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Successful treatment of antifungal- and cryotherapy-resistant subcutaneous hyalohyphomycosis in an immunocompetent case with topical 5% imiquimod cream

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Abstract

Hyalohyphomycosis is an unusual opportunistic mycotic infection where the tissue morphology of the causative organism is mycelial. Etiological agents, which are not responsible for the otherwise-named infections like aspergillosis, are the species of non-dematiaceous hyaline hyphomycetes including Penicillium, Paecilomyces, Acremonium (formerly known Cephalosporium), Beauveria, Fusarium, and Scopulariopsis. Several cases of Acremonium infection have been described in immunocompromised patients; however it can cause invasive disease in an immunocompetent person very rarely. Optimum therapy of Acremonium infection is unclear because of the limited number of reported cases and conflicting results of therapies. Imiquimod, an imidazoquinoline with potent antiviral, antitumor and immunoregulatory properties, is currently approved for the topical treatment of external anogenital warts and actinic keratosis. Imiquimod has also been found to be effective for other virus-associated dermatologic lesions, including common and flat warts, molluscum contagiosum, and herpes simplex virus type-2 as well as for some cases of cutaneous leishmaniasis. We report herein, for the first time, a case of unusually recalcitrant hyalohyphomycosis of the face due to Acremonium strictum successfully treated with topical 5% imiquimod in an immunocompetent patient, who had failed to respond to various antifungals, including itraconazole, and cryotherapy.

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Authors and Affiliations

  1. Departments of Dermatology, Gaziantep University Medical Faculty, Gazimuhtarpasa Bulvari. Gecit 1. No: 1/5, 27090, Gaziantep, Turkey

    Zulal Erbagci & A. Almila Tuncel

  2. Departments of Pathology, Gaziantep University Medical Faculty, Gaziantep, Turkey

    Suna Erkilic

  3. Departments of Microbiology, Gaziantep University Medical Faculty, Gaziantep, Turkey

    Yasemin Zer

Authors
  1. Zulal Erbagci
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  2. A. Almila Tuncel
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  3. Suna Erkilic
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  4. Yasemin Zer
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Correspondence to Zulal Erbagci.

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Erbagci, Z., Tuncel, A.A., Erkilic, S. et al. Successful treatment of antifungal- and cryotherapy-resistant subcutaneous hyalohyphomycosis in an immunocompetent case with topical 5% imiquimod cream. Mycopathologia 159, 521–526 (2005). https://doi.org/10.1007/s11046-005-5260-z

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  • DOI: https://doi.org/10.1007/s11046-005-5260-z

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