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Journal Compilation © 2019 Acta Dermato-Venereologica. doi: 10.2340/00015555-3320 Purpureocillium lilacinum, previously known as Paecilomyces lilacinus, is a saprophytic and filamentous mould that exists in soil, decaying food, and paper. It can produce conidia and spores in human tissue, but it seldom results in infectious disease because of its low virulence (1, 2). Nonetheless, P. lilacinus has become an emerging pathogen in both immunocompromised and immunocompetent hosts recently (3–5). A chronic recalcitrant cutaneous ulcer induced by P. lilacinum is rare, and there is no consensus regarding its treatment. Treatment response to traditional antifungal agents, such as amphotericin B, fluconazole, griseofulvin, and echinocandins, was poor. Newer triazoles, including voriconazole and posaconazole, have lower minimum inhibitory concentration (MIC) in vitro. Previously reported patients with cutaneous infection treated with voriconazole responded well. However, only one patient was treated with posaconazole for 4 weeks but was lost to follow-up (3, 6). Herein, we describe a rare case of recurrent cutaneous P. lilacinum infection in a patient with Evans’ syndrome who was successfully treated with oral posaconazole and surgical debridement.

Successful Treatment of Recurrent Cutaneous Purpureocillium lilacinum (Paecilomyces lilacinus) Infection with Posaconazole and Surgical Debridement