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Two cases of cutaneous phaeohyphomycosis, one with a nodular appearance and the other with an erythematous infiltrating patch, are reported in immunocompromised patients. Diagnosis was based on histological examination, which revealed hyphae and round-shaped fungal cells in a granulomatous dermal infiltrate, and on identification of the moulds when biopsy fragments were cultured on Sabouraud-dextrose agar without cycloheximide. The pathogens were Alternaria tenuissima in the first case and A. alternata in the second. The fungi were examined by scanning electron microscopy. The patients were checked for bone and lung involvement and were then treated with surgical excision and itraconazole, and itraconazole only, respectively, with clinical and mycological resolution.

Between 1985 and 1990 we observed 2085 cases of dermatophytoses in the Florence area of Italy. Trichophyton rubrum and Microsporum canis were the major etiological agents. 126 cases of dermatophytoses observed during this period were caused by Trichophyton mentagrophytes. Most of the patients came from rural areas or they kept pets. Epidermophyton floccosum ranked fourth in frequency (95 cases). The patients were adults and mainly males, most of whom engaged in sports or lived in group environments. Microsporum gypseum was isolated in 31 cases. Infections occurred directly from contact with soil or domestic animals. We report the principal clinical data concerning these last three dermatophyte infections.

We evaluated the immunological aspects of a case of tinea capitis in an adult. Tests revealed alteration of the T4/T8 lymphocyte ratio (T4 increase and T8 decrease) and a decrease in polymorphonuclear leukocyte activity.

The authors describe two cases of tinea capitis in adults, one due to Microsporum canis and the other to Trichophyton rubrum. The atypical clinical presentation of the dermatophytosis in these two cases is stressed. It is hypothesized that in both cases the disease spread from primary lesion on the face.