Hand dermatitis with Hanseniaspora uvarum as a plausible causative agent

The ascomycetes genus Hanseniaspora was created with the description of Hanseniaspora valbyensis in 1912. Yet, the first species from this genus was described as early as in 1870 under the name of Saccharomyces apiculatus [1]. Over the years, a total of six species of Hanseniaspora yeasts have been described. Molecular taxonomy studies have demonstrated Hanseniaspora as the teleomorphic genus of Kloeckera species. Hanseniaspora uvarum is a synonym and valid name of the aforesaid species S. apiculatus, whereas its anamorph is known as Kloeckera apiculata [2].
Hanseniaspora uvarum is commonly found on fresh fruit, and grapes in particular, being an important part of the natural microbiome involved in alcoholic fermentation. The fungus has also been isolated from soil, plants, fruit-eating insects, birds and seafood [3]. The occurrence of H. uvarum in humans is very unusual with only seven documented isolations in the literature [4–7].
Here we present a patient in whom H. uvarum was isolated from the skin lesion, which resolved after antifungal therapy. To the best of our knowledge, this is the first case where H. uvarum could be linked to the human pathology.
A 51-year-old, otherwise healthy and immunocompetent Polish woman presented to the dermatologist with a 3-month history of pruritic lesions localized on the dorsal and lateral aspects of the distal interphalangeal joints of the middle and ring finger of her left hand (Figure 1 A). The lesions, consisting of small vesicles and occasionally pustules on a relatively well-demarcated erythematous base with lichenification, were inconspicuous and allergic contact dermatitis was suspected. However, neither potential allergen nor irritant agent could be identified from anamnesis, and patch testing with European Baseline Series (Chemotechnique Diagnostics) produced negative results. Empirical treatment with topical 0.1% mometasone furoate (Elocom) for 2 weeks as well as topical 0.05% betamethasone dipropionate combined with 0.1% gentamicin (Bedicort G) for 2 weeks resulted in only temporal improvement.
Lesional skin scrapings were collected for bacterial and fungal culture. On MacConkey and Columbia agar with 5% sheep blood (Oxoid) no bacterial growth was observed. Whereas, on Sabouraud dextrose agar (SDA) with chloramphenicol and gentamicin as well as on SDA with chloramphenicol and cycloheximide (Graso), after 48-hour incubation at 30°C, smooth, creamy white, yeast-like colonies were...


View full text...