Indolent Acremonium strictum infection in an immunocompetent patient.

A 35‐year‐old housewife presented with an 11‐year history of a painless lesion on the right cheek, which had enlarged over the last 2 years. She had no history of travel or trauma. Various topical and systemic antimicrobial and antifungal agents, such as fluconazole, ketoconazole, sulbactam/ampicillin, and mupirocin, had been prescribed, with a probable diagnosis of pyoderma and blastomycosis, without significant benefit. Her medical history was otherwise unremarkable. Dermatologic examination revealed a well‐circumscribed, erythematous, infiltrative, 8 × 10 cm plaque covering the right cheek and a 2 × 3.5 cm vegetative, ulcerated lesion on the chin ( Fig. 1 ). There were no sinus tracts or grains.

Figure 1 Open in figure viewer PowerPoint Erythematous, infiltrative plaque covering the right cheek, and vegetative, ulcerated lesion on the chin