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Background: Schizophyllum commune, a basidiomycetous fungus, is a common invader of rotten wood. This fungus rarely causes mycotic disease in humans, especially cutaneous infection. In this paper, we describe the first case of cutaneous granuloma caused by S. commune in a Chinese woman., Case Presentation: A 25-year-old female with a two-year history of erythema, papules, nodules, and scales on her sole of left foot was presented to our outpatient center. Samples were obtained by the scraping of lesion and for light microscopy. Hyphae were observed by microscopic examination. We carried out a skin tissue biopsy, which showed multiple granulomatous nodules. Biopsy specimens were also inoculated onto media. After being cultured on SDA at 27 °C for 7 days, spreading-woolly-white colonies grew on the inoculation sites of media containing chloramphenicol only and there , s no other colonies grew. S. commune was identified by morphology methods, biochemical tests, and PCR sequencing. Pathological findings also aided in diagnosing cutaneous fungal granuloma. Oral itraconazole was applied. After 1 month of therapy, rashes on her left foot and pain were improved., Conclusion: We describe the first case of cutaneous granuloma caused by Schizophyllum commune, which illustrates the importance of recognizing uncommon pathogenic fungal infections.

Abstract: Cutaneous infections can present with a great variety of histological findings. Granulomatous infiltrates represent a reaction pattern commonly seen in this setting. However, it cannot be forgotten that granulomatous infiltrates do not equate an infective process. In the present article, we present a review of current concepts regarding the definition, pathogenesis, classification and diagnosis of cutaneous granulomatous infiltrates. The main types of granulomas associated with infectious processes are reviewed, including suppurative, tuberculoid and the so-called “histiocytic granulomas” (diffuse infiltrates composed of histiocytes frequently containing intracellular organisms). The most representative infections in immunocompetent patients associated with each group are discussed. In suppurative granulomas, the discussion includes deep fungal infections and atypical mycobacterioses. In tuberculoid granulomas, the main entities discussed include tuberculosis, tuberculoid leprosy and syphilis. With respect to histiocytic granulomas, emphasis will be put on cutaneous leishmaniasis, with a brief mention of other entities. The main non-infectious entities included in the differential diagnosis of each of these granulomatous infiltrates will also be discussed. [Copyright &y& Elsevier]