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Majocchi's Granuloma: A Rare Form of Tinea Corporis in an Immunocompetent Adolescent

Ariana Tavares¹, Inês Azevedo², Miguel Costa², Diogo Teixeira³
¹Department of Pediatrics, Unidade Local de Saúde Gaia/ Espinho in Vila Nova de Gaia, Portugal, ²Department of Pediatrics, Unidade Local de Saúde Entre Douro e Vouga in Santa Maria da Feira, Portugal, ³Department of Dermatology, Unidade Local de Saúde Gaia/ Espinho in Vila Nova de Gaia, Portugal

Address for Correspondence: Rua Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia. Email: ariana_tavares@hotmail.com

Keywords: Majocchi Granuloma, Dermatophytosis, Terbinafine, Majocchi's Granuloma

Clinical Problem:
A 17-year-old female adolescent, previously healthy, was evaluated in pediatric consultation for an erythematous desquamative lesion on the lateral aspect of the right leg, associated with pruritus and pain, with approximately 1 month of evolution. She had previously received systemic corticosteroids and topical antifungal treatment without improvement and subsequently, amoxicillin with clavulanic acid without resolution. Physical examination revealed an erythematous-violaceous plaque with exudative crust and purulent drainage (Figure 1). She was referred to dermatology consultation where a skin biopsy was performed. Histopathological examination showed marked lymphohistiocytic inflammatory infiltrate with abundant neutrophils in the deep dermis and hypodermis. Mycological examination confirmed growth of Trichophytum mentagrophytes, leading to the diagnosis of tinea corporis variant Majocchi's Granuloma (MG). Treatment was initiated with terbinafine 250 mg once daily orally and ciclopirox cream for 6 weeks, with progressive resolution of the lesion. Three months after the end of therapy, only a scar lesion remained (Figure 2).

Figure 1. Erythematoviolaceous plaque with exudative crust and purulent drainage prior to treatment.