Name of the Condition

• Subcutaneous pheomycotic abscess and cyst
• ICD-10-CM Code B43.2

Summary

Subcutaneous pheomycotic abscess and cyst is a rare fungal infection characterized by the formation of abscesses and cysts beneath the skin. These lesions are caused by the infiltration of fungi from the order Chaetothyriales.

Causes

The condition is primarily caused by a group of fungi known as dematiaceous (or "black") fungi. These fungi reside in soil and decaying organic material, potentially entering the body through minor cuts or wounds.

Risk Factors

• Occupational or recreational exposure to soil or organic materials.
• Immunocompromised status, such as due to HIV/AIDS or immunosuppressive therapy.
• Living in or traveling to endemic areas with a high prevalence of these fungi.

Symptoms

• Formation of firm, painless nodules beneath the skin, which may become swollen or inflamed.
• These nodules may coalesce into abscesses or cystic lesions.
• Possible skin discoloration or ulceration over affected areas.

Diagnosis

• Physical examination to assess the characteristics of skin lesions.
• Biopsy of the nodules or abscesses to identify fungal elements under microscopy.
• Fungal cultures and molecular tests to determine the specific fungal species.

Treatment Options

• Antifungal medications, such as itraconazole, that target the responsible fungi.
• Surgical excision in some cases to remove large or refractory lesions.
• Treatment aims to eliminate the infection and reduce the size of abscesses or cysts.

Prognosis and Follow-Up

• The prognosis is generally good with timely and appropriate antifungal treatment.
• Recurrence may occur, necessitating ongoing monitoring and possibly extended therapy.
• Regular follow-ups are crucial to ensure resolution and manage any complications.

Complications

• Potential for secondary bacterial infections.
• Chronicity or recurrence of lesions if not adequately treated.
• Scarring or disfigurement from extensive or prolonged infection.

Lifestyle & Prevention

• Minimize exposure to potentially contaminated soil or organic matter, especially in endemic regions.
• Use protective clothing and gloves when handling soil or organic materials.
• Maintain good wound hygiene to prevent fungal entry.

When to Seek Professional Help

• Appearance of unexplained nodules or lesions beneath the skin.
• Worsening or persistent swelling and pain in the affected area.
• Signs of infection, such as fever or drainage from the lesion.

Additional Resources

• Centers for Disease Control and Prevention (CDC) – Fungal Diseases
• Infectious Diseases Society of America – Guidelines and updates
• Patient support groups focusing on skin infections and fungal diseases.

Tips for Medical Coders

• Verify the presence of specific fungal species documentation in the patient's medical records.
• Ensure accurate entry of the ICD-10-CM code B43.2 for billing and insurance purposes.
• Avoid miscoding as a different type of skin infection or abscess that is not fungal-related.