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Trichophyton mentagrophytes-associated Majocchi's granuloma treated with cryotherapy.
MedLine Citation:
PMID:  23042284     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
We here report the case of a woman with dermatophytosis of the thighs due to Trichophyton mentagrophyteswhere an unusual clinical picture posed considerable diagnostic and therapeutic problems. She presented numerousskin lesions located on the dorsolateral face of the left thigh and the medial surface of the right calf. The initial lesionsconsisted of small itchy pustules that evolved to exfoliation after scratching. Results of histopathologic examination ofa skin biopsy were consistent with dermatophytosis, although the negativity of PAS staining did not allow confirmationof this diagnosis. Direct microscopic examination with 10% KOH was negative; however, skin cultures on BioMerieuxmedia revealed Tr. Mentagrophytes. Following the diagnosis of Trichophyton infection, the patient was treated witha combination of isoconazole nitrate and difluocortolone valerate. After therapy, both direct microscopic mycologicexamination and culture on BioMerieux medium were negative; however, the lesions persisted, assuming a completelydifferent aspect. Cryotherapy with liquid nitrogen was started. This led to a spectacular improvement: the surface ofthe skin became almost normal, merely showing slight discoloration. An unusual clinical presentation and non-responsivenessto treatment should prompt revision of the primary diagnosis. A negative result of direct microscopyshould not exclude the diagnosis of dermatophytosis. Cryotherapy should be considered in cases that do not respondto conventional antifungal medication.
Authors:
Aldona Pietrzak; Krzysztof Tomasiewicz; Jean Kanitakis; Tomasz Paszkowski; Ewa Dybiec; Helena Donica; Agnieszka Wójtowicz; Piotr Terlecki; Grażyna Chodorowska
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Publication Detail:
Type:  Journal Article     Date:  2012-10-08
Journal Detail:
Title:  Folia histochemica et cytobiologica / Polish Academy of Sciences, Polish Histochemical and Cytochemical Society     Volume:  50     ISSN:  1897-5631     ISO Abbreviation:  Folia Histochem. Cytobiol.     Publication Date:  2012  
Date Detail:
Created Date:  2012-10-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8502651     Medline TA:  Folia Histochem Cytobiol     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  486-9     Citation Subset:  IM    
Affiliation:
. aldonkapietrzak2@o2.pl.
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