{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T19:20:12Z","timestamp":1789154412048,"version":"build-2803163510"},"reference-count":119,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Cutaneous infections caused by dematiaceous fungi are rare in the general population but are increasingly recognized in solid organ transplant recipients as a consequence of prolonged immunosuppression. When Alternaria species are confirmed as the causative agents of a skin infection, the condition is referred to as alternariosis. These infections may clinically resemble bacterial or neoplastic lesions and require accurate diagnosis and individualized therapy. We report one case of cutaneous alternariosis in a kidney transplant recipient receiving tacrolimus-based immunosuppression. The patient was a 47-year-old woman who sustained minor trauma to her knee three months after transplantation. She developed an ulcerated, crusted lesion, which coincided with severe neutropenia. Histology, culture and molecular identification confirmed A. infectoria. Treatment included systemic azole therapy (voriconazole followed by isavuconazole) and surgical excision, resulting in resolution without recurrence. This case highlights the importance of early recognition of alternariosis in transplant recipients. Successful management typically requires combined surgical and systemic antifungal therapy, with careful monitoring of drug interactions and immunosuppressive levels to prevent toxicity or rejection.<\/jats:p>","DOI":"10.3390\/jof12010032","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T15:05:01Z","timestamp":1767193501000},"page":"32","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cutaneous Alternariosis Caused by Alternaria\u00a0infectoria: A Case Report in Kidney Transplant Recipient and Literature Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1439-7662","authenticated-orcid":false,"given":"Maria Antonietta","family":"Grignano","sequence":"first","affiliation":[{"name":"Unit of Nephrology, Dialysis and Renal Transplant, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation, Piazzale Golgi 19, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1440-6872","authenticated-orcid":false,"given":"Marilena","family":"Gregorini","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Dialysis and Renal Transplant, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation, Piazzale Golgi 19, 27100 Pavia, Italy"},{"name":"Department of Internal Medicine and Therapeutics, University of Pavia, Via Aselli 43\/45, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8513-8505","authenticated-orcid":false,"given":"Tefik","family":"Islami","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Therapeutics, University of Pavia, Via Aselli 43\/45, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6614-2461","authenticated-orcid":false,"given":"Maria Carmela","family":"Esposto","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health, Universit\u00e0 degli Studi di Milano, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6689-6714","authenticated-orcid":false,"given":"Camilla","family":"Vassallo","sequence":"additional","affiliation":[{"name":"Department of Clinical-Surgical, Diagnostic and Paediatric Science, Institute of Dermatology, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation, Piazzale Golgi 19, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Di Matteo","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation, Piazzale Golgi 19, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5246-928X","authenticated-orcid":false,"given":"Elena","family":"Seminari","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation, Piazzale Golgi 19, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palma","family":"Minutillo","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Unit, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation, Piazzale Golgi 19, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora Francesca","family":"Pattonieri","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Dialysis and Renal Transplant, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation, Piazzale Golgi 19, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma Diletta","family":"Stea","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Dialysis and Renal Transplant, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation, Piazzale Golgi 19, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Lanotte","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Therapeutics, University of Pavia, Via Aselli 43\/45, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Portalupi","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Dialysis and Renal Transplant, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation, Piazzale