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Lupus
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Cutaneous alternariosis in a patient with systemic lupus erythematosus

A. Akman

Department of Dermatology and Venerology, aakman{at}akdeniz.edu.tr

D. Sakalli Cakcak

Department of Dermatology and Venerology

B. Ozhak Baysan

Department of Microbiology

V. Yazisiz

Department of Clinical Immunology and Rheumatology

E. Terzioglu

Department of Clinical Immunology and Rheumatology

M.A. Ciftcioglu

Department of Pathology, Akdeniz University School of Medicine, Antalya, Turkey

E. Alpsoy

Department of Dermatology and Venerology

Alternaria species are common saprophytic fungi that naturally subsist on decaying plant materials, and occasionally may cause diseases in human beings and domestic animals. They can be a potential opportunistic pathogen in immunocompromized hosts or those with significant underlying disease. However, rarely they are also pathogen in otherwise healthy hosts. We report here the first case of cutaneous alternariosis in a 30-year-old woman who was on systemic steroid therapy for active systemic lupus erythematosus. The patient was referred to our department with purple papules and ulcerated nodules on the dorsum of the hands, wrists and ankles. Skin biopsy showed granulomatous reaction with fungal elements that were subsequently identified as Alternaria species. Individual lesions were successfully treated with oral itracanozole 200mg daily for six weeks. Besides the patient's own disease, the use of systemic steroid use might be a possible predisposing factor for the development of cutaneous alternariosis. Lupus (2007) 16, 993—996.

Key Words: cutanesous alternariosis • systemic lupus erythematosus • immunosuppression

Lupus, Vol. 16, No. 12, 993-996 (2007)
DOI: 10.1177/0961203307084168
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