A Case Considering of Majocchi's Granuloma Caused by Trichophyton mentagrophytes

Kim, Ji Eun; Choe, Seong Wook; Kim, Myeung Nam; Ro, Byung In; Song, Kye Yong

Abstract

Majocchi's granuloma is well recognized, uncommon infection of dermal and subcutaneous tissue by dermatophytes. The organism usually associated with Majocchi's granuloma is Trichophyton (T.) rubrum. However, other dermatophytes including T. mentagrophytes, T. violaceum, M. audouinii, M. gypseum, M. ferrugineum, and M. canis may be the causative agent. Dermatophytes usually do not invade beyond epidermis. However mechanical breakage of the skin resulting from scratching or trauma and immunocompromised state, such as diabetes mellitus, malignancy, and long term steroid use may allow penetration of fungi together with keratin and necrotic materials into the dermis. A 19-year-old woman presented with erythematous patch on the left lower extremity for 2 years. She had a history of breeding pet dog infected with fungus 3 years ago and treated with antifungal agent for 6 months in local clinic under the impression of tinea corporis. The examination revealed erythematous discrete papulopustular patch with brownish to violaceous scaly margin. KOH examination showed negative result, but histopathologic finding of pustular skin lesion showed chronic granulomatous inflammation with fungal element. The fungal culture grew T. mentagrophytes. The patient was started on itraconazole 200mg daily for 4 weeks and successfully treated. Herein we report a case considering of Majocchi's granuloma by T. mentagrophytes.