A Case of Deep Candidiasis Presenting with Verrucous Plaque and Ulcer

Kim, Sung Ae; Kang, Min Chul; Cho, Jae We; Lee, Kyu Suk

Abstract

The infections by the Candida species are superficial in most cases. Deep-seated ulcer due to Candida species usually occurs in immunocompromised or immunodeficiency patients and it is often misdiagnosed as neoplasm or pyoderma gangrenosum. A 72-year-old man presented with a verrucous plaque and ulcer on the both wrists and he'd had these lesions for several years. He had been previously treated at a private clinic with anti-diabetics and topical steroid cream to cure the verrucous lesion. The smear and fungal culture revealed Candidia species and this was identified as Candida albicans. The skin biopsies taken from both wrists revealed yeast cells and pseudohyphae in the dermis. Complete healing was obtained with administering fluconazole 100 mg twice daily for 10 days, followed by itraconazole1 200 mg, twice daily for 14 days. We report here on a rare case of dermal candidiasis that presented as verrucous plaque and deep ulcer in a diabetic patient.