Golgi 19, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3266-195X","authenticated-orcid":false,"given":"Andreana","family":"De Mauri","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Dialysis and Renal Transplant, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation, Piazzale Golgi 19, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Margiotta","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Dialysis and Renal Transplant, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation, Piazzale Golgi 19, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Tragni","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Therapeutics, University of Pavia, Via Aselli 43\/45, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grazia","family":"Soccio","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Dialysis and Renal Transplant, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation, Piazzale Golgi 19, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2381-5213","authenticated-orcid":false,"given":"Caterina","family":"Cavanna","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Department, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation, Piazzale Golgi 19, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5311-9174","authenticated-orcid":false,"given":"Teresa","family":"Rampino","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Dialysis and Renal Transplant, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation, Piazzale Golgi 19, 27100 Pavia, Italy"},{"name":"Department of Internal Medicine and Therapeutics, University of Pavia, Via Aselli 43\/45, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"ref_1","first-page":"1188","article-title":"A Retrospective Analysis of Dermatological Lesions in Kidney Transplant Patients","volume":"137","author":"Castello","year":"2013","journal-title":"Indian J. Med. Res."},{"key":"ref_2","first-page":"355","article-title":"Invasive Fungal Infections in Renal Transplant Recipients","volume":"9","author":"Badiee","year":"2011","journal-title":"Exp. Clin. Transplant."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1007\/s11606-011-1758-x","article-title":"Scabies Crustosa in a 61-Year-Old Kidney-Transplanted Patient","volume":"27","author":"Gregorini","year":"2012","journal-title":"J. Gen. Intern. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1111\/j.1469-0691.2008.02024.x","article-title":"Alternaria Infections: Laboratory Diagnosis and Relevant Clinical Features","volume":"14","author":"Pastor","year":"2008","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_5","first-page":"e153","article-title":"Alternaria infectoria Skin Infection in a Renal Transplant Recipient: An Emerging Phaeohyphomycosis of Occidental Countries?","volume":"56","year":"2017","journal-title":"Int. J. Dermatol."},{"key":"ref_6","unstructured":"de Hoog, G.S., Guarro, J., Gen\u00e9, J., and Figueras, M.J. Atlas of Clinical Fungi, [2nd ed.]. Available online: https:\/\/www.researchgate.net\/publication\/41903192_Atlas_of_clincal_fungi_2nd_edn_GS_de_Hoog_J_Guarro_J_Gene_MJ_Figueras#fullTextFile-Content."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2585","DOI":"10.1093\/jac\/dkr365","article-title":"Antifungal susceptibility profile of clinical Alternaria spp. identified by molecular methods","volume":"66","author":"Cuesta","year":"2011","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1111\/j.1365-2133.1976.tb04371.x","article-title":"Cutaneous Alternariosis","volume":"94","author":"Pedersen","year":"1976","journal-title":"Br. J. Dermatol."},{"key":"ref_9","first-page":"653","article-title":"Human cutaneous alternariosis. 3 cases. Review of the literature (author\u2019s transl)","volume":"108","author":"Guiguen","year":"1981","journal-title":"Ann. Dermatol. Venereol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1159\/000249690","article-title":"Dermal Alternariasis in a Kidney Transplant Recipient","volume":"168","author":"Bourlond","year":"1984","journal-title":"Dermatologica"},{"key":"ref_11","first-page":"213","article-title":"Alternariose Cutan\u00e9e Chez Un Transplante R\u00e9nal","volume":"13","author":"Blanc","year":"1984","journal-title":"Bull. Soc. Fr. Mycol. Med."},{"key":"ref_12","first-page":"255","article-title":"Cutaneous alternariosis in a patient with a kidney graft: A new case","volume":"112","author":"Laudren","year":"1985","journal-title":"Ann. Dermatol. Venereol."},{"key":"ref_13","first-page":"35","article-title":"Alternaria mycosis in a kidney transplant patient","volume":"122","author":"Aloi","year":"1987","journal-title":"G. Ital. Dermatol. Venereol."