Majocchi’s Granuloma – The Great Mimicker: A Case Report
Fungal infections can be challenging to diagnose, but doctors of every specialty may encounter this issue. They can be mistaken for other common dermatoses such as eczema or psoriasis and inadvertently be treated with topical corticosteroids or calcineurin inhibitors. This may lead to tinea incognit...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2023-10-01
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| Series: | Case Reports in Dermatology |
| Subjects: | |
| Online Access: | https://beta.karger.com/Article/FullText/533475 |
| _version_ | 1797626815915753472 |
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| author | Jakob Lillemoen Drivenes Mette Ramsing Anette Bygum |
| author_facet | Jakob Lillemoen Drivenes Mette Ramsing Anette Bygum |
| author_sort | Jakob Lillemoen Drivenes |
| collection | DOAJ |
| description | Fungal infections can be challenging to diagnose, but doctors of every specialty may encounter this issue. They can be mistaken for other common dermatoses such as eczema or psoriasis and inadvertently be treated with topical corticosteroids or calcineurin inhibitors. This may lead to tinea incognita, a term used to describe a fungal infection with an altered clinical appearance, which may confuse the clinician even further. This case report presents a 54-year-old previously healthy man with a 4-month history of a painful and pruritic rash in the genitoinguinal region. The patient’s general practitioner had unsuccessfully attempted to treat the rash with topical terbinafine, econazole-triamcinolone, and betamethasone-fusidic acid, in addition to peroral dicloxacillin capsules. On examination, there were multiple red-bluish nodules and pustules coalescing into infiltrating erythematous plaques on both thighs and in the pubic region. Fungal cultures were negative, but the clinical features together with the history of prolonged use of combined topical steroids and antifungals raised suspicion of a deep fungal infection. Histopathological skin examination revealed deep suppurative and granulomatous folliculitis with ruptured hair follicles which was consistent with a diagnosis of Majocchi’s granuloma. Treatment with itraconazole capsules was initiated, and after a 16-week course of systemic antifungal therapy, the rash resolved. In conclusion, our case report presents a case of Majocchi’s granuloma, which is a great mimicker, especially for non-dermatologists. It is therefore important that the diagnosis is considered as a differential diagnosis, even though a patient has previously been treated with a topical antifungal. |
| first_indexed | 2024-03-11T10:15:33Z |
| format | Article |
| id | doaj.art-360569638b1b444e88b3d3e017672159 |
| institution | Directory Open Access Journal |
| issn | 1662-6567 |
| language | English |
| last_indexed | 2024-03-11T10:15:33Z |
| publishDate | 2023-10-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Dermatology |
| spelling | doaj.art-360569638b1b444e88b3d3e0176721592023-11-16T07:58:20ZengKarger PublishersCase Reports in Dermatology1662-65672023-10-0115119019310.1159/000533475533475Majocchi’s Granuloma – The Great Mimicker: A Case ReportJakob Lillemoen Drivenes0Mette Ramsing1Anette Bygum2Skin Clinic, Kolding, DenmarkDepartment of Pathology, Vejle Hospital, Vejle, DenmarkSkin Clinic, Kolding, DenmarkFungal infections can be challenging to diagnose, but doctors of every specialty may encounter this issue. They can be mistaken for other common dermatoses such as eczema or psoriasis and inadvertently be treated with topical corticosteroids or calcineurin inhibitors. This may lead to tinea incognita, a term used to describe a fungal infection with an altered clinical appearance, which may confuse the clinician even further. This case report presents a 54-year-old previously healthy man with a 4-month history of a painful and pruritic rash in the genitoinguinal region. The patient’s general practitioner had unsuccessfully attempted to treat the rash with topical terbinafine, econazole-triamcinolone, and betamethasone-fusidic acid, in addition to peroral dicloxacillin capsules. On examination, there were multiple red-bluish nodules and pustules coalescing into infiltrating erythematous plaques on both thighs and in the pubic region. Fungal cultures were negative, but the clinical features together with the history of prolonged use of combined topical steroids and antifungals raised suspicion of a deep fungal infection. Histopathological skin examination revealed deep suppurative and granulomatous folliculitis with ruptured hair follicles which was consistent with a diagnosis of Majocchi’s granuloma. Treatment with itraconazole capsules was initiated, and after a 16-week course of systemic antifungal therapy, the rash resolved. In conclusion, our case report presents a case of Majocchi’s granuloma, which is a great mimicker, especially for non-dermatologists. It is therefore important that the diagnosis is considered as a differential diagnosis, even though a patient has previously been treated with a topical antifungal.https://beta.karger.com/Article/FullText/533475majocchi’s granulomatinea incognitafungal infectionitraconazoletinea incognito |
| spellingShingle | Jakob Lillemoen Drivenes Mette Ramsing Anette Bygum Majocchi’s Granuloma – The Great Mimicker: A Case Report Case Reports in Dermatology majocchi’s granuloma tinea incognita fungal infection itraconazole tinea incognito |
| title | Majocchi’s Granuloma – The Great Mimicker: A Case Report |
| title_full | Majocchi’s Granuloma – The Great Mimicker: A Case Report |
| title_fullStr | Majocchi’s Granuloma – The Great Mimicker: A Case Report |
| title_full_unstemmed | Majocchi’s Granuloma – The Great Mimicker: A Case Report |
| title_short | Majocchi’s Granuloma – The Great Mimicker: A Case Report |
| title_sort | majocchi s granuloma the great mimicker a case report |
| topic | majocchi’s granuloma tinea incognita fungal infection itraconazole tinea incognito |
| url | https://beta.karger.com/Article/FullText/533475 |
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