Cutaneous Alternariosis in a Patient with Idiopathic Pulmonary Fibrosis

    Despoina Ioannidou, Maria Stefanidou, Sophia Maraki, John Panayiotides, Androniki Tosca
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    TLDR A 78-year-old farmer with lung disease had skin lesions from a fungal infection that healed completely with medication.
    A 78-year-old farmer with idiopathic pulmonary fibrosis (IPF) developed symptomless skin lesions, which were diagnosed as cutaneous alternariosis caused by Alternaria alternata. The patient had been on oral prednisolone and colchicine for IPF. Examination revealed erythematoviolaceous plaques with pustules on his hands and forearms. Laboratory tests showed elevated white blood cell count and C-reactive protein, with low immunoglobulin G. Histological analysis of skin biopsies confirmed fungal infection. Treatment involved reducing prednisolone to 10 mg/day and administering oral itraconazole (200 mg/day), leading to complete healing of the lesions within 3 months. There was no recurrence after 2 years.
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