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CORRESPONDENCE |
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| Year : 2013 | Volume
: 58
| Issue : 1 | Page : 81 |
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| Authors' reply |
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Caroline T Nguyen, Siba P Raychaudhuri
Department of Medicine, VA Medical Center Sacramento and UC Davis School of Medicine, Division of Rheumatology, Allergy and Clinical Immunology, Hospital Way, Mather, CA 95655, USA
| Date of Web Publication | 31-Dec-2012 |
Correspondence Address:
Siba P Raychaudhuri
Department of Medicine, VA Medical Center Sacramento and UC Davis School of Medicine, Division of Rheumatology, Allergy and Clinical Immunology, Hospital Way, Mather, CA 95655
USA
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 23372224 
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How to cite this article:
Nguyen CT, Raychaudhuri SP. Authors' reply. Indian J Dermatol 2013;58:81 |
Sir,
In response to our report on Scedosporium apiospermum sinusitis in a patient following prolonged anti-TNFα therapy, [1] Dr. Monika Matlani has brought to our notice about a case of Scedosporium prolificans osteomyelitis in an immunocompetent child. Scedosporium infection has been reported in both immunocompetent and immunocompromised subjects. However, Scedosporium is mostly an opportunistic fungus.
In recent years, an increasing number of cases of human disease with S. apiospermum have been reported, probably due to widespread use of corticosteroids, immunosuppressants, antineoplastics and broad-spectrum antibiotics. Thus, it is essential for dermatologists to be aware of clinical presentations and diagnosis of Scedosporium infection.
Cutaneous manifestations of Scedosporium infection are protean. In most cases, inoculation of spores in the cutaneous and subcutaneous tissues is due to penetrating trauma or surgery. Scedosporium spp. infections can present as papules, erythematous plaques, folliculitis, necrotic papules, cutaneous ulcers, nodules, subcutaneous abscesses, and ulcers in a sporotrichoid (lymphangitic) pattern, ecchymosis, and hemorrhagic bullae. [2],[3],[4] Thus, the cutaneous manifestations are nonspecific and can be misleading in respect to the underlying disease. In appropriate clinical scenario, specifically in immunocompromised patients, physicians need to be suspicious for Scedosporium and other opportunistic infections. On occasions, a specific diagnosis of Scedosporium infection may require repeated biopsies, specific fungal staining, and fungal culture.
 References | |  |
| 1. | Nguyen CT, Raychaudhuri SP. Scedosporium infection in a patient with anti-TNFα therapy. Indian J Dermatol 2011;56:82-3. 
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| 2. | Bower CP, Oxley JD, Campbell CK, Archer CB. Cutaneous Scedosporium apiospermum infection in an immunocompromised patient. J Clin Pathol 1999;52:846-8.
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| 3. | Miyamoto T, Sasaoka R, Kawaguchi M, Ishioka S, Inoue T, Yamada N, et al. Scedosporium apiospermum skin infection: A case report and review of the literature. J Am Acad Dermatol 1998;39:498-500.
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| 4. | Uenotsuchi T, Moroi Y, Urabe K, Tsuji G, Koga T, Matsuda T, et al. Cutaneous Scedosporium apiospermum infection in an immunocompromised patient and a review of the literature. Acta Derm Venereol 2005;85:156-9.
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