Subcutaneous Phaeohyphomycosis of Scalp Caused by Rhytidysteron Rufulum

The term phaeohyphomycosis is used to describe cutaneous, subcutaneous and systemic infections caused by a rare group of heterogenous dematiaceous (brown pigment producing) fungi. Rhytidhysteron is a dematiaceous fungus, which has been recently found to be causing human infections. Till date only five cases of infection with Rhytidhysteron rufulum have been reported in the literature. An adult immunocompetent male presented with a subcutaneous nodule over the scalp after an alleged history of trauma. The diagnosis was made by direct microscopy, histopathology and culture. the isolates were confirmed by pcr based its sequencing. The diagnosis is often missed due to lack of knowledge regarding the fungi causing the infections and physicians should have a high degree of clinical suspiscion followed by clinicopathological and microbiological examination. Molecular studies may be required to identify a fungus if growth in artificial culture media fail. This case highlights the importance of molecular techniques for identification of nonsporulating pathogenic fungi. We report a case of subcutaneous phaeohyphomycosis of scalp in an immunocompetent male caused by a dematiaceous fungus belonging to genus Rhytidhysteron.