A case of phaeohyphomycosis on the hand due to Exophiala jeanselmei

A 77-year-old man was referred to our department with a red plaque on the right hand. He had been prone to frequent injury because of his farm work, and he had been treated with oral prednisolone (10 mg/day) for 20 years due to emphysema. Histopathological examination revealed granulomatous changes and brown fungal elements with hyphal forms in the dermis. We diagnosed this case as having phaeohyphomycosis. Complete surgical excision and postoperative oral itraconazole 100 mg/day led to a clinical resolution. Based on the morphological findings in the mycological cultures from the tissue and restriction fragment length polymorphism analysis of the internal transcribed space regions of ribosomal RNA genes, the isolate was identified as E. jeanselmei, type 5.