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CASE REPORT
Year : 1998  |  Volume : 64  |  Issue : 2  |  Page : 89-90

Subcutaneous phycomycosis


Department of Pathology, JJM Medical college, Davegere- 577004, India

Correspondence Address:
H R Chandrasekhar
Department of Pathology, JJM Medical college, Davegere- 577004
India
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Source of Support: None, Conflict of Interest: None


PMID: 20921726

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How to cite this article:
Chandrasekhar H R, Shashikala P, Haravi R, Kadam S R. Subcutaneous phycomycosis. Indian J Dermatol Venereol Leprol 1998;64:89-90

How to cite this URL:
Chandrasekhar H R, Shashikala P, Haravi R, Kadam S R. Subcutaneous phycomycosis. Indian J Dermatol Venereol Leprol [serial online] 1998 [cited 2020 Oct 29];64:89-90. Available from: https://www.ijdvl.com/text.asp?1998/64/2/89/4656





  Introduction Top


The phycomycosis include infections caused by species of absidia, mucor, rhizopus, mortierella and by Basidiobolus haptosporus, Entomophthora coronata and Hyphomyces destruens.[1] Subcutaneous phycomycosis is a rare, chronic self-limiting fungal infection of the Indonesian children, with occasional reports from India.[1]

Most of the patients are male children, under 15 years of age. The lesion begins as a small subcutaneous nodule that gradually increases in size to become extensive over a period of months or years. Frequently involved areas are trunk, buttocks and limbs. Lesions are painless and ulceration of overlying skin is uncommon. [1, 2]


  Case Report Top


A 10-year-old boy, was admitted with complaint of a gradually increasing swelling over the buttock of 15 days duration. Past history revealed that two years ago, he had a swelling at the same site, which regressed after local therapy.

His general, physical and systemic examination and routine laboratory investigations were normal. Local examination showed a swelling on the left buttock, 9x8 cm with well-defined borders, soft to firm consistency and slightly restricted mobility. The swelling was completely excised.

Excision biopsy specimen had a grey white homogenous, nodular cut surface [Figure - 1]. Underlying muscle was free. Histopathology showed normal skin with subcutaneous tissue consisting of a chronic granulomatous inflammation with many giant cells, lymphocytes, a few eosinophils and neutrophils. On careful examination, non branching, broad thin walled faintly eosinophilic hyphae with occasional septae were seen in the tissues as well as within the giant cells. These hyphae stained positively with Gomori's methenamine silver, Masson's trichrome and faintly with periodic acidSchiff stain.


  Discussion Top


Definitive diagnosis of subcutaneous phycomycosis can be made on histopathological study. The clinical and histopathologic features of skin lesion in our patient were characteristic of basidiobolus infection.[1] The possibility of mucormycosis was ruled out by the following differentiating features:

Infections with basidiobolus are subcutaneous and painless, overlying skin remains intact, and vessel involvement and thrombosis are absent. Patients are in good general health and nutrition, unlike those affected by mucormycosis.

Exact mode of infection is not known. The fungus is found in rotting vegetation in the soil. Though the lesions may resolve spontaneously after several months, potassium iodide is the therapeutic drug of choice.[2]



 
  References Top

1.Burkitt DP, Wilson AMM, Jelliffe DB. Subcutaneous phycomycosis; A review of 31 cases seen in Uganda. Br Med J 1969; 1:1669-1672.  Back to cited text no. 1    
2.Scholtens RE, Harrison SM, Subcutaneous phycomycosis. Trop Geogr Med 1994; 46:371-373.  Back to cited text no. 2    


    Figures

[Figure - 1]



 

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