Trichophyton rubrum Infection Characterized by Majocchi’s Granuloma and Deeper Dermatophytosis: Case Report and Review of Published Literature

Su, Huilin; Li, Li; Cheng, Biao; Zhu, Junhao; Zhang, Qiangqiang; Xu, Jinhua; Zhu, Min

doi:10.1007/s11046-016-0099-z

Cited by 22 publications

(12 citation statements)

References 22 publications

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“…Majocchi granuloma, also known as nodular granulomatous perifolliculitis, results from penetration of the fungus along the hair follicle to the dermal or subcutaneous tissue, leading to a suppurative folliculitis. 71 The condition may be precipitated by occlusion of hair follicles or trauma to the skin. 24 Majocchi granuloma is most commonly seen in immunocompromised individuals or those treated with topical corticosteroids.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Tinea corporis: an updated review

Leung¹,

Lam²,

Leong³

et al. 2020

DIC

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Background Tinea corporis is a common fungal infection that mimics many other annular lesions. Physicians must familiarize themselves with this condition and its treatment. Objective This article aimed to provide a narrative updated review on the evaluation, diagnosis, and treatment of tinea corporis. Methods A PubMed search was performed with Clinical Queries using the key term ‘tinea corporis.’ The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies, and reviews. The search was restricted to the English language. The information retrieved from the mentioned search was used in the compilation of the present article. Results Tinea corporis typically presents as a well-demarcated, sharply circumscribed, oval or circular, mildly erythematous, scaly patch or plaque with a raised leading edge. Mild pruritus is common. The diagnosis is often clinical but can be difficult with prior use of medications, such as calcineurin inhibitors or corticosteroids. Dermoscopy is a useful and non-invasive diagnostic tool. If necessary, the diagnosis can be confirmed by microscopic examination of potassium hydroxide wet-mount preparations of skin scrapings from the active border of the lesion. Fungal culture is the gold standard to diagnose dermatophytosis especially if the diagnosis is in doubt and results of other tests are inconclusive or the infection is widespread, severe, or resistant to treatment. The standard treatment of tinea corporis is with topical antifungals. Systemic antifungal treatment is indicated if the lesion is multiple, extensive, deep, recurrent, chronic, or unresponsive to topical antifungal treatment, or if the patient is immunodeficient. Conclusion The diagnosis of tinea corporis is usually clinical and should pose no problem to the physician provided the lesion is typical. However, many clinical variants of tinea corporis exist, rendering the diagnosis difficult especially with prior use of medications, such as calcineurin inhibitors or corticosteroids. As such, physicians must be familiar with this condition so that an accurate diagnosis can be made and appropriate treatment initiated.

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Section: Clinical Manifestationsmentioning

confidence: 99%

Tinea corporis: an updated review

Leung¹,

Lam²,

Leong³

et al. 2020

DIC

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“…The most frequently used staining methods for eliminating this deficiency are the periodic acid-Schiff (PAS) (n=18) and Grocott-Gomori’s methenamine silver (GMS) (n=5) methods. 49 , 54 , 55 …”

Section: Laboratory Diagnosismentioning

confidence: 99%

“…As histological examination is not sufficient for the identification of a fungus, especially in immunosuppressed patients, it is important to use molecular-based techniques, such as internal transcribed spacer (ITS) sequencing, for identifying fungal species. 1 , 55 , 61 , 62 A fungal culture is required both to detect fungal pathogens and to recognize the species eventually by combining histological analysis and ITS sequencing. Among the studies that were reviewed, fungal culturing was performed for 28 cases, only 1 of which was negative.…”

Section: Laboratory Diagnosismentioning

confidence: 99%

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Majocchi’s granuloma: current perspectives