},{"key":"ref_14","first-page":"84","article-title":"Alternariose Cutan\u00e9e et Sarcome de Kaposi Chez Un Greff\u00e9 Renal","volume":"1","author":"Frantz","year":"1991","journal-title":"J. Mycol. M\u00e9dicale"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1093\/clind\/16.5.729","article-title":"Cutaneous Alternariosis in a Liver Transplant Recipient","volume":"16","author":"Repiso","year":"1993","journal-title":"Clin. Infect. Dis."},{"key":"ref_16","first-page":"497","article-title":"Cutaneous Alternariosis and Regional Lymphadenitis during Allogeneic BMT","volume":"11","author":"Shearer","year":"1993","journal-title":"Bone Marrow Transpl."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"71","DOI":"10.7326\/0003-4819-122-1-199501010-00024","article-title":"Cutaneous Alternariosis after Renal Transplantation","volume":"122","author":"Chosidow","year":"1995","journal-title":"Ann. Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1023\/A:1006815429916","article-title":"Two Cases of Cutaneous Phaeohyphomycosis by Alternaria alternata and Alternaria tenuissima","volume":"137","author":"Romano","year":"1997","journal-title":"Mycopathologia"},{"key":"ref_19","first-page":"97","article-title":"Cutaneous Alternariosis","volume":"15","author":"Vieira","year":"1998","journal-title":"Rev. Iberoam. Micol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1046\/j.1365-2133.1998.02091.x","article-title":"Cutaneous Infection with Alternaria alternata Complicating Immunosuppression: Successful Treatment with Itraconazole","volume":"138","author":"Acland","year":"1998","journal-title":"Br. J. Dermatol."},{"key":"ref_21","first-page":"192","article-title":"Cutaneous Alternaria infectoria infection after liver transplantation","volume":"18","author":"Degeilh","year":"1998","journal-title":"Ann. Pathol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1080\/000155599750011165","article-title":"Cutaneous Alternariosis Due to Alternaria Chlamydospora after Bone Marrow Transplantation","volume":"79","author":"Bartolome","year":"1999","journal-title":"Acta Derm. Venereol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1046\/j.1365-2133.2000.03577.x","article-title":"Cutaneous Alternariosis by Alternaria chartarum in a Renal Transplanted Patient","volume":"142","author":"Magina","year":"2000","journal-title":"Br. J. Dermatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1046\/j.1365-2133.2000.03453.x","article-title":"Effectiveness of Terbinafine in Cutaneous Alternariosis","volume":"142","author":"Altomare","year":"2000","journal-title":"Br. J. Dermatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1046\/j.1365-2133.2000.03808.x","article-title":"Simultaneous Cutaneous and Ungual Alternariosis in a Renal Transplant Recipient","volume":"143","author":"Baykal","year":"2000","journal-title":"Br. J. Dermatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1086\/313638","article-title":"Photo Quiz. Cutaneous Alternariosis","volume":"30","author":"Romero","year":"2000","journal-title":"Clin. Infect. Dis."},{"key":"ref_27","unstructured":"Masson, E. (2025, May 29). Cutaneous Infection by Alternaria tenuissima in An Immunosuppressed Patient. Available online: https:\/\/www.emconsulte.com\/it\/article\/108214\/cutaneous-infection-by-alternaria-tenuissima-in-an."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1097\/00007890-200112150-00023","article-title":"Alternariosis after Liver Transplantation","volume":"72","author":"Benito","year":"2001","journal-title":"Transplantation"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1952","DOI":"10.1128\/JCM.39.5.1952-1955.2001","article-title":"Phaeohyphomycosis Caused by Alternaria Infectoria in a Renal Transplant Recipient","volume":"39","author":"Halaby","year":"2001","journal-title":"J. Clin. Microbiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1046\/j.1440-0960.2001.00473.x","article-title":"Cutaneous Alternariosis in a Cardiac Transplant Recipient","volume":"42","author":"Gilmour","year":"2001","journal-title":"Australas. J. Dermatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1046\/j.1365-2133.2001.04382.x","article-title":"Sporotrichoid Phaeohyphomycosis Due to Alternaria infectoria","volume":"145","author":"Gerdsen","year":"2001","journal-title":"Br. J. Dermatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1034\/j.1600-6143.2002.20716.x","article-title":"Primary Cutaneous Fungal Infections in Solid Organ Transplantation: A Case Series","volume":"2","author":"Miele","year":"2002","journal-title":"Am. J. Transpl."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0213-005X(02)72764-X","article-title":"Subcutaneous verrucous lesions in a female renal transplant recipient","volume":"20","author":"Eguino","year":"2002","journal-title":"Enferm. Infecc. Microbiol. Clin."