Korean J Dermatol.  2017 Jul;55(6):360-363.

A Case of Multiple Fungal Abscesses on Inguinal Area Caused by Itraconazole-resistant Trichophyton rubrum

• Kang HJ
• Won CH
• Chang SE
• Lee MW
• Choi JH
• Lee WJ

Abstract

Dermatophytes usually infect keratinized epithelial structures such as hair and nails. However, they can also cause deep and extensive fungal infections, especially in immunocompromised patients. We report a case with multiple dermal abscesses, which is a rare manifestation of Trichophyton rubrum infection. A 54-year-old man presented with multiple subcutaneous nodules in both inguinal areas with associated tinea cruris. Histopathological findings showed abscesses with fungal hyphae highlighted using Periodic acid-Schiff diastase (PAS-D) staining. Trichophyton rubrum was isolated on a fungal culture of the biopsy specimen obtained from a subcutaneous nodule in the inguinal area. The lesions were resistant to treatment with itraconazole (100 mg twice a day for 6 months); thus, we changed the drug to voriconazole (200 mg twice a day for 3 months). In addition, we extracted the remaining big lesions by incision and drainage. The patient was successfully treated with voriconazole and surgical method.

Keyword

Fungal abscess; Itraconazole; Trichophyton rubrum; Voriconazole

MeSH Terms

Abscess*
Amylases
Arthrodermataceae
Biopsy
Drainage
Hair
Humans
Hyphae
Immunocompromised Host
Itraconazole
Methods
Middle Aged
Tinea
Trichophyton*
Voriconazole
Amylases
Itraconazole
Voriconazole