Boral¹,

Durdu²,

İlkit³

2018

IDR

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Majocchi’s granuloma (MG) is a rare fungal infection of the dermis that is mainly caused by dermatophytes (in ≥95% of cases); the most frequently identified cause is anthropophilic Trichophyton rubrum. In the rest of the cases, the causes are non-dermatophytic fungi such as Aspergillus species. This review aimed to provide information about the current perspectives on MG regarding its clinical characteristics, predisposing factors, laboratory diagnosis, and treatment strategies. Although the lower extremities were reported to be the most common site of infection, facial involvement has been predominant in the past 5 years. Our literature research showed that the most common predisposing factor (55%) is the use of topical steroid creams without potassium hydroxide examination during treatment of erythematous squamous dermatoses. A reliable diagnosis of MG is based on histopathological examination, including fungal culture and molecular analyses. MG should be treated not only with topical agents but also with systemic antifungal agents that are continued until the lesions are completely resolved. In systemic treatment, the most preferred drug is terbinafine, because of its efficacy, side effects, and safety.

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“…Both patients had satisfactory relief after treatment with terbinafine. Su et al[ 11 ] also successfully treated a case of Trichophyton rubrum infection characterized by MG and deeper dermatophytosis with oral terbinafine 250 mg/d, and the patient's skin lesion disappeared. However, terbinafine-resistant strains have been found in cases of drug-resistant dermatophyte infection, including Trichophyton rubrum infection, in recent years[ 12 - 14 ].…”

Section: Discussionmentioning

confidence: 99%

Majocchi's granuloma caused by Trichophyton rubrum after facial injection with hyaluronic acid: A case report

Liu

Yang

Liu

et al. 2020

WJCC

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BACKGROUND Facial cosmetic procedures become popular for people with a desire to have a younger appearance, and cosmetic technology has developed rapidly over the past several decades. However, increasing complications related to cosmetic injections have been reported, and infection is one of the most serious problems and can cause anxiety and facial injury. We here report a case of Majocchi's granuloma (MG) caused by Trichophyton rubrum after facial injection of hyaluronic acid. CASE SUMMARY A 37-year-old woman presented to our hospital with a history of red papules, nodules, and abscesses on her left zygomatic arch for 2 mo. She had received a cosmetic injection of hyaluronic acid on the left side of her face prior to the appearance of the lesions. MG caused by Trichophyton rubrum after facial injection of hyaluronic acid was diagnosed based on morphology and molecular biological identification. In vitro antifungal susceptibility testing was conducted according to the Clinical and Laboratory Standards Institute M38-A2 method. Minimal inhibitory concentrations were used to evaluate the antifungal susceptibility. The antifungal agents and their minimal inhibitory concentrations for the strain were terbinafine (< 0.5 μg/mL), itraconazole (0.06 μg/mL), amphotericin B (0.25 μg/mL), fluconazole (32 μg/mL), voriconazole (0.125 μg/mL), posaconazole (0.125 μg/mL), and isavuconazole (0.06 μg/mL). We initially administered 250 mg/d oral terbinafine for 2 mo, but the patient still had painful papules, nodules and abscesses on her face. Then, we adjusted the treatment to itraconazole 400 mg/d for 8 wk based on the in vitro antifungal susceptibility testing results. The skin lesions improved significantly, and there was no recurrence during follow-up. CONCLUSION This case revealed that facial injection of hyaluronic acid may cause serious MG. Antifungal susceptibility testing should be considered in the treatment of MG caused by Trichophyton rubrum .

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Trichophyton rubrum Infection Characterized by Majocchi’s Granuloma and Deeper Dermatophytosis: Case Report and Review of Published Literature

Cited by 22 publications

References 22 publications

Tinea corporis: an updated review

Tinea corporis: an updated review

Majocchi’s granuloma: current perspectives

Majocchi's granuloma caused by Trichophyton rubrum after facial injection with hyaluronic acid: A case report

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Trichophyton rubrum Infection Characterized by Majocchi’s Granuloma and Deeper Dermatophytosis: Case Report and Review of Published Literature

Cited by 22 publications

References 22 publications

Tinea corporis: an updated review

Tinea corporis: an updated review

Majocchi&rsquo;s granuloma: current perspectives

Majocchi's granuloma caused by Trichophyton rubrum after facial injection with hyaluronic acid: A case report

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Product

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Majocchi’s granuloma: current perspectives