Last Updated: 2020-08-12

Author(s): Anzengruber F., Navarini A.

ICD11: 1F24

  • Rudolph 1914
  • Lane 1915
  • Medlar 1915


Worldwide occurring fungal infection mainly of the lower extremities and hands.

  • Worldwide, but mainly found in South America, the south of the USA, Europe and Russia
  • Mostly middle-aged men
  • Mainly occurring in rural areas

  • Pathogen
  • 6 species of fungi with strong structural similarities:
    • Phialophora verrucosa jeanselmii or - gougerotii
    • Fonsecae pedrosoi
    • Fonsecae compacta
    • Botromyces caespitosus
    • Cladosporium carrionii
    • Rhinocladiella aquaspersa
  • The fungi are usually found on wood or plants. Small skin lesions lead to inoculation. In rare cases insect bites may also lead to an infection.

Initially a slightly painful, pruriginous papule, plaque or pustule may appear in the area of the inoculation site. In the course of time, there is a progression in size and the development of erythematous, verruziform, granulomatous, partly ulcerated, crusty nodules. Secondary impetiginizations are observed more frequently.

  • Clinical features
  • Pathogen detection (myco. smear, biopsy)

  • Lower extremity > upper extremity or face
  • Especially lower legs, feet, but also hands (gardening)

Mostly chronic course.

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