case_images: PMC7310607_01
case_images: Erythematous and violaceous papules and nodules, some of them with exulcerated surface on the limbs.
case_images: 1678-9946-rimtsp-62-S1678-9946202062042-gf01.jpg
case_images: PMC7310607_01_1678-9946-rimtsp-62-S1678-9946202062042-gf01.jpg
case_images: f01
case_images: Subsequently, they progressed to ulcerated plaques with a blood-draining s discharge (Figure 1).
case_images: - Microculture showing macroconidia of Arthroderma gypseum and Macroculture on Agar Sabouraud displaying the Arthroderma gypseum growth.
case_images: 1678-9946-rimtsp-62-S1678-9946202062042-gf02.jpg
case_images: PMC7310607_01_1678-9946-rimtsp-62-S1678-9946202062042-gf02.jpg
case_images: f02
case_images: The confirmation of deep mycosis by M. gypseum (N. gypsea) was made through a direct mycological examination, culture in Agar Sabouraud (Figure 2) and a cutaneous biopsy, however, the molecular identification of the strain was not performed.
case_images: - Top image: intense mixed inflammatory infiltrate with suppuration in the dermis and the hypodermis. HE, OM: x 40 magnification; Bottom image: granulomatous and suppurative inflammation with epithelioid and giant multinucleated histiocytes and neutrophils in the dermis. HE, OM: x 400 magnification.
case_images: 1678-9946-rimtsp-62-S1678-9946202062042-gf03.jpg
case_images: PMC7310607_01_1678-9946-rimtsp-62-S1678-9946202062042-gf03.jpg
case_images: f03
case_images: The histopathology demonstrated acanthosis and spongiosis of epidermis, a granulomatous and suppurative intense inflammation of the dermis and hypodermis (Figure 3) along with the presence of fungal septate hyphae in Grocott' staining (Figure 4).
case_images: Histopathology: Grocott's staining disclosing fungal hyphae in the dermis. OM: x 400 magnification.
case_images: 1678-9946-rimtsp-62-S1678-9946202062042-gf04.jpg
case_images: PMC7310607_01_1678-9946-rimtsp-62-S1678-9946202062042-gf04.jpg
case_images: f04
case_images: The histopathology demonstrated acanthosis and spongiosis of epidermis, a granulomatous and suppurative intense inflammation of the dermis and hypodermis (Figure 3) along with the presence of fungal septate hyphae in Grocott' staining (Figure 4).