Unveiling Atypical Subcutaneous Phaeohyphomycosis in a Diabetic Patient: A Case Report

Phaeohyphomycosis is a rare mycotic infection caused by various heterogeneous groups of phaeoid (dematiaceous) fungi that affect the skin and subcutaneous tissues. Common clinical manifestations include subcutaneous abscesses or cystic swellings. We report the case of a 39-year-old male presenting with a subcutaneous phaeohyphomycosis manifesting as swelling over the left elbow. Initial examination suggested a differential diagnosis of abscess or olecranon bursitis. Histopathological analysis revealed granulomatous inammation, and special staining with Grocott's methenamine silver stain showed broad pigmented hyphae. Culture produced black-colored colonies identied as Exophiala jeanselmi. The patient underwent surgical excision of the lesions. This case underscores the importance of considering fungal infections in atypical presentations of chronic subcutaneous swellings, especially in diabetic patients.