Subcutaneous <i>Trichophyton rubrum </i>Abscesses

Abstract

A patient had the sudden onset of multiple deep subcutaneous abscesses from which Trichophyton rubrum was isolated. The clinical history and physical findings of the patient suggested that the abscesses were the result of hematologic spread rather than by the usual penetration of the dermatophyte through the epidermis and the pilosebaceous appendage.

Majocchi's granuloma

“…7). have also been reported as causative organisms, and in the experience of one of us (JHG), Majocchi's granuloma can also be caused by T. verrucosum and T. tonsurans (7)(8)(9)(10)(11)(12). In most cases, the source of infection is probably the skin of the patient.…”

Multiple Subcutaneous Trichophyton rubrum Abscesses-a Case Report and Review of the Japanese Literature Multiple subkutane Trichophyton-rubrum-Abszesse - Fallbericht und Übersicht über die japanische Literatur

“…They believed that this unusual type of dermatophytosis shared some characteristics with the maladie dermatophytiqes of Hadida and Shousboe, but it could be distinguished both clinically and histologically from granuloma trichophyticum Majocchi, tinea granulomatosa nodularis cruris and acute suppurative dermatophytosis of the Kerion Celsi type. They also recorded five cases from the world literature (3)(4)(5)(6) and summarized the characteristic findings as follows: 1) Development under the influence of any disease with mykosen 24, Heft 10 (1981) immunological paralysis or long term treatment of corticosteroids or immunosuppresants, 2) The fmdings of large subcutaneous abscess formation, which was not associated with follicular dermatophyte infection and showed distinctly growth of hyphae, 3) The fungus was Trichophyton rubrum, not considered to be a typical cause of suppurative dermatophytosis. Recently Swart and Smit (2) also reported two cases ofdeep cold abscesses due to T. violaceum with suppressed cellular immunity and reviewed similar conditions from the literature.…”

Trichophytic Granuloma Associated with Bullous Pemphigoid

“…Bullous pemphigoid is a disease caused by autoantibody to basement membrane and immunosuppressive drugs are used for treatment (3,14); erosions or ulcers due to bullous pemphigoid as well as hair follicle injury through maceration and sweat retention caused by occlusive dressings with ointments offer good opportunities for dermatophytes to invade the dermis. A case of bullous pemphigoid complicated with trichophytic abscess has been described (5). Hematologic spread of the dermatophyte rather than penetration through the epidermis and the pilosebaceous appendage was suggested by the author.…”

“…Majocchi's granuloma and nodular granulomatous perifolliculitis are used for the localized type; widespread Trichophyton rubrum granuloma and deep generalized trichophytosis indicate generalized forms. The generalized form is often associated with underlying diseases and immunosuppressive therapy; it is controversial whether the association is coincidental (3,5,13).…”