engleski

Majocchi's granuloma caused by Microsporum gypseum

INTRODUCTION AND OBJECTIVES: Majocchi’s granuloma is a deep folliculitis due to a cutaneous dermatophyte infection. It might occur as a result of the use of topical steroids on unsuspected tinea. Majocchi’s granuloma is also known as granuloma trichophyticum, as the most frequently reported agents are Trichophyton rubrum and Trichophyton violaceum. We report case of a Majocchi’s granuloma caused by geophylic Microsporum (M.) gypseum in a fifty- three-year- old female patient. MATERIALS AND METHODS: Fifty-three-year-old, otherwise healthy female patient, has been referred to our Department due to solitary, well- circumscribed plaque on the left forearm, with perifollicular papulopustules, erythema and scaling. Pressure did not result in pus exudation. Prior to this visit the lesion had been unsuccessfully treated with topical hydrocortisone/oxitetraciklin-hydrochloride ointment, for a month. Moreover the condition had even deteriorated, with lesion becoming bigger and pruritic. RESULTS: Direct microscopic potassium hydroxide (KOH) examination of the skin scrapings was positive, revealing fungal hyphae and M. gypseum was confirmed by culture on the glucose-modified Sabouraud medium. Topical antimycotic treatment with terbinafine cream and oral terbinafine, 250 mg daily, have been administered during 6 weeks. The liver enzymes, as well as the serum lipids level were within normal ranges at the beginning during and at the end of treatment. After 6 weeks of therapy, almost complete regression with slight residual erythema could be clinically observed. The results of the mycological examination were negative at the end of treatment. CONCLUSION: Majocchi’s granuloma is uncommon, but well recognized dermatophyte infection. Although Trichophyton spp. has been traditionally the expected pathogen, and, accordingly, the term granuloma trichophyticum has been used, in our patient geophylic fungus Microsporum gypseum has been confirmed by culture as an aetiological agent. Thus, the change of the name to “Majocchi’s granuloma” instead of traditional “Granuloma trichophyticum Majocchi” should be seriously considered.

Majocchi's granuloma ; Microsporum gypseum

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