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/S0025-7753(03)74027-5","article-title":"Cutaneous alternarisis after a kidney allograft","volume":"121","author":"Diz","year":"2003","journal-title":"Med. Clin."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s10096-002-0856-4","article-title":"Relapsing Cutaneous Alternariosis in a Kidney Transplant Recipient Cured with Liposomal Amphotericin B","volume":"22","author":"Merino","year":"2003","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1046\/j.1365-4362.2003.01673.x","article-title":"Cutaneous Alternariosis in a Renal Transplant Recipient","volume":"42","author":"Kim","year":"2003","journal-title":"Int. J. Dermatol."},{"key":"ref_37","first-page":"354","article-title":"Indolent erythematous cutaneous\/subcutaneous nodes following combined kidney and pancreas transplantation","volume":"54","author":"Mittag","year":"2003","journal-title":"Hautarzt"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1007\/s00105-004-0773-9","article-title":"Cutaneous alternariosis. Clinical diagnosis and therapeutic options","volume":"55","author":"Mayser","year":"2004","journal-title":"Hautarzt"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1080\/13693780310001610047","article-title":"Cutaneous Infection Caused by Alternaria in Patients Receiving Tacrolimus","volume":"42","author":"Pereiro","year":"2004","journal-title":"Med. Mycol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1111\/j.1399-3062.2004.00046.x","article-title":"Cutaneous Alternaria Infection in Renal Transplant Recipients: A Report of Two Cases with an Unusual Mode of Transmission","volume":"6","author":"Kazory","year":"2004","journal-title":"Transpl. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1097\/01.TP.0000107287.70512.E7","article-title":"Subcutaneous Black Fungus (Phaeohyphomycosis) Infection in Renal Transplant Recipients: Three Cases","volume":"77","author":"Yehia","year":"2004","journal-title":"Transplantation"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"5334","DOI":"10.1128\/JCM.42.11.5334-5336.2004","article-title":"Utility of Molecular Identification in Opportunistic Mycotic Infections: A Case of Cutaneous Alternaria infectoria Infection in a Cardiac Transplant Recipient","volume":"42","author":"Ligozzi","year":"2004","journal-title":"J. Clin. Microbiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1002\/dc.10323","article-title":"Cutaneous Alternariosis: Cytohistological Findings in a Case Diagnosed by Fine-Needle Aspiration Biopsy","volume":"30","author":"Ortiz","year":"2004","journal-title":"Diagn. Cytopathol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.jaad.2004.10.875","article-title":"Cutaneous Alternariosis in Transplant Recipients: Clinicopathologic Review of 9 Cases","volume":"52","author":"Gilaberte","year":"2005","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_45","first-page":"1171","article-title":"Successful Thermotherapy for a Subcutaneous Infection Due to Alternaria alternata in a Renal Transplant Recipient","volume":"141","author":"Corominas","year":"2005","journal-title":"Arch. Dermatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1111\/j.1439-0507.2005.01162.x","article-title":"Subcutaneous Alternariosis","volume":"48","author":"Romano","year":"2005","journal-title":"Mycoses"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1111\/j.1365-2133.2005.06833.x","article-title":"Cutaneous Infection with Alternaria Tenuissima in an Immunocompromised Patient","volume":"153","author":"Robertshaw","year":"2005","journal-title":"Br. J. Dermatol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/S1130-1406(06)70025-0","article-title":"Cutaneous Alternariosis in a Liver Transplant Recipient","volume":"23","author":"Vieira","year":"2006","journal-title":"Rev. Iberoam. Micol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1080\/13693780500412004","article-title":"Alternaria Infectoria Phaeohyphomycosis in a Renal Transplant Patient","volume":"44","author":"Nulens","year":"2006","journal-title":"Med. Mycol."},{"key":"ref_50","first-page":"668","article-title":"Skin Infection Due to Alternaria Species in Kidney Allograft Recipients: Report of a New Case and Review of the Literature","volume":"19","author":"Gallelli","year":"2006","journal-title":"J. Nephrol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"154","DOI":"10.2340\/00015555-0013","article-title":"Relapse of Cutaneous Alternaria Infectoria in a Renal Transplant Recipient after 2 Years","volume":"86","author":"Ara","year":"2006","journal-title":"Acta Derm. Venereol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1086\/507029","article-title":"Febrile Neutropenia Associated with Painful Lesions of the Palms and Digits","volume":"43","author":"Henn","year":"2006","journal-title":"Clin. Infect. Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2514","DOI":"10.1016\/j.transproceed.2006.08.031","article-title":"Treatment of Cutaneous Infection by Alternaria alternata with Voriconazole in a Liver Transplant Patient","volume":"38","author":"Luque","year":"2006","journal-title":"Transpl. Proc."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1016\/j.transproceed.2006.11.023","article-title":"Pheohyphomycotic Soft Tissue Disease Caused by Alternaria Alternata in a Kidney Transplant Patient: A Case Report and Literature Review","volume":"39","author":"Farina","year":"2007","journal-title":"Transpl. Proc."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.1001\/archderm.143.12.1583-a","article-title":"Solitary Cutaneous Nodule in an Immunocompromised Patient","volume":"143","author":"Singh","year":"2007","journal-title":"Arch. Dermatol."},{"key":"ref_56","first-page":"341","article-title":"Warty epidermal hyperplasia in a kidney transplant recipient","volume":"25","author":"Rovira","year":"2007","journal-title":"Enferm. Infecc. Microbiol. Clin."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"160","DOI":"10.2340\/00015555-0332","article-title":"Cutaneous Phaeohyphomycosis Caused by Alternaria infectoria","volume":"88","author":"Brasch","year":"2008","journal-title":"Acta Derm. Venereol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1080\/09546630701713485","article-title":"Cutaneous Alternariosis in a Kidney Transplantation Recipient: Report of a Case","volume":"19","author":"Nino","year":"2008","journal-title":"J. Dermatol. Treat."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1111\/j.1399-3062.2009.00420.x","article-title":"Cutaneous Infection by Alternaria infectoria in a Renal Transplant Patient","volume":"11","author":"Segner","year":"2009","journal-title":"Transpl. Infect. Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"657","DOI":"10.2340\/00015555-0732","article-title":"Subcutaneous Phaeohyphomycosis in a Renal Transplant Recipient Successfully Treated with Voriconazole","volume":"89","author":"Larsen","year":"2009","journal-title":"Acta Derm. Venereol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.diagmicrobio.2010.06.002","article-title":"Cutaneous Phaeohyphomycosis in Renal Allograft Recipients: Report of 2 Cases and Review of the Literature","volume":"68","author":"Vermeire","year":"2010","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1111\/j.1399-3062.2009.00482.x","article-title":"Phaeohyphomycosis Due to Alternaria Species in Transplant Recipients","volume":"12","author":"Boyce","year":"2010","journal-title":"Transpl. Infect. Dis."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/j.ad.2009.11.017","article-title":"Cutaneous alternariosis in a heart transplant recipient","volume":"101","author":"Morales","year":"2010","journal-title":"Actas Dermosifiliogr."},{"key":"ref_64","first-page":"841","article-title":"Successful Cryotherapy for a Cutaneous Alternariosis in a Renal Transplant Recipient","volume":"20","author":"Santiago","year":"2010","journal-title":"Eur. J. Dermatol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1111\/j.1600-0560.2011.01738.x","article-title":"Cutaneous Alternariosis Microscopically Mimicking Blastomycosis","volume":"38","author":"Osmond","year":"2011","journal-title":"J. Cutan. Pathol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"435","DOI":"10.3109\/13693786.2010.540723","article-title":"Co-Existence of Cutaneous Alternariosis and Tinea Corporis in a Renal Transplant Recipient","volume":"49","author":"Zhang","year":"2011","journal-title":"Med. Mycol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.riam.2011.06.010","article-title":"Phaeohyphomycosis Caused by Alternaria infectoria Presenting as Multiple Vegetating Lesions in a Renal Transplant Patient","volume":"29","author":"Cunha","year":"2012","journal-title":"Rev. Iberoam. Micol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1111\/j.1439-0507.2012.02171.x","article-title":"Successful Treatment of Cutaneous Alternariosis with Caspofungin in a Renal Transplant Recipient","volume":"55","author":"Seyfarth","year":"2012","journal-title":"Mycoses"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"131","DOI":"10.2310\/7750.2011.10129","article-title":"A Suspected Squamous Cell Carcinoma in a Renal Transplant Recipient Revealing a Rare Cutaneous Phaeohyphomycosis by Alternaria infectoria","volume":"16","author":"Tambasco","year":"2012","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"594","DOI":"10.3109\/13693786.2012.663508","article-title":"Phaeohyphomycosis Due to Alternaria Infectoria: A Single-Center Experience with Utility of PCR for Diagnosis and Species Identification","volume":"50","author":"Robert","year":"2012","journal-title":"Med. Mycol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"518","DOI":"10.3109\/13693786.2011.641165","article-title":"Success of Posaconazole Therapy in a Heart Transplanted Patient with Alternaria infectoria Cutaneous Infection","volume":"50","author":"Rammaert","year":"2012","journal-title":"Med. Mycol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"E156","DOI":"10.1111\/tid.12020","article-title":"Simultaneous Cutaneous Infection Due to Paecilomyces Lilacinus and Alternaria in a Heart Transplant Patient","volume":"14","author":"Lavergne","year":"2012","journal-title":"Transpl. Infect. Dis."