Clinical and histopathologic findings of dermatophytic granulomas

Kim, Kwang; Chae, Young Soo; Suh, Kee Suck; Kim, Sang Tae

Abstract

We reviewed the cliniccipat.hologic findings of 11 cases of dermatophytic granulomas. Patients consisted of 8 male and 3 females with a mean age of 45 years (range 5-80 years). The symptom was neither painful nor pruritic except one case. Skin lesions mimicked tuberculosis (2 cases), sporotriehosis (2 cases), calcinosis cutis (1 case) or eczema (1 case). The commonest sites involved were upper extremities, followed by legs, cace and scalp. The duration between the onset of the diseases and final diagnosis ranged 1 month to 3 years. Possible predisposing factors causing dermatophytic granulomas appeared to be due to application of steroid ointment (6 cases), diabetes mellitus (2 cases) and trauma (1 case). Histopathologic featured revealed suppurative folliculitis with fo eign body granuloma in most cases and lobular ponniculitis in 2 cases. With PAS and methenamine silver stains, hyphae and spores could be identified on the horny layers, within hair follicles and/or on the dermis in biopsy specimen.', of all cases. Culture of the causativi; organisms using dermal fragment on abouraud media demon-strated T. rubrum in seven patients and M. canis in two. A test for recall antigen(Multitest CMI) showed suppression of cellular immunity in 3 cases. Treatment with griseofulvin or ketoconazole for 2-10 weeks was effective except one case.