Dermatophytic Pseudomycetoma of the Scalp

Area of Science:

• Dermatology
• Mycology
• Pathology

Background:

• Dermatophytic pseudomycetoma is a chronic fungal infection distinct from mycetoma.
• It presents as tumor-like dermal growths composed of dermatophytes arranged in grains.
• Unlike mycetomas, pseudomycetomas lack sinus tracts and commonly affect the scalp.

Observation:

• A case of dermatophytic pseudomycetoma on the scalp of an 18-year-old African-American woman is presented.
• Histopathology revealed a dense mixed-cell infiltrate with numerous dermal grains.
• No sinus tracts were observed, but grains were present on the epidermal surface with serum crust.

Findings:

• The histopathologic findings confirmed dermatophytic pseudomycetoma.
• The absence of sinus tracts and presence of dermal grains were key diagnostic features.
• The superficial presence of grains suggests potential for spread or diagnostic artifact.

Implications:

• Accurate diagnosis of dermatophytic pseudomycetoma via biopsy is critical.
• Distinguishing pseudomycetoma from mycetoma is important for treatment planning.
• Surgical intervention may be a necessary component of treatment for this condition.