Majocchi’s granuloma on the forearm caused by Trichophyton tonsurans in an immunocompetent patient

Abstract

Majocchi's granuloma is an uncommon fungal infection of the dermis and subcutaneous tissue. The most frequently identified cause of Majocchi's granuloma is anthropophilic Trichophyton rubrum, and it is most commonly located on the anterior aspect of the lower limbs in women. Here, we report a case of Majocchi's granuloma on the forearm, a site that is rarely involved, in a 62-year-old woman who had been bitten by a dog. Histological examination revealed a dense dermal infiltrate composed of lymphoplasmacytic cells and neutrophils, with hyphae in the dermis. The presence of the fungus, Trichophyton tonsurans, was confirmed by mycological examination and molecular methods. Therefore, histological and mycological examination confirmed the diagnosis of Majocchi's granuloma. The patient was treated with local moxibustion and itraconazole, 200 mg/day, for 60 days, which facilitated a complete resolution of the lesions.

Majocchi's granuloma: Autoinoculation and adaption of Trichophyton rubrum with molecular evidence

“…The source of MG can be a prior dermatophyte infection, or exposure to infected or asymptomatic animals or humans. 13 Conventional laboratory methods for identification present homogeneity of morphological characters of T. rubrum, but have limitations in strain typing. It is difficult to find sources of infection.…”