Candida folliculitis mimicking tinea barbae

Abstract

A 55‐year‐old man, a farmer, was referred to our dermatology department in June 1993 with inflammatory and infiltrated nodular lesions on his left cheek and neck. These nodular lesions had appeared about a month previously and had enlarged quickly. He was unaware of any antecedent trauma. Physical examination revealed a painless, slightly erythematous, soft, fluctuant plaque which measured 8 cm in diameter. It consisted of follicular papules and pustules and was partially covered with brown‐black crusts (Fig. 1), Two similar plaques, 3 cm in diameter, were also detected on the neck. The regional lymph nodes were not palpable. The hair on the lesions was easily removed with a pair of forceps without causing pain. The patient had not previously had any skin disease. Laboratory investigations, including full blood count, erythrocyte sedimentation rate, serum concentrations of sodium, potassium, chloride, transaminases, alkaline phosphatase, sugar, cortisol, and renal function tests, were all normal. No fluorescence was seen on Wood's light examination. Direct microscopic examination with 15% potassium hydroxide solution revealed yeast cells and hyphae in three consecutive scrapings of the lesions. Candida albicans was isolated from the mycologic cultures; but no growth was observed in mycologic cultures of oral and anogenital mucosae swabs. Bacteriologic cultures of the lesions were also negative. A skin biopsy was performed for histologic confirmation. Examination of the biopsy specimen revealed dermal oedema and PAS(‐I‐) yeast cells among the infiltration of lymphocytes and plasma cells (Fig. 2). The patient was started on a regimen with fluconazole 100 mg once a day orally for a week, after which the dosage was decreased to 100 mg once every other day for a month. Also, the hair on the lesions was depilated. We noted a significant clinical improvement at the fifth week of the therapy (Fig. 3). Repeated mycologic examinations of the lesions were all negative even 1 month after the end of the therapy

Isotopic response of fungal granuloma following facial herpes zoster infections – report of three cases

“…Two of our patients had Candida granulomatous folliculitis, a rare disease in immunocompetent patients 9–15 . Candida is a common inhabitant of the human flora, isolated from the mouth and the intestinal tract in 50% of the general population and from the genital tract in 15–20% of women 16 .…”

“…Two of our patients had Candida granulomatous folliculitis, a rare disease in immunocompetent patients. [9][10][11][12][13][14][15] Candida is a common inhabitant of the human flora, isolated from the mouth and the intestinal tract in 50% of the general population and from the genital tract in 15-20% of women. 16 Primary candidiasis usually involves moist areas of the body, such as the oral and genital mucous membranes, intertriginous areas, and nail folds, but rarely invades the hair follicles.…”

Candida folliculitis mimicking tinea barbae

“…The present case showed both clinical and histological characteristics similar to tinea barbae. There are only 3 cases of Candida folliculitis similar to tinea barbae reported in the English literature (3,4), and all were in healthy patients. A few cases of other types of candida folliculitis, such as folliculitis simplex, acne or perioral dermatitis-like, have also been reported, some associated with other lesions or conditions (5 ± 10).…”