Skip to main content
Top
Published in: World Journal of Surgery 12/2018

01-12-2018 | Original Scientific Report

Subcutaneous Phaeohyphomycosis: A Clinical Mimic of Skin and Soft Tissue Neoplasms—A Descriptive Study from India

Authors: Sree Rekha Jinkala, Debdatta Basu, Siddaraju Neelaiah, Norton Stephen, Srinivas Bheemanati Hanuman, Rakesh Singh

Published in: World Journal of Surgery | Issue 12/2018

Login to get access

Abstract

Background

Phaeohyphomycosis is a fungal infection caused by heterogenous group of fungi known as phaeoid or dematiaceous fungi. It manifests in four clinical forms—cutaneous, subcutaneous, systemic and cerebral phaeohyphomycosis. The subcutaneous form is the most common presentation. Clinically these subcutaneous swellings resemble benign skin and soft tissue neoplasms like lipoma, sebaceous cyst or neurofibroma. Histopathology serves as a very useful tool in diagnosing these cysts by identifying the fungal elements.

Methods

A retrospective review of all cases diagnosed as phaeohyphomycosis in the department of Pathology at a tertiary care centre in South India over 9 years (January 2009–December 2017) was done. The clinical, histopathological findings of these cases were reviewed and analysed.

Results

Sixty-six cases of subcutaneous phaeohyphomycosis were reported during the 9 year period. Sixty-two per cent of these patients were diagnosed as skin and soft tissue neoplasms. In 94% cases, the extremities were affected. Multiple cysts were seen in 11% of patients. Fine needle aspiration cytology was done in 29 cases with fungal hyphae identified in all cases on cytology.

Conclusion

Subcutaneous phaeohyphomycosis mimics benign skin and soft tissue neoplasms clinically. Histopathological examination along with cytology plays a major role in diagnosis of phaeohyphomycosis and thus helps in appropriate patient management.
Literature
1.
go back to reference Chester R, Cooper JR (2005) Deep phaeohyphomycosis. In: Merz WG, Hay RJ (eds) Topley and Wilsons microbiology and microbial infections. Hodder Arnold, London, pp 739–748 Chester R, Cooper JR (2005) Deep phaeohyphomycosis. In: Merz WG, Hay RJ (eds) Topley and Wilsons microbiology and microbial infections. Hodder Arnold, London, pp 739–748
2.
go back to reference Matsumoto T (2011) Chromoblastomycosis and phaeohyphomycosis. In: Guerrant RL, Walker DH, Weller PF (eds) Tropical infectious diseases—principles, pathogens and practice. Churchill Livingstone: Elsevier Saunders, London, pp 569–572CrossRef Matsumoto T (2011) Chromoblastomycosis and phaeohyphomycosis. In: Guerrant RL, Walker DH, Weller PF (eds) Tropical infectious diseases—principles, pathogens and practice. Churchill Livingstone: Elsevier Saunders, London, pp 569–572CrossRef
3.
go back to reference Revankar SG, Patterson JE, Sutton DA et al (2002) Disseminated phaeohyphomycosis: review of an emerging mycosis. Clin Infect Dis 34:467–476CrossRef Revankar SG, Patterson JE, Sutton DA et al (2002) Disseminated phaeohyphomycosis: review of an emerging mycosis. Clin Infect Dis 34:467–476CrossRef
4.
go back to reference Ajello L, George LK, Steigbigel RT et al (1974) A case of phaeohyphomycosis caused by new species of Phialophora. Mycology 66:490–498CrossRef Ajello L, George LK, Steigbigel RT et al (1974) A case of phaeohyphomycosis caused by new species of Phialophora. Mycology 66:490–498CrossRef
5.
go back to reference Chander J (2008) Phaeohyphomycosis. In: Textbook of medical mycology. Mehta Publishers, New Delhi, pp 187–199 Chander J (2008) Phaeohyphomycosis. In: Textbook of medical mycology. Mehta Publishers, New Delhi, pp 187–199
6.
go back to reference Pappagianis D, Ajello L (1994) Dematiaceous—a mycological misnomer? J Med Vet Mycol 32:319–321CrossRef Pappagianis D, Ajello L (1994) Dematiaceous—a mycological misnomer? J Med Vet Mycol 32:319–321CrossRef
7.
go back to reference Shivaswamy KN, Pradhan P, Laxmisha C et al (2007) Disseminated phaeohyphomycosis. Int J Dermatol 46:278–281CrossRef Shivaswamy KN, Pradhan P, Laxmisha C et al (2007) Disseminated phaeohyphomycosis. Int J Dermatol 46:278–281CrossRef
8.
go back to reference Kimura M, Furuta T, Satou T et al (2003) Multifocal subcutaneous phaeohyphomycosis caused by Phialophora verrucosa. Arch Pathol Lab 127:91–93 Kimura M, Furuta T, Satou T et al (2003) Multifocal subcutaneous phaeohyphomycosis caused by Phialophora verrucosa. Arch Pathol Lab 127:91–93
9.
go back to reference Jacobson ES (2000) Pathogenic roles for fungal melanins. Clin Microbiol Rev 13:708–717CrossRef Jacobson ES (2000) Pathogenic roles for fungal melanins. Clin Microbiol Rev 13:708–717CrossRef
10.
go back to reference Schnitzler N, Peltroche-Liacsahuanga H, Bestier N et al (1999) Effect of melanins and carotenoids of Exophiala (Wangiella) dermatitidis on phagocytosis, oxidative burst, and killing by human neutrophils. Infect Immun 67:94–101PubMedPubMedCentral Schnitzler N, Peltroche-Liacsahuanga H, Bestier N et al (1999) Effect of melanins and carotenoids of Exophiala (Wangiella) dermatitidis on phagocytosis, oxidative burst, and killing by human neutrophils. Infect Immun 67:94–101PubMedPubMedCentral
11.
go back to reference Haridasan S, Parameshwaran S, Bheemanathi SH et al (2017) Subcutaneous phaeohyphomycosis in kidney transplant recipients: a series of seven cases. Transpl Infect Dis 19:e12788CrossRef Haridasan S, Parameshwaran S, Bheemanathi SH et al (2017) Subcutaneous phaeohyphomycosis in kidney transplant recipients: a series of seven cases. Transpl Infect Dis 19:e12788CrossRef
Metadata
Title
Subcutaneous Phaeohyphomycosis: A Clinical Mimic of Skin and Soft Tissue Neoplasms—A Descriptive Study from India
Authors
Sree Rekha Jinkala
Debdatta Basu
Siddaraju Neelaiah
Norton Stephen
Srinivas Bheemanati Hanuman
Rakesh Singh
Publication date
01-12-2018
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 12/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-018-4745-0

Other articles of this Issue 12/2018

World Journal of Surgery 12/2018 Go to the issue

Original Scientific Report

Paediatric Osteomyelitis in Fiji