Lupus-erythematosus-Like Eruption Induced by <i>Trichophyton mentagrophytes</i> Infection

Abstract

Background: Several factors are known to trigger acute manifestations of lupus erythematosus (drugs, ultraviolet radiation, bacterial or viral infections, pregnancy), but fungal infections have never been reported to induce lupus-like lesions. We describe 2 children with tinea capitis caused by Trichophyton mentagrophytes (TM), who developed transient skin and serological manifestations of systemic lupus erythematosus. Patients: Case 1, a 3-year-old girl, had a kerion due to TM transmitted by an octodon, and a facial skin eruption suggestive of systemic lupus erythematosus. Antinuclear antibodies (ANA) were positive at 1:250. After griseofulvin treatment, the lupus-like rash completely regressed, and the ANA titre decreased. Case 2, a 4-year-old girl, had occipital kerion and an annular scaly erythema on the shoulder caused by TM. She also had a non-scaly rash on the face and a recent history of photosensitivity. The ANA titre was positive at 1:8,000. Cutaneous lesions disappeared after an 8-week griseofulvin therapy, and ANA titres decreased progressively. Conclusions: ‘New pets’ are usually the vectors of TM, especially familiar rodents like the degu of Chile (also named octodon). In our 2 cases, lupus-like rashes began before the onset of griseofulvin treatment, suggesting a pathogenic role of the dermatophyte. A wide variety of lesions named ‘mycides’ was described several decades ago associated with TM infections. We hypothesize that these mycides and the TM-induced lupus-like lesions reported in our 2 cases could represent the same entity.

The unprecedented epidemic-like scenario of dermatophytosis in India: I. Epidemiology, risk factors and clinical features

“…This is characterized by annular lesions with raised, vesicular edges. 45 Superficial dermatophytosis mimicking other dermatological conditions Tinea has been observed to mimic a wide variety of conditions including lupus erythematosus, 46 psoriasis, lichenoid lesions, atopic eczema, 47 nummular eczema, erythema multiforme, 48 granuloma annulare, granuloma faciale, lymphocytic infiltration of the skin, pityriasis rosea, seborrheic dermatitis, 49 leprosy, 50 molluscum contagiosum, 51 rosacea 52 and annular secondary syphilis, 37 pustular psoriasis, Sweet's syndrome and impetiginized herpes. 53 Cutaneous dermatophytosis caused by Trichophyton mentagrophytes mimicking bullous pemphigoid clinically, histopathologically and on direct immunofluorescence has been recently reported.…”

Management of tinea capitis in childhood

“…Due to electrostatic attraction, plastic boxes are unsuitable, so specimens have to be collected in sterile glass containers. 12,13 Toothbrush culture sampling is largely of value for scaly lesions and consists of rubbing a sterilized toothbrush over the suspected areas.…”

Studies on invasive keratinophilic Dermatophytes of human hair

“…These dermatophytes can be transmitted from person to person and through fomites. [12][13][14] The clinical presentation of the disease varies depending on the aetiological agent and type of hair invasion, the level of host resistance and the degree of inflammatory host response. [15][16][17][18] There are three main clinical forms: a) tinea capitis superficialis (noninflammatory form), b) tinea capitis profunda (inflammatory form), and c) tinea capitis favosa (favus) .The noninflammatory form may have a variety of clinical patterns, ranging from diffuse scaling to black dot alopecia.…”