Cutaneous Alternariosis in an Adolescent Patient

Abstract

Cutaneous alternariosis is a rare infection typically observed only in immunocompromised adults, but we report here that the infection can occur in apparently healthy adolescents. We saw a clinically healthy adolescent boy who presented with cutaneous alternariosis 6 weeks after suffering a laceration to his right ankle. Treatment with itraconazole resulted in significant improvement after 1 month.

Unusual location of cutaneous alternariosis in an immunocompetent patient

“…To our knowledge, there are nine cases reported of cutaneous alternariosis in immunocompetent patients ( Table 1 ). The most common locations are the lower extremities, and there is a trauma story in most cases [2] , [10] , [11] , [12] , [13] , However in our case the notion of minor or major face trauma was not found. Hu in a review of all cutaneous alternariosis, reported 29 cases, and no one was located in the face.…”

Cutaneous alternariosis in a renal transplant patient successfully treated with posaconazole: Case report and literature review

“… Sx+ITZ Cure 2010 AM Morales [31] M 63 Cardiac Tx Alternaria spp. Cryotherapy+ITZ Cure 2010 F Santiago [32] M 55 Renal Tx Alternaria alternata ITZ Failure 2010 SEM Vermeire [ 21 ] F 51 Renal Tx Alternaria alternata Sx+Vori Cure 2010 TR Leahy [ 19 ] F 14 AML Alternaria infectoria LamB+Vori Cure 2010 M Yasui [33] M 68 None Alternaria alternata Thermotherapy Cure 2010 DR Matson [34] M 17 None Alternaria spp. ITZ Improved 2011 GW Osmond [35] M 57 Cardiac Tx Alternaria spp.…”

Cutaneous alternariosis in an immunocompetent patient

“…There was one reported case involving the dorsum of the hand due to trauma from a thorn [3] and one case with a lesion on the cheek [4]. Two of the cases reported infection of the ankle from a previous laceration [5,6], one case reported cutaneous infection of the thigh [7] another case involved the knee [8], and one case involved the anterior tibia after an abrasion outdoors [9]. One study concluded that of the 29 total Alternaria cases they found in literature, all infections were on the extremities including forearms, legs, hands, knees, thighs, wrists, ankles, tibia, and elbow [9].…”

“…Lesions of cutaneous alternariosis have a variety of presentations on examination and include thickening, ulcerations, nodules, plaques, scales, and erosions [3][4][5][6][7][8][9]. This variation makes clinical diagnosis difficult and often requires laboratory isolation and identification of the organism via culture or biopsy.…”