},{"key":"ref_73","first-page":"219","article-title":"Paecilomyces Lilacinus and Alternaria infectoria Cutaneous Infections in a Sarcoidosis Patient after Double-Lung Transplantation","volume":"67","author":"Saegeman","year":"2012","journal-title":"Acta Clin. Belg."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1590\/S0074-02762012000700003","article-title":"Phaeohyphomycosis: A Clinical-Epidemiological and Diagnostic Study of Eighteen Cases in Rio Grande Do Sul, Brazil","volume":"107","author":"Severo","year":"2012","journal-title":"Mem. Inst. Oswaldo Cruz"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"464","DOI":"10.6002\/ect.2012.0195","article-title":"Cutaneous Alternariosis with Trichosporon Infection in a Heart Transplant Recipient: A Case Report","volume":"11","author":"Sharifkashani","year":"2013","journal-title":"Exp. Clin. Transpl."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"S33","DOI":"10.1007\/s40261-012-0018-0","article-title":"Alternaria alternata Invasive Fungal Infection in a Patient with Fanconi\u2019s Anemia after an Unrelated Bone Marrow Transplant","volume":"33","author":"Ferreira","year":"2013","journal-title":"Clin. Drug. Investig."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"100","DOI":"10.3390\/healthcare1010100","article-title":"Cutaneous Alternariosis Caused by Alternaria infectoria: Three Cases in Kidney Transplant Patients","volume":"1","author":"Lopes","year":"2013","journal-title":"Healthcare"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1684\/ejd.2012.1885","article-title":"Deep Cutaneous Mycosis Due to Alternaria infectoria after Liver Transplantation: Successful Treatment with Fluconazole","volume":"23","author":"Alhmali","year":"2013","journal-title":"Eur. J. Dermatol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/dth.12096","article-title":"The Rare Case of Alternaria alternata Cutaneous and Pulmonary Infection in a Heart Transplant Recipient Treated by Azole Antifungals","volume":"27","author":"Kazakov","year":"2014","journal-title":"Dermatol. Ther."},{"key":"ref_80","first-page":"237","article-title":"Cutaneous Alternariosis in a Renal Transplant Recipient","volume":"93","author":"Essabbah","year":"2014","journal-title":"Cutis"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"11","DOI":"10.5070\/D3207023138","article-title":"Multifocal Cutaneous Alternariosis in a 70-Year-Old Kenyan Renal Transplant Patient","volume":"20","author":"Michelon","year":"2014","journal-title":"Dermatol. Online J."},{"key":"ref_82","first-page":"256","article-title":"Cutaneous Infection by Alternaria infectoria in a Liver Transplant Recipient: A Case Report","volume":"77","author":"Coussens","year":"2014","journal-title":"Acta Gastroenterol. Belg."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.riam.2012.06.004","article-title":"Subcutaneous Phaeohyphomycosis Due to Alternaria infectoria in a Renal Transplant Patient: Surgical Treatment with No Long-Term Relapse","volume":"31","year":"2014","journal-title":"Rev. Iberoam. Micol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.7754\/Clin.Lab.2014.131223","article-title":"Cutaneous Alternaria Infectoria Infection Diagnosed by Molecular Techniques in a Renal Transplant Patient","volume":"60","author":"Daglar","year":"2014","journal-title":"Clin. Lab."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"e51","DOI":"10.1016\/j.ad.2013.11.003","article-title":"Cutaneous Infection with Alternaria triticina in a Bilateral Lung Transplant Recipient","volume":"105","author":"Armesto","year":"2014","journal-title":"Actas Dermosifiliogr."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1111\/jdv.12589","article-title":"Cutaneous Alternariosis\u2014A Case Series of an Increasing Phaeohyphomycosis","volume":"29","author":"Coutinho","year":"2015","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"e19082","DOI":"10.5812\/jjm.8(5)2015.19082","article-title":"Cutaneous Alternariasis in a Patient with Renal Transplant","volume":"8","author":"Demirci","year":"2015","journal-title":"Jundishapur J. Microbiol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.asjsur.2012.08.010","article-title":"Cutaneous Alternariosis in a Renal Transplant Recipient: A Case Report and Literature Review","volume":"38","author":"Hsu","year":"2015","journal-title":"Asian J. Surg."