(b)).
Lesions after 3 weeks of treatment with Voriconazole.
CRIM.DM2011-385803.003.jpg
PMC3504245_01_CRIM.DM2011-385803.003.jpg
fig3
Treatment with intravenous voriconazole at a dose of 4 mg/kg every 12 hours was initiated, followed by 100 mg orally after day 10, with marked improvement of the lesions (Figures 3(a) and 3(b)).