{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T20:04:20Z","timestamp":1772136260798,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2014,6,5]],"date-time":"2014-06-05T00:00:00Z","timestamp":1401926400000},"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":["Int J Dermatology"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Subcutaneous phaeohyphomycosis usually results from traumatic inoculation with the fungus and generally occurs in immunosuppressed men.<jats:italic>Cladosporium<\/jats:italic>,<jats:italic>Exophiala<\/jats:italic>, and<jats:italic>Alternaria<\/jats:italic>spp. are commonly implicated pathogens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We present a case of subcutaneous phaeohyphomycosis caused by<jats:italic>Rhytidhysteron<\/jats:italic>sp. that was refractory to conventional antifungal therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case report<\/jats:title><jats:p>A 72\u2010year\u2010old man with hypertension and diabetes presented with a multiloculated, large cystic swelling over the right dorsal foot. Laboratory findings and x\u2010rays of the chest and left foot were normal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Adequate control of the patient's diabetes was achieved, and the swelling was excised under itraconazole\/terbinafine coverage. Histology showed multiple areas of neutrophilic abscess, epithelioid cells, foreign body giant cells, and multiple septate hyphae and yeast\u2010like cells. Dematiaceous fungus was cultured but failed to produce spores. Sequencing of the isolate showed a match of &gt;\u00a099% with<jats:italic>Rhytidhysteron rufulum<\/jats:italic>. The patient demonstrated no response after one\u00a0year of therapy with itraconazole\/terbinafine. Weekly infiltration of the lesion with liposomal amphotericin B resulted in its complete resolution within 15\u00a0weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lesions of phaeohyphomycosis appear morphologically similar regardless of the organism implicated. Hence, their diagnosis rests entirely on the clinicopathological and microbiological presentation. Molecular studies may be required to identify a fungus if attempts to grow it in artificial culture media fail.<jats:italic>Rhytidhysteron<\/jats:italic>spp. are not known as pathogens in humans, and no treatment protocol exists. Intralesional amphotericin was highly effective in our patient and caused no systemic adverse effects. Voriconazole and posaconazole are effective against disseminated\/visceral phaeohyphomycotic infections, but their efficacy against<jats:italic>Rhytidhysteron<\/jats:italic>spp. remains unstudied.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.12529","type":"journal-article","created":{"date-parts":[[2014,6,5]],"date-time":"2014-06-05T08:37:22Z","timestamp":1401957442000},"page":"1485-1489","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["A rare case of subcutaneous phaeohyphomycosis caused by a<i>Rhytidhysteron<\/i>species: a clinico\u2010therapeutic experience"],"prefix":"10.1111","volume":"53","author":[{"given":"Vikram K.","family":"Mahajan","sequence":"first","affiliation":[{"name":"Department of Dermatology Venereology and Leprosy Dr Rajendra Prasad Government Medical College Kangra at Tanda Himachal Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikas","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Dermatology Venereology and Leprosy Dr Rajendra Prasad Government Medical College Kangra at Tanda Himachal Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neel","family":"Prabha","sequence":"additional","affiliation":[{"name":"Department of Dermatology Venereology and Leprosy Dr Rajendra Prasad Government Medical College Kangra at Tanda Himachal Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamlesh","family":"Thakur","sequence":"additional","affiliation":[{"name":"Department of Microbiology Dr Rajendra Prasad Government Medical College Kangra at Tanda Himachal Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nand Lal","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Dermatology Venereology and Leprosy Dr Rajendra Prasad Government Medical College Kangra at Tanda Himachal Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shivaprakash M.","family":"Rudramurthy","sequence":"additional","affiliation":[{"name":"Department of Mycology Division Department of Medical Microbiology Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pushpinder S.","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Department of Dermatology Venereology and Leprosy Dr Rajendra Prasad Government Medical College Kangra at Tanda Himachal Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karaninder S.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Dermatology Venereology and Leprosy Dr Rajendra Prasad Government Medical College Kangra at Tanda Himachal Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Abhinav","sequence":"additional","affiliation":[{"name":"Department of Dermatology Venereology and Leprosy Dr Rajendra Prasad Government Medical College Kangra at Tanda Himachal Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,6,5]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.2307\/3758492"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/338636"},{"key":"e_1_2_5_4_1","first-page":"620","volume-title":"Medical Mycology","author":"Kwon\u2010Chung KJ","year":"1992"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-4362.2002.01337.x"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1439-0507.2000.00545.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/00362178485380681"},{"key":"e_1_2_5_8_1","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/j.1439-0507.2007.01417.x","article-title":"Subcutaneous phaeohyphomycosis caused by Cladosporium sphaerospermum","volume":"51","author":"Qiu\u2010Xia C","year":"2007","journal-title":"Mycoses"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1439-0507.2003.00853.x"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0036-46652005000100009"},{"key":"e_1_2_5_11_1","first-page":"97","article-title":"Cutaneous alternariosis","volume":"15","author":"Vieira MR","year":"1998","journal-title":"Rev Iberoam Micol"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1086\/597400"},{"key":"e_1_2_5_13_1","first-page":"739","volume-title":"Topley & Wilson's Microbiology & Microbial Infections: Medical Mycology","author":"Cooper CR","year":"2005"},{"key":"e_1_2_5_14_1","first-page":"277","article-title":"Life\u2010history studies of Brazilian ascomycetes. 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