Subcutaneous zygomycosis

A 55-year-old male patient presented with a painless, subcutaneous, slowly spreading, disc-shaped, indurated plaque over the anterolateral aspect of the left thigh [Figure 1] for 6 months. Fingers could be insinuated under the disc-like plaque from the periphery of the lesion. There was no history of prior trauma, pain, tenderness, itching, warmth, erythema, or discharge from the plaque. Histopathological examination revealed mixed inflammatory infiltrate in the subcutis with few scattered aseptate fungal hyphae surrounded by eosinophilic material suggestive of Splendore-Hoeppli phenomenon. Based on these clinical and histopathological findings, we made a diagnosis of subcutaneous zygomycosis. Subcutaneous zygomycosis caused by Basidiobolus ranarum typically involves the thighs and buttocks. The infection nearly almost always occurs in immunocompetent individuals.^[1] Treatment options include systemic therapy with potassium iodide, itraconazole, amphotericin B, local hyperbaric oxygen, and surgical debridement.

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Figure 1:

Painless, subcutaneous, slowly spreading, disc-shaped, indurated plaque over the anterolateral aspect of the left thigh.

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