A young man notices a darkened area of skin on the palm of his hand. It seems to be increasing in size over the past 2 weeks. His health care provider collects a skin scraping for microscopic examination, which shows septate hyphal elements and budding cells. This organism is most likely

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The presence of septate hyphal elements and budding cells is suggestive of a dematiaceous (dark pigmented) yeast, which is characteristic of Hortaea werneckii. This organism is known to cause a skin condition called Tinea nigra, which is characterized by the presence of darkened patches on the palms of the hands or soles of the feet. Malassezia furfur and Microsporum canis are both fungi that can cause skin infections, but they do not typically present with the same clinical features as Tinea nigra. Mucor spp. are a type of filamentous fungus that can cause invasive infections primarily in immunocompromised individuals and are not typically associated with skin infections.

A Young Man Notices a Darkened Area of Skin on the Palm