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Majocchi's Granuloma


Presentation

  • In both healthy individuals and immunocompromised hosts, MG often presents as nodules, plaques, and papules on areas that are prone to trauma.[ncbi.nlm.nih.gov]
  • General observations are presented emphasizing the relevance of close clinical and dermatologic follow-up in high-risk SOT patients with specific comments regarding treatment regimens and outcomes.[ncbi.nlm.nih.gov]
  • Pustules may also be present. 5 Immunocompromised patients may present similar symptoms as immunocompetent patients or with subcutaneous nodules and abscesses. 6 - 8 Trauma is also considered an incitation factor in these cases.[doi.org]
  • In this case report, a renal transplant patient with coexisting Trichophyton rubrum granuloma (Majocchi's granuloma) and posttransplant lymphoproliferative disease (PTLD) is presented, showing the undesirable effects of heavy immunosuppression.[ncbi.nlm.nih.gov]
  • Majocchi's granuloma (MG) is an atypical and uncommon presentation of dermatophytic infection involving the invasion of dermal and subcutaneous tissue by fungal organisms.[ncbi.nlm.nih.gov]
Inguinal Lymphadenopathy
  • In addition, inguinal lymphadenopathy and a fever of 38.3 C were present. History revealed that the patient used to shave this area during the past years.[karger.com]
Sputum
  • Sputum cultures grew Pseudomonas species. Blood and urine cultures were negative. Lactate dehydrogen- ase level was raised (1404 U L; normal 90–190). Clinical suspicion of human immunodeficiency infection was confirmed by ELISA.[de.slideshare.net]
Periodontitis
  • […] normal but is actually elastotic. benign granuloma of thyroid chronic inflammation of the thyroid gland, converting it into a bulky tumor that later becomes extremely hard. dental granuloma one usually surrounded by a fibrous sac continuous with the periodontal[medical-dictionary.thefreedictionary.com]
Leukonychia
  • Nail changes including nail pitting, leukonychia, oil stains, distal ungual crumbling, and subungual hyperkeratosis were also found (Figure 1A).[journals.lww.com]

Workup

  • In severe or recurrent cases, further workup may also be required. Oral antifungal medications are the standard of care of majocchi's granuloma.[en.wikipedia.org]
  • What was missing from this patient’s workup was a definitive diagnosis, which could have been obtained with a biopsy, culture or KOH preparation to identify fungal elements.[clinicaladvisor.com]
Alternaria
  • Keratinous material that is introduced into the dermis after follicular disruption can potentially provide a substrate for dermatophytic fungi; however, this should not affect non-dermatophytic molds, such as those of the Alternaria and Aspergillus genera[doi.org]
Calymmatobacterium Granulomatis

Treatment

  • It is important to perform a thorough examination for latent dermatophyte infection, including skin and nail lesions, before treatment with TNF-alpha inhibitors and during traditional psoriasis treatment.[ncbi.nlm.nih.gov]
  • Previous treatment with either oral itraconazole or terbinafine yielded no apparent improvement.[ncbi.nlm.nih.gov]
  • These data suggest that itraconazole pulse therapy should be effective in the treatment of tinea capitis.[ncbi.nlm.nih.gov]
  • After confirmed as Majocchi's granuloma, the patient was cured after 11-month treatment with terbinafine.[ncbi.nlm.nih.gov]
  • Treatment with oral Griseofulvin was successful.[doi.org]

Prognosis

  • However, there are only a few reports in the literature of facial involvement. [2], [3], [4] The prognosis of MG can be regarded as good, because there is effective pharmacotherapy available for it.[ijdvl.com]
  • A patient was recently described in Brazil. [2] Prognosis Majocchi granuloma cure is expected with appropriate systemic antifungal therapy.[emedicine.medscape.com]

Etiology

  • Although primarily caused by keratinophilic dermatophytes such as anthropophilic Trichophyton rubrum, species from the Aspergillus and Phoma genera have been occasionally detected as etiologic agents of MG.[ncbi.nlm.nih.gov]
  • Onychomycosis - Etiology en_US dc.subject.mesh Tinea - Etiology en_US dc.subject.mesh Tinea Pedis - Etiology en_US dc.title Majocchi's granuloma and posttransplant lymphoproliferative disease in a renal transplant recipient. en_HK dc.type Article en_HK[hub.hku.hk]
  • Epidemiology Commonly occurs in young women that shave their legs frequently Etiology Linked to Trichophyton Rubrum infection, also occurs when potent topical steroids are used on unsuspected tinea Pathogenesis Begins as a suppurative folliculitis and[dermpathdiagnostics.com]
  • Table 3 Etiologic agent of 79 cases of Majocchi’s granuloma and their frequency.[doi.org]

Epidemiology

  • It provides a comprehensive review of the epidemiology, diagnosis, and management of opportunistic infections and presents strategies for infection prevention and control.[books.google.com]
  • Epidemiology Commonly occurs in young women that shave their legs frequently Etiology Linked to Trichophyton Rubrum infection, also occurs when potent topical steroids are used on unsuspected tinea Pathogenesis Begins as a suppurative folliculitis and[dermpathdiagnostics.com]
  • Updates on the epidemiology of dermatophyte infections. Mychopathologia 2008;166:335-52. 20. Gupta AK, Groen K, Woestenborghs R, De Doncker P.[degruyter.com]
  • Epidemiological trends in skin mycoses worldwide. Mycoses. 2008;51:2–15. CrossRef Google Scholar 2. Gong JQ, Liu XQ, Xu HB, Zeng XS, Chen W, Li XF. Deep dermatophytosis