Cutaneous Phaeohyphomycosis Caused by Paraconiothyrium

Paraconiothyrium cyclothyrioides is a recently described coelomycetous fungal species. We present a case in a renal transplant patient with chronic skin lesions of the lower extremities caused by P. cyclothyrioides. Treatment with posaconazole led to com-plete resolution of the lesions. P. cyclothyrioides should be considered an opportunistic human pathogen in immunocompro-mised patients. CASE REPORT A49-year-old Latin Americanmanwith end-stage renal diseaseand a cadaveric renal transplant (2 years prior to the current admission) was hospitalized with cutaneous lesions in his lower extremities. The patient had history of type II diabetes, hyperten-sion, and atrial fibrillation. One and half years previous to admis-sion, the patient received thymoglobulin for acute T-cell rejection, with improvement of the episode. Approximately 6 months be-fore the current admission, the patient first noticed a painless, nonpruritic, mildly tender scaly papule on the left tibia just infe-rior to the knee joint and applied a local adhesive band to prevent friction injury. Over the next few months, other lesions appeare