Phaeohyphomycosis in Kidney Transplant Recipients: A Case Series.

Phaeohyphomycosis is a rare subcutaneous fungal infection caused by dematiaceous fungi, commonly presenting as cystic swellings or subcutaneous abscesses. These infections predominantly affect immunocompromised individuals, including transplant recipients, due to impaired cell-mediated immunity, which plays a crucial role in fungal defense. We report three cases of post-renal transplant phaeohyphomycosis, presenting within six to 12 months post transplant. The diagnosis was based on clinical features and potassium hydroxide (KOH) mount findings showing pigmented septate hyphae. Histopathological examination of skin biopsy with Gomori methenamine silver stain confirmed pigmented hyphae, and culture identified Phialophora verrucosa. Treatment included surgical excision of lesions combined with oral itraconazole and voriconazole.