This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Web of Science (1) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Akman, A. Articles by Alpsoy, E. Search for Related Content PubMed PubMed Citation Articles by Akman, A. Articles by Alpsoy, E. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Lupus Social Bookmarking                         What's this?

Cutaneous alternariosis in a patient with systemic lupus erythematosus

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

References

• Iwatsu T. Cutaneous alternariosis. Arch Dermatol 1988; 124: 1822.[Abstract/Free Full Text]
• Horner WE, Helbling A., Salvaggio JE et al. Fungual allergens. Clin Microbiol Rev 1995; 8: 161—179.[Abstract]
• Male O., Pehamberger H. Secondary cutaneous mycoses caused by Alternaria species. Hautarzt 1989; 40: 718—720.[Web of Science][Medline] [Order article via Infotrieve]
• Romano C., Vanzi L., Massi D., Difonzo EM Subcutaneous alternariosis. Mycoses 2005; 48: 408—412.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Uenotsuchi T., Moroi Y., Urabe K. et al. Cutaneous alternariosis with chronic granulomatous disease. Eur J Dermatol 2005; 15: 406—408.[Web of Science][Medline] [Order article via Infotrieve]
• Longley BJ Fungal diseases. In Elder D, Elenitsas R, Jaworsky C, Johnson B, eds. Lever's histopathology of skin. Lippincott-Raven Publishers, 1997: 517—551.
• Magina S., Lisboa C., Santos P. et al. Cutaneous alternariosis by Alternaria chartarum in a renal transplanted patient. Br J Dermatol 2000; 142: 1261—1262.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Lamaille C., Le Gall F., Gegeilh B. et al. Cutaneous Alternaria infectoria infection after liver transplantation. Ann Pathol 1998; 18: 192—194.[Web of Science][Medline] [Order article via Infotrieve]
• Vieira MR, Martins ML, Afonso A., Rego F., Cardoso J. Cutaneous alternariosis. Rev Iberoam Micol 1998; 15: 97—9.[Medline] [Order article via Infotrieve]
• Katz A., Ehrenfeld M., Livneh A. et al. Aspergillosis in systemic lupus erythematosus. Semin Arthritis Rheum 1996; 26: 635—640.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Le Moing V., Leport C. Infections and lupus. Rev Prat 1998; 48: 637—642.[Medline] [Order article via Infotrieve]
• Tlacuilo-Parra A., Guevara-Gutierrez E., Mayorga J. et al. Onychomycosis in systemic lupus erythematosus: a case control study. J Rheumatol 2003; 30: 1491—1494.[Abstract/Free Full Text]
• Liou J., Chiu C., Tseng C. et al. Cryptococcal meningitis in pediatric systemic lupus erythematosus. Mycoses 2003; 46: 153—156.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Murayama N., Takimoto R., Kawai M. et al. A case of subcutaneous phaeohyphomycotic cyst due to Exophiala jeanselmei complicated with systemic lupus erythematosus. Mycoses 2003; 46: 145—148.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Huang JL, Chou ML, Hung IJ et al. Multiple cryptococcal brain abscesses in systemic lupus erythematosus. Br J Rheumatol 1996; 35: 1334—1335.[Free Full Text]
• Price DA, Ong EL Cutaneous histoplasmosis in a patient with systemic lupus erythematosis. Lancet Infect Dis 2003; 3: 296.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Tanaka H., Suzuki K., Nakahata T. Disseminated candidiasis following prednisolone therapy in systemic lupus erythematosus. Pediatr Int 2002; 44: 702—704.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Canova EG, Rosa DC, Vallada MG, Silva CA Invasive aspergillosis in juvenile systemic lupus erythematosus. Clin Exp Rheumatol 2002; 20: 736.[Web of Science][Medline] [Order article via Infotrieve]
• Tlacuilo-Parra A., Guevara-Gutierrez E., Mayorga J., Salazar-Paramo M. Proximal white subungual onychomycosis caused by Microsporum canis in systemic lupus erythematosus. Rheumatol Int 2002; 21: 250—252.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Maeda M., Makimura KC, Yamaguchi H. Pityriasis versicolor rubra. Eur J Dermatol 2002; 12: 160—164.[Web of Science][Medline] [Order article via Infotrieve]
• Baykal C., Kazancioglu R., Buyukbabani N. et al. Simultaneous cutaneous and ungual alternariosis in a renal transplant recipient. Br J Dermatol 2000; 143: 910—912.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Farmer SG, Komorowski RA Cutaneous microabscess formation from Alternaria alternata. Am J Clin Pathol 1976; 66: 161—179.
• Mitchell AJ, Solomon AR, Beneke ES et al. Subcutaneous alternariosis. J Am Acad Dermatol 1983; 8: 673.[Web of Science][Medline] [Order article via Infotrieve]
• Acland KM, Hay RJ, Groves R. Cutaneous infection with Alternaria alternata complicating immunosuppression: successful treatment with itraconazole. Br J Dermatol 1998; 138: 354—356.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]

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


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Web of Science (1) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Akman, A. Articles by Alpsoy, E. Search for Related Content PubMed PubMed Citation Articles by Akman, A. Articles by Alpsoy, E. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Lupus Social Bookmarking                         What's this?