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.mmcr.2015.01.004","article-title":"Cutaneous Infection by Different Alternaria Species in a Liver Transplant Recipient","volume":"8","author":"Sabino","year":"2015","journal-title":"Med. Mycol. Case Rep."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1097\/DSS.0000000000000625","article-title":"Refractory Cutaneous Alternariosis Successfully Treated with Mohs Surgery and Full-Thickness Skin Grafting","volume":"42","author":"Simpson","year":"2016","journal-title":"Dermatol. Surg."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1111\/ced.12917","article-title":"Tzanck Smear as an Accurate and Rapid Diagnostic Tool for Cutaneous Alternariosis in a Renal Transplant Recipient","volume":"41","year":"2016","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1007\/s11046-016-0094-4","article-title":"Successful Posaconazole Therapy of Disseminated Alternariosis Due to Alternaria infectoria in a Heart Transplant Recipient","volume":"182","author":"Lyskova","year":"2017","journal-title":"Mycopathologia"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.mmcr.2017.01.003","article-title":"Cutaneous Alternariosis in a Renal Transplant Patient Successfully Treated witth Posaconazole: Case Report and Literature Review","volume":"15","author":"Bajwa","year":"2017","journal-title":"Med. Mycol. Case Rep."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"e12698","DOI":"10.1111\/tid.12698","article-title":"Cutaneous Phaeohyphomycosis in a Hematopoietic Stem Cell Transplant Patient Caused by Alternaria Rosae: First Case Report","volume":"19","author":"Liu","year":"2017","journal-title":"Transpl. Infect. Dis."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1111\/ijd.13590","article-title":"Cutaneous Phaeohyphomycosis","volume":"56","author":"Caviedes","year":"2017","journal-title":"Int. J. Dermatol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1007\/s11046-017-0166-0","article-title":"Molecular Identification of Cutaneous Alternariosis in a Renal Transplant Patient","volume":"182","author":"Schuermans","year":"2017","journal-title":"Mycopathologia"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.medcli.2017.11.005","article-title":"Feohifomicosis in a Renal and Pulmonary Transplant Patient","volume":"151","year":"2018","journal-title":"Med. Clin."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"e13197","DOI":"10.1111\/tid.13197","article-title":"Successful Treatment with Isavuconazole of Subcutaneous Phaeohyphomycosis in a Kidney Transplant Recipient","volume":"21","author":"Lombardi","year":"2019","journal-title":"Transpl. Infect. Dis."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"7","DOI":"10.5070\/D32512046723","article-title":"Onset of Disseminated Cutaneous Nodules Following Toe Amputation in Heart Transplant Patient","volume":"25","author":"Margheim","year":"2019","journal-title":"Dermatol. Online J."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1111\/myc.13026","article-title":"Polyphasic Identification of Three New Species in Alternaria Section Infectoriae Causing Human Cutaneous Infection","volume":"63","author":"Pujol","year":"2020","journal-title":"Mycoses"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.mmcr.2020.04.007","article-title":"Diffuse Primary Cutaneous Infection by Alternaria Alternata in a Liver Transplant Recipient with Pulmonary Nocardiosis: Importance of Prompt Identification for Clinical Resolution","volume":"28","author":"Campoli","year":"2020","journal-title":"Med. Mycol. Case Rep."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"101235","DOI":"10.1016\/j.mycmed.2021.101235","article-title":"Intricate Isavuconazole Therapy of a Subcutaneous Nodule Caused by Alternaria Infectoria in a Heart Transplant Recipient","volume":"32","author":"Maisons","year":"2022","journal-title":"J. Med. Mycol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1016\/j.ad.2023.12.010","article-title":"Sporotrichoid Lymphocutaneous Presentation in Ulcerative Cutaneous Alternariosis: A Phaeohyphomycosis Case in a Renal Transplant","volume":"116","year":"2025","journal-title":"Actas Dermosifiliogr"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1177\/0961203307084168","article-title":"Cutaneous Alternariosis in a Patient with Systemic Lupus Erythematosus","volume":"16","author":"Akman","year":"2007","journal-title":"Lupus"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1086\/319751","article-title":"A Case of Cutaneous Ulcerative Alternariosis: Rare Association with Diabetes Mellitus and Unusual Failure of Itraconazole Treatment","volume":"32","author":"Lyke","year":"2001","journal-title":"Clin. Infect. Dis."