[Tinea follicularis presenting as trichophytic Majocchi granuloma]

We report on a 75 year old patient with a bronchial asthma treated at least for 15 years with low dose prednisolone. Under this treatment he developed a tinea follicularis and was demonstrated in our clinic with papulopustular skin lesions on both forearms, left malleolus and left thigh. We saw tender to touch granulomata on erythematosquamous atrophic skin. A dermatomycosis was diagnosed by isolation and identification of Trichophyton rubrum. In addition the onychomycosis of all finger- and footnails was caused by T. rubrum. Clinical and accessory clinical findings (histology) agreed with a 1883 described disease, granuloma trichophyticum Majocchi. An internal treatment with terbinafine 250 mg/d and topical with tioconazole cream completely cured the skin lesions and the nails.