{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T14:10:21Z","timestamp":1758550221547,"version":"3.44.0"},"reference-count":12,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Phaeohyphomycosis is a very rare fungal infection, which is one of more usual complications in immunocompromised and\/or traumatic patients, has never been reported especially in a cytological field. We describe a first case of subcutaneous phaeohyphomycosis caused by <jats:italic>Exophiala xenobiotica<\/jats:italic> (<jats:italic>E. xenobiotica<\/jats:italic>) in a poorly controlled diabetic patient, and in which a correct cytological diagnosis of phaeohyphomycosis was possible to conclude.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>The diabetic obese patient was a 60's\u2010year\u2010old male with a chief complaint of subcutaneous cyst\u2010like nodule on the left knee. The Papanicolaou staining on aspiration cytology from this central fluid contained a substantial number of characteristically brown hyphae with dichotomous branching conidiophores and annelloconidia formation, in the necrotic and inflammatory backgrounds. Culture on potato dextrose agar showed many slow\u2010growing yeast\u2010like colonies particularly in an olivaceous gray to black colored fashion. Furthermore, sequencing data for the rRNA internal transcribed spacer (ITS) regions confirmed phaeohyphomycosis caused by <jats:italic>E. xenobiotica<\/jats:italic> infection. Histologically, the resected subcutaneous nodule was diagnosed as necrotizing epithelioid granulomas with central abscess formation, admixed with a large number of dichotomous branching fungal organisms with conidia, reminiscent of <jats:italic>Aspergillus<\/jats:italic>. However, Fontana\u2010Masson staining readily identified the melanin pigments in these fungal hyphae.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this subcutaneous cyst\u2010like case of immunocompromised patient, it is critical to consider the possibility of subcutaneous phaeohyphomycosis. The conventional methodology of Papanicolaou staining on cytology specimen can recognize characteristically typical dichotomous branching and brown\u2010pigmented fungi, potentially guiding us to the correct and quick diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dc.25444","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T07:24:17Z","timestamp":1737962657000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Case of Subcutaneous Phaeohyphomycosis Caused by <i>Exophiala xenobiotica<\/i> in a Poorly\u2010Controlled Diabetic Patient: The Conventional Papanicolaou Staining on Cytology Specimen Can Potentially Guide Us to the Correct Diagnosis"],"prefix":"10.1002","volume":"53","author":[{"given":"Rie","family":"Kadoguchi","sequence":"first","affiliation":[{"name":"Department of Pathology Kanazawa Medical University Hospital  Ishikawa Japan"},{"name":"Department of Pathology Kanazawa Medical University Himi Municipal Hospital  Toyama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazushi","family":"Anzawa","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kanazawa Medical University  Ishikawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiiku","family":"Okanemasa","sequence":"additional","affiliation":[{"name":"Department of Pathology Kanazawa Medical University Hospital  Ishikawa Japan"},{"name":"Department of Pathology and Laboratory Medicine Kanazawa Medical University  Kanazawa Ishikawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Kanazawa Medical University  Kanazawa Ishikawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vu Anh","family":"Dung","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Kanazawa Medical University  Kanazawa Ishikawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Shioya","sequence":"additional","affiliation":[{"name":"Department of Pathology Kanazawa Medical University Hospital  Ishikawa Japan"},{"name":"Department of Pathology Kanazawa Medical University Himi Municipal Hospital  Toyama Japan"},{"name":"Department of Pathology and Laboratory Medicine Kanazawa Medical University  Kanazawa Ishikawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2662-0024","authenticated-orcid":false,"given":"Sohsuke","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Pathology Kanazawa Medical University Hospital  Ishikawa Japan"},{"name":"Department of Pathology Kanazawa Medical University Himi Municipal Hospital  Toyama Japan"},{"name":"Department of Pathology and Laboratory Medicine Kanazawa Medical University  Kanazawa Ishikawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(83)70001-0"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/13693780802526857"},{"issue":"8","key":"e_1_2_11_4_1","first-page":"964","article-title":"Subcutaneous Phaeohyphomycosis due to Exophiala jeanselmei Following Renal Transplantation: A Case Report With a Published Work Review of Phaeohyphomycosis in Japan","volume":"49","author":"Takenaka M.","year":"2021","journal-title":"Diagnostic Cytopathology"},{"issue":"9","key":"e_1_2_11_5_1","first-page":"1050","article-title":"Spectrum of Clinically Relevant Exophiala Species in the United States","volume":"47","author":"Zeng J. 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