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Tinea corporis gladiatorum presenting as a majocchi granuloma
1Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada L8S 4L8.
Abstract:
Background. Wrestlers are at increased risk of developing cutaneous infections, including fungal infections caused by dermatophytes. Erythematous lesions due to tinea infections can be mistakenly diagnosed as an inflammatory dermatitis and incorrectly treated with potent topical corticosteroid treatments which cause localized skin immunosuppression. This can eventuate in a Majocchi granuloma which then becomes refractory to topical antifungal therapy. To our knowledge, this is the first case of tinea corporis gladiatorum presenting as a Majocchi granuloma. Observations. A 20-year-old wrestler presented with a 4-year history of a large pruritic, scaly erythematous plaque with follicular papules, and pustules on his right forearm. The lesion had the clinical appearance of a Majocchi granuloma. He had been treated with potent topical corticosteroids and topical antifungal therapy. KOH and fungal culture of the lesion were negative. An erythematous scaly lesion in the scalp was cultured and grew Trichophyton tonsurans. Oral Terbinafine therapy was initiated and complete resolution of both lesions occurred within 6 weeks. Conclusion. The purpose of this report is to inform dermatologists that tinea corporis gladiatorum can present as a Majocchi granuloma and needs to be considered in the differential diagnosis of persistent skin lesions in wrestlers.
Insights
Wrestlers can develop Majocchi granuloma from tinea corporis gladiatorum, a fungal infection often misdiagnosed. Early diagnosis and oral antifungal treatment are crucial for resolving these persistent skin lesions.
Area of Science:
- Dermatology
- Mycology
- Sports Medicine
Background:
- Wrestlers are prone to dermatophyte fungal infections.
- Tinea infections can be misdiagnosed as inflammatory dermatitis.
- Misdiagnosis leads to topical corticosteroid use, causing immunosuppression and potential Majocchi granuloma.
Observation:
- A 20-year-old wrestler presented with a 4-year history of a pruritic, scaly, erythematous plaque with follicular papules and pustules.
- The lesion clinically resembled Majocchi granuloma and was refractory to topical treatments.
- Scalp culture revealed Trichophyton tonsurans, confirming a fungal etiology.
Findings:
- This is the first reported case of tinea corporis gladiatorum presenting as Majocchi granuloma.
- Despite negative initial lesion cultures, oral Terbinafine resolved both forearm and scalp lesions within 6 weeks.
Implications:
- Dermatologists should consider tinea corporis gladiatorum in the differential diagnosis of Majocchi granuloma in wrestlers.
- Prompt diagnosis and appropriate oral antifungal therapy are essential for managing these complex fungal infections.
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