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1159\/000246287","article-title":"Cutaneous Alternariosis: Role of Corticosteroid-Induced Cutaneous Fragility","volume":"193","author":"Machet","year":"1996","journal-title":"Dermatology"},{"key":"ref_107","unstructured":"Rotem, J. (1994). The Genus Alternaria: Biology, Epidemiology, and Pathogenicity, American Phytopathological Society."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1097\/00001432-200112000-00003","article-title":"Emergence of Black Moulds in Fungal Disease: Epidemiology and Therapy","volume":"14","author":"Silveira","year":"2001","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1023\/A:1007038211176","article-title":"Production of Mycotoxins on Artificially and Naturally Infested Building Materials","volume":"145","author":"Nielsen","year":"1999","journal-title":"Mycopathologia"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1094\/MPMI.1999.12.1.59","article-title":"Targeted Disruption of a Melanin Biosynthesis Gene Affects Conidial Development and UV Tolerance in the Japanese Pear Pathotype of Alternaria alternata","volume":"12","author":"Kawamura","year":"1999","journal-title":"Mol. Plant Microbe Interact."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1006\/pmpp.1996.0057","article-title":"The Isolation and Characterization of Melanin-Deficient Mutants of Monilinia fructicola","volume":"49","author":"Rehnstrom","year":"1996","journal-title":"Physiol. Mol. Plant Pathol."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1128\/JCM.01684-06","article-title":"Discovering Potential Pathogens among Fungi Identified as Nonsporulating Molds","volume":"45","author":"Pounder","year":"2007","journal-title":"J. Clin. Microbiol."},{"key":"ref_113","first-page":"126","article-title":"Studies on Fungi of the Normal Skin","volume":"60","author":"Yu","year":"1965","journal-title":"Hifuka kiyo. Acta Dermatol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/s11046-012-9608-x","article-title":"637 Molecular Identification of Melanised Non-Sporulating Moulds: A Useful Tool for Studying the Epidemiology of Phaeohyphomycosis","volume":"175","author":"Santos","year":"2013","journal-title":"Mycopathologia"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1128\/CVI.00009-09","article-title":"Detection of (1\u21923)-\u03b2-D-Glucan as an Adjunct to Diagnosis in a Mixed Population with Uncommon Proven Invasive Fungal Diseases or with an Unusual Clinical Presentation","volume":"16","author":"Alhambra","year":"2009","journal-title":"Clin. Vaccine Immunol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1086\/588660","article-title":"European Organization for Research and Treatment of Cancer\/Invasive Fungal Infections Cooperative Group; National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC\/MSG) Consensus Group. Revised Definitions of Invasive Fungal Disease","volume":"46","author":"Walsh","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"e246","DOI":"10.1016\/S1473-3099(20)30784-2","article-title":"Global Guideline for the Diagnosis and Management of Rare Mould Infections: An Initiative of the European Confederation of Medical Mycology in Cooperation with the International Society for Human and Animal Mycology and the American Society for Microbiology","volume":"21","author":"Hoenigl","year":"2021","journal-title":"Lancet Infect. Dis."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1097\/01.tp.0000226080.71764.8c","article-title":"Clinically Relevant Drug Interaction between Voriconazole and Tacrolimus in a Primary Renal Allograft Recipient","volume":"81","author":"Kuypers","year":"2006","journal-title":"Transplantation"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"e13587","DOI":"10.1111\/ctr.13587","article-title":"AST Infectious Diseases Community of Practice. Pneumocystis jirovecii in Solid Organ Transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice","volume":"33","author":"Fishman","year":"2019","journal-title":"Clin. Transplant."}],"container-title":["Journal of Fungi"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2309-608X\/12\/1\/32\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:16:16Z","timestamp":1767676576000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2309-608X\/12\/1\/32"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,31]]},"references-count":119,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jof12010032"],"URL":"https:\/\/doi.org\/10.3390\/jof12010032","relation":{},"ISSN":["2309-608X"],"issn-type":[{"value":"2309-608X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,31]]}}}