Last Updated: 2023-07-07

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

ICD11: 1F24

  • Rudolph 1914
  • Lane 1915
  • Medlar 1915


World-wide fungal infection mainly of the lower extremities and hands.

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

  • Pathogen
  • 6 fungal species with strong structural similarities:
    • Phialophora verrucosa jeanselmii and - gougerotii
    • respectively
    • Fonsecae pedrosoi
    • Fonsecae compacta
    • Botromyces caespitosus
    • Cladosporium carrionii
    • Rhinocladiella aquaspersa
  • The fungi are usually found on wood or plants. Inoculation occurs through small skin lesions. Possibly, in rare cases, insect bites can also lead to infection

Initially, a slightly dull, pruritic papule, plaque or pustule may appear in the area of the inoculation site. In the course of the disease, the lesions progress in size and develop erythematous, verrucous, granulomatous, sometimes ulcerated, crusty nodules. Secondary impetiginisation is frequently observed

  • clinic
  • Detection of pathogens (myco. smear, biopsy)

  • Lower extremity > upper extremity or face
  • In particular lower leg, feet, but also hands (gardening)

Mostly chronic course.

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