Premium
Trichophytic Majocchi granuloma mimicking Kaposi sarcoma
Author(s) -
Brod Corinna,
Benedix Frauke,
Röcken Martin,
Schaller Martin
Publication year - 2007
Publication title -
jddg: journal der deutschen dermatologischen gesellschaft
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 60
eISSN - 1610-0387
pISSN - 1610-0379
DOI - 10.1111/j.1610-0387.2007.06283.x
Subject(s) - trichophyton rubrum , medicine , terbinafine , tacrolimus , pathology , biopsy , immunosuppression , prednisolone , sarcoma , granuloma , dermatology , skin biopsy , transplantation , antifungal , surgery , itraconazole , immunology
Summary A 68‐year‐old man presented with a one month history of painful blue‐red papules and nodules on an erythematous base on the top of his feet, as well as dystrophic toenails. He had undergone renal transplantation six months previously for membranous glomerulonephritis, and was immunosuppressed with tacrolimus 3 g, mycophenolate mofetil 1500 mg and prednisolone 5 mg daily. His tacrolimus level was 29.8 ng/ml (expected level 6–8 ng/ml). Even though the cutaneous lesions strongly suggested Kaposi sarcoma, the histological examination revealed a dermal abscess in which hyphae and spores were seen with PAS staining. ELISA‐PCR of the biopsy identified Trichophyton rubrum , which was also grown on culture of the biopsy tissue. The diagnosis of Majocchi granuloma secondary to excessive immunosuppression was made. Systemic treatment with terbinafine 250 mg per day and topical ciclopirox olamine completely cured the granulomatous skin lesions, and later the nails.