A case of localized skin infection due to purpureocillium lilacinum

Purpureocillium lilacinum, formerly Paecilomyces lilacinus, is a saprophytic fungus found in soil and rotting vegetation and rarely pathogenic to humans. Only 4 cases of cutaneous infection caused by Purpureocillium lilacinum have been reported in the name of Paecilomyces lilacinus. Herein, we report a case of localized cutaneous infection due to Purpureocillium lilacinum. A healthy 81-year-old immunocompetent male presented with an erythematous scaly and pustular plaque on his left dorsal hand that had begun 3 months ago. Histopathologic examination showed suppurative granulomatous inflammation with hyphae and round spores in the dermis. Periodic acid-Schiff and methenamine silver stain revealed fungal spores. Fungus culture from the biopsy specimen revealed velvety pink to white colonies after 15 day-incubation period. The slide culture stained with lactophenol-cotton blue showed typical long hyphae and flask-shaped phialides with oval conidia in chains. The result of DNA sequencing from the colony was identical to that of Purpureocillium lilacinum.