Painless rash in a transplant patient

Area of Science:

• Medical Mycology
• Infectious Diseases
• Dermatology

Background:

• Dermatophytes cause superficial skin infections.
• Deep dermatophytosis is a rare invasive form seen in immunocompromised individuals.

Observation:

• A 65-year-old liver transplant recipient presented with painless, erythematous, umbilicated papules on the lower limbs.
• Skin biopsy revealed dermal non-necrotizing granulomatous inflammation surrounding fungal elements.

Findings:

• The causative agent was identified as Trichophyton rubrum.
• Identification was confirmed through fungal culture and internal transcribed spacer sequencing.

Implications:

• This case highlights the risk of deep dermatophytosis in immunocompromised patients post-transplant.
• Early diagnosis and identification of the fungal species are crucial for managing invasive infections.