Phaeohyphomycose cutanée à Scytalidium dimidiatum chez une transplantée rénale

Scytalidium dimidiatum, the synanamorph of Nattrassia mangiferae, is a mold plant pathogen that is exclusively found in tropical and subtropical areas. This dematiaceous fungus can cause superficial skin and nail infections that mimic those caused by dermatophytes, but deep subcutaneous infections and disseminated diseases have also been described in immunosuppressed patients. Here, we report the case of a kidney transplant female recipient who was hospitalized for profound physical deterioration in a context of severe immunodepression. In addition to many other opportunistic infections, she presented a pseudotumoral lesion localized to the right forearm. The histological examination of a biopsy specimen revealed septate hyphae and culture allowed the isolation of Scytalidium dimidiatum. This case of cutaneous scytalidiosis is particular, as the patient, who lived in Bulgaria, did not recently stay in a tropical or subtropical country.