Five months since his farming accident, the strange rash on his arm still hadn't gone away. In fact, it had gotten bigger.

Mold can be pretty gross—and potentially hazardous to your health—whether it’s growing on a stale piece of food or lurking on the walls of a damp room. Now picture that same type of mold growing on your skin, or even inside your body. This week’s New England Journal of Medicine has a creepy story (complete with photos!) of an unlucky man in China who had to deal with just that.

The 65-year-old farmer, whose story appears in the journal’s Images in Clinical Medicine section, visited a dermatologist to get a strange rash on his right hand and forearm checked out. The ring-shaped rash, “with ulceration and crusting,” had gotten progressively larger over the last five months, and the man recalled that it had started after he’d cut his hand while doing agricultural work.

The patient had “treated himself with a topical mixture of juices and fragments from herbs,” his doctors wrote in the case report, but the rash had not improved. So they took a skin biopsy, which revealed a fungal culture called Sporothrix schenckii. This fungus, which is found in soil and on plant matter worldwide and is related to the mold on your stale food, causes an infection known as sporotrichosis.

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“The infection usually involves the skin and subcutaneous tissue and occurs from inoculation of the fungus from plants and soil through the skin,” his doctors wrote. Occasionally, the disease can spread to the lungs, the joints, or other parts of the body, but this usually only happens in people with weakened immune systems or other underlying diseases.

According to the CDC, sporotrichosis is a fungus sometimes found on rose bushes, sphagnum moss, and hay. People become infected with sporotrichosis when the fungus enters the skin, usually through a cut or scrape while handling contaminated plants. There have also been cases when an infection has been transmitted to humans by cat scratches or bites.

Infection with sporotrichosis is rare. While it seems to be more common in Latin America, China, and other parts of the world, it’s been estimated that in the United States, the disease occurs in less than one in a million people every year.

But there are a few cases in the medical literature: In 1971, two 12-year-old boys in Long Island, New York, became infected after playing around bales of hay, according to the International Journal of Dermatology.

Before that, a group of college students in Florida developed the infection after handling bricks covered in contaminated moss and soil, and a rose gardener became sick after drinking wine at work, falling asleep, and being pricked by a thorn. (Because of that last case, the infection was at one point referred to as “the syndrome of the alcoholic rose gardener.”)

Sporotrichosis can be treated with antifungal medications, and prognosis is generally good as long as the infection is only skin-deep. The patient in China was given two and a half months of drugs and heat therapy, and his rash cleared up completely.

As for the rest of us, we certainly don’t have to worry too much about such a rare condition—especially if we don’t spend a lot of time around plants and soil. But to reduce your risk even further, the CDC recommends wearing gloves and long sleeves when you’re out gardening or farming, especially when you’re handling plant material that can cause cuts or scrapes.

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