Trichophyton Tonsurans Infection Manifesting as Multiple Concentric Annular Erythemas

Abstract

We report a case of dermatophytosis in a Judo wrestler caused by Trichophyton tonsurans (T. tonsurans) with clinical features that mimicked the concentric rings of tinea imbricata. Tinea imbricata is a unique dermatophytosis caused by Trichophyton concentricum (T. concentricum), observed endemically in subtropical to torrid zones and characterized by impressive concentric rings. We found three similar cases of the dermatophytosis in the literature that were reported as tinea pseudoimbricata or tinea indecisiva. All of these cases were associated with systemic or local immunosuppression, perhaps simulating the mechanism of tinea imbricata, which is known to involve the lack of delayed type hypersensitivity to T. concentricum. These cases imply that iatrogenic immunosuppression may perhaps play an important role in the development of the unique clinical features mimicking tinea imbricata. Furthermore, three of the four cases, including the presented case, were caused by T. tonsurans. It may be necessary to consider T. tonsurans infection when multiple concentric erythemas are encountered.

Tinea Cruris and Tinea Corporis Masquerading as Tinea Indecisiva: Case Report and Review of the Literature

“…mentagrophytes. [2][3][4][5][6][7][8] This case report is the first in which a different variant of T. mentagrophytes, that is, T. mentagrophytes var. interdigitale, was isolated as the etiologic agent.…”

Tinea imbricata in the Americas

“…There are some studies of secondary syphilis mimicking tinea imbricata in immunocompromised patients [29]. There are also studies of some other superficial fungal diseases that clinically resemble tinea imbricata, for example dermatophytic infections due T. rubrum that adopt the concentric patterns of tinea imbricata and can be confused clinically; they are only distinguishable by the laboratory findings [30][31][32][33]. Pityriasis versicolor Tinea imbricata Bonifaz and Vá zquez-Gonzá lez 109 'imbricata' is another superficial fungal disease that can adopt the concentric pattern of tinea imbricata [34].…”

Canine dermatophytosis caused by an anthropophilic species: molecular and phenotypical characterization of Trichophyton tonsurans

“…Brilhante et al (2004), evaluating the incidence of Tinea capitis in Fortaleza, Ceará, Brazil, noted that T. tonsurans was the main (62?8 %) dermatophyte isolated. This species has been recognized as a causative agent of Majocchi's granuloma (Rajpara et al, 2005) and has been cited in cases with clinical features that mimicked the concentric rings of Tinea imbricata caused by Trichophyton concentricum (Ouchi et al, 2005).…”