Abstract
Majocchi’s granuloma is an intracutaneous or subcutaneous granulomatous inflammation caused by invasion of dermatophytic fungus, especially Trichophyton rubrum. This type of lesion is misdiagnosed frequently without proper auxiliary examination. Here, we report a case of widespread Majocchi’s granuloma caused by T. rubrum in a 35-year-old woman with systemic lupus erythematosus for 9 years. The patient was initially misdiagnosed as SLE-associated skin lesions, which delayed her treatment and resulted in severe multiple disseminated lesions. After confirmed as Majocchi’s granuloma, the patient was cured after 11-month treatment with terbinafine.
References
Majocchi D. A new trichophytic granuloma: clinical and mycologic studies. Sopra una nuova tricofizia (Granuloma tricofitico), Studi clinici e micologici. Bull R Acad Med Roma. 1883;9:220–3.
Brod C, Benedix F, Röcken M, et al. Trichophytic Majocchi granuloma mimicking Kaposi sarcoma. J Dtsch Dermatol Ges. 2007;5:591–3.
Virgili A, Zampino MR, Mantovani L. Fungal skin infections in organ transplant recipients. Am J Clin Dermatol. 2002;3:9–35.
Yang Y, Hu Y, Zhang J, et al. A refractory case of chromoblastomycosis caused by Fonsecaea monorphora. Med Mycol. 2012;50:649–53.
Sequeira M, Burdick AE, Elgart GW, et al. New-onset Majocchi’s granuloma in two kidney transplant recipients under tacrolimus treatment. J Am Acad Dermatol. 1998;38:486–8.
Gule AT, Demirbilek M, Seckin D, et al. Superficial fungal infections in 102 renal transplant recipients: a case-control study. J Am Acad Dermatol. 2003;49:187–92.
Smith KJ, Welsh M, Skelton H. Trichophyton rubrum showing deep dermal invasion directly from the epidermis in immunosuppressed patients. Br J Dermatol. 2001;145:344–8.
İlkit Macit, Durdu Murat, Karakaş Mehmet. Majocchi’s granuloma: a symptom complex caused by fungal pathogens. Med Mycol. 2012;50:449–57.
Hoesly FJ, Huerter CJ, Shehan JM. Purpura annularis telangiectodes of Majocchi: case report and review of the literature. Int J Dermatol. 2009;48:1129–33.
Saadat P, Kappel S, Young S, et al. Aspergillus fumigatus Majocchi’s granuloma in a patient with acquired immunodeficiency syndrome. Clin Exp Dermatol. 2008;33:450–3.
Kim ST, Baek JW, Kim TK, et al. Majocchi’s granuloma in a woman with iatrogenic Cushing’s syndrome. J Dermatol. 2008;35:789–91.
Smith KJ, Neafi e RC, Skelton HG, et al. Majocchi’s granuloma. J Cutan Pathol. 1991;18:28–35.
Radentz WH, Yanase DJ. Papular lesions in an immunocompromised patient. Trichophyton rubrum granulomas (Majocchi’s granuloma). Arch Dermatol. 1993;129:1189–90.
Acknowledgements
This work was kindly supported by the Guangdong province science and technology plan project (2013B021800141). The authors would like to thank Dr. Clayton Dyck in the Department of Family Medicine at the University of Manitoba for many useful comments and suggestions.
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Sitong Zhou and Yemei Yang contributed equally to this work.
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Zhou, S., Yang, Y., Liu, K. et al. A Case Report of Widespread Majocchi’s Granuloma in a Patient with Systemic Lupus Erythematosus. Mycopathologia 182, 577–581 (2017). https://doi.org/10.1007/s11046-017-0109-9
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DOI: https://doi.org/10.1007/s11046-017-0109-9