Korean J Dermatol.  2005 Mar;43(3):366-370.

A Case of Fungal Folliculitis Clinically Mimicking Lupus Miliaris Disseminatus Faciei

• Um SH
• Kang NK
• Ahn KJ
• Oh CW

Abstract

Dermatophytes generally cause infection of the stratum corneum and superficial layers of skin. They are, therefore, found less frequently in the rete layer and do not ordinarily penetrate deeper than the basal cell layer. Nevertheless, under special circumstances such as the pressure generated during trauma or long term topical steroid application, the fungus elements of some dermatophytes will be forced into the dermis where they instigate a chronic granulomatous reaction. We report a 43-year-old male who presented with multiple erythematous brown colored dome-shaped papules on both periorbital areas, which were clinically similar to lupus miliaris disseminatus faciei (LMDF). Histologic examination revealed follicular and perifollicular infiltration by inflammatory cells, and perifollicular granuloma. Trichophyton species were isolated from the fungus culture of the lesional tissue. The patient was treated with an antifungal agent, resulting in clearance of the skin lesions, and there was no recurrence of skin lesions during a 13-month follow-up period. We suggest that it is important to perform biopsies and cultures on periorbital papules which mimick LMDF, refractory to conventional therapy.

Keyword

Trichophyton species; Fungal folliculitis; Lupus miliaris disseminatus faciei

MeSH Terms

Adult
Arthrodermataceae
Biopsy
Dermis
Folliculitis*
Follow-Up Studies
Fungi
Granuloma
Humans
Male
Recurrence
Skin
Trichophyton