Subcutaneous phaeohyphomycosis: infection with pigmented fungi.

Phaeohyphomycosis falls into a large group of diseases caused by Dematiaceous fungi and is a well known deep fungal infection having a worldwide distribution, but principally localized to the tropics and subtropics. It is broadly categorized into subcutaneous and systemic forms, the latter being more common in the immunocompromised host, often with visceral dissemination, although examples in the immunocompetent population are not unknown . There are numerous species of about twenty genera which am distin guishable by their growth pattern in culture and are characterised by thin, septate, branched or unbmnched hyphae with brown to yellow pigmentation of their cell walls. These need to be distinguished from chromoblastomycosis which have spherical pigmented fungus cell. Agents causing phaeohyphomycosis are most commonly found in decaying wood and soil, hence, the infection is more common in gardeners and farmers. During the past ten years, there has been significant increase in the number of phaeohyphomycotic infections in humans, although it is debatable whether the increase is real or due to the increasing awareness of its existence. Because of the relative rarity of this infection in the United Kingdom, we describe three cases of subcutaneous phaeohyphomycosis diagnosed at the Northern General Hospital in Sheffield between 1984-93 in immunocompetent nonwhite patients.