Trichophyton rubrum-induced Majocchi’s Granuloma in a heart transplant recipient. A therapeutic challenge.

Steiner, Urs; Trüeb, Ralph M.; Schad, Karin; Kamarashev, Jivko; Koch, Simon; French, Lars E.; Hofbauer, Günther F.L.

doi:10.3315/jdcr.2012.1105

Cited by 28 publications

(21 citation statements)

References 4 publications

(5 reference statements)

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“…Other predisposing factors include shaving legs (presumably related to injury of hair follicles) and, thus, the development of tinea. MG is also associated in transplanted patients (the most commonly associated was renal transplant, followed by heart and liver) [14,[27][28][29][30][31] and in cases of idiopathic interstitial lung disease, Behcet's syndrome, rheumatoid arthritis, systemic lupus erythematosus, bullous pemphigoid, and immunosuppressant therapy; the failure of the mechanism of cell-mediated immunity can be related to AIDS and atopic dermatitis. The association of MG with tinea has been observed in many patients, agreeing on the same etiologic agents.…”

Section: Etiologic Agentsmentioning

confidence: 99%

Majocchi’s Granuloma (Dermatophytic Granuloma): Updated Therapeutic Options

Tirado‐Sánchez

Ponce-Olivera

Bonifáz

2015

Curr Fungal Infect Rep

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Majocchi's granuloma (MG) is a rare, well-recognized, deep skin infection caused by dermatophyte, which can be seen in immunosuppressed as well as immunocompetent individuals. It is primarily caused by dermatophytes, most commonly Trichophyton rubrum; however, occasionally other Trichophyton sp., Trichosporon sp., Aspergillus sp., and Phoma sp. are involved. Diagnosis is based on clinical, mycological, and histological characteristics. This review focuses on clinical characteristics of MG and diagnosis and therapeutic options of MG.

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Section: Etiologic Agentsmentioning

confidence: 99%

Majocchi’s Granuloma (Dermatophytic Granuloma): Updated Therapeutic Options

Tirado‐Sánchez

Ponce-Olivera

Bonifáz

2015

Curr Fungal Infect Rep

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“…First described by Professor Domenico Majocchi as granuloma tricofitico in 1883, nowadays Majocchi granuloma is defined as a deep folliculitis, caused by dermatophyte infection . Although, the most commonly isolated causative agent is Trichophyton rubrum, numerous different dermotophytes are reported in association with this condition, including Trichophyton mentagrophytes, Trichophyton violaceum, and Epidermophyton floccosum . A precursory trauma on the skin, as shaving or waxing or disruption of hair follicles and transfer of the dermatophyte into the dermis, as a result of folliculate occlusion could be a predisposing factor .…”

Section: Introductionmentioning

confidence: 99%

Tinea profunda of the genital area. Successful treatment of a rare skin disease

Bakardzhiev

Chokoeva²,

Tchernev

et al. 2015

Dermatologic Therapy

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We present a rare case of 36-year-old female patient, who developed a severe Majocchi granuloma in the pubis after waxing, with isolated causative agent Trichophyton mentagrophytes. The condition was initially misdiagnosed as a bacterial folliculitis and treated unsuccessfully with topical corticosteroids and antibiotics. After the adequate diagnose was confirmed by mycological examination, followed by histopathological verification, complete remission of the symptoms was achieved at the 4th week after initiating 6 weeks course of antifungal therapy with Terbinafine 250 mg/daily dose, while good therapeutic response was observed even in the 10th day. The etiopathogenesis of the disease, as well as its current treatment options are considered, in respect to the rare occurrence of this condition in the pubic area and its frequent misdiagnosis.

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“…The superficial perifollicular form usually occurs in immunocompetent individuals with chronic dermatophytosis, and local trauma may be the initiating factor [1,22]. The deep nodular form, however, is usually seen in immunocompromised individuals, such as patients taking immunosuppressive agents for post-organ transplantation [25,26]. The deep nodular form found in immunocompetent individuals (Cases 8, 23, and present case) suggests the exception.…”

Section: Discussionmentioning

confidence: 60%

Successful Treatment of Refractory Majocchi’s Granuloma with Voriconazole and Review of Published Literature

Liu

Kong

et al. 2015

Mycopathologia

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Majocchi's granuloma (MG) is a rare deep skin dermatophyte infection that can occur either in immunocompetent or in immunocompromised individuals. Oral itraconazole or terbinafine is considered to be the first choice of treatment. We report an immunocompetent man with deep nodular form of MG, the form which is generally found in immunosuppressed individuals. Previous treatment with either oral itraconazole or terbinafine yielded no apparent improvement. After a series of examination, the man was diagnosed as having Trichophyton rubrum-induced MG mixed with bacterial infection as evidenced by growth of Klebsiella pneumoniae in tissue bacterial culture. The patient was treated with a combination of cefoselis and levofloxacin for bacterial clearance followed by voriconazole treatment. After approximately 4 months of voriconazole treatment, the lesions completely resolved. Alternative medicine (voriconazole) can be considered in case of refractory infections during MG treatment.

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Trichophyton rubrum-induced Majocchi’s Granuloma in a heart transplant recipient. A therapeutic challenge.

Abstract: In patients with Trichophyton rubrum infections, refractory to itraconazole treatment, altered drug absorption or drug interactions has to be considered. Careful monitoring and adjustment of itraconazole is of vital importance.

Cited by 28 publications

References 4 publications

Majocchi’s Granuloma (Dermatophytic Granuloma): Updated Therapeutic Options

Majocchi’s Granuloma (Dermatophytic Granuloma): Updated Therapeutic Options

Tinea profunda of the genital area. Successful treatment of a rare skin disease

Successful Treatment of Refractory Majocchi’s Granuloma with Voriconazole and Review of Published Literature

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