Cutaneous Alternaria spp. infections occur mainly in immunosuppressed patients and itraconazole is considered as the drug of choice. We report the case of a 64-year-old heart transplanted female patient with multiple cutaneous lesions caused by Alternaria infectoria. Treatment with posaconazole resulted in complete recovery. Due to lower minimal inhibitory concentrations, better distribution and less drug interactions than with itraconazole, posaconazole may become the antifungal drug to consider in the management of cutaneous infections caused by Alternaria spp. in solid organ transplant recipients.