Trichophytic granuloma

Also known as Majocchi granuloma.

A deep suppurative and granulomatous folliculitis due to a cutaneous dermatophyte infection with organisms including Trichophyton mentagrophytes, Trichophyton violaceum, Microsporrum audouinii, Microsporum gypsum, Microsporum f2242igineum, Micrsporum canis and most commonly T rubrum.

Two clinical forms: follicular and subcutaneous nodular.

Follicular type occurs primarily in young women who shave their legs.

Subcutaneous nodular type lesions typically occur in immunocompromised patients.

Differential diagnosis includes histiocytosis, cutaneous lymphoma, or Kaposi’s sarcoma.

Biopsy is essential for diagnosis.

Effective treatment includes allylamines terbinafine and butenafine and azoles.

Oral ketocanizole, and intraconazole, voriconazole, and posaconazole are effective.

Treatment required for a minimum of 4-6 weeks, or until all lesions have resolved.

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