CUTANEOUS ALTERNARIOSIS OCCURRING IN THE COURSE OF PEMPHIGUS - REPORTON 2 CASES

Alternaria is a very common fungus. Its pathogenic role in human patho logy is mainly expressed by asthma. Cutaneous infection is rare and on ly about 70 cases have been described. Because of its wide distributio n in the environment, cutaneous biopsy is necessary to ensure the diag nosis. We reporte two cases of dermal alternariosis occurring in the c ourse of pemphigus treated with immunosuppressive therapy. Histologica l examination revealed a hyperplasic epidermis. The upper dermis showe d a mixed inflammatory infiltrate with neutrophils, histiocytes and gi ant cells. Round intracytoplasmic inclusions staining faintly with PAS were seen in giant cells. Long intercellular filaments were present i n the infiltrate. This histopathological aspect is not specific, and c ultures of both cutaneous biopsies were necessary. The association of dermal alternariosis and pemphigus is explained both by the immunosupp ressive therapy for pemphigus and by the cutaneous fragility induced b y the acantholytic disease permitting direct inoculation of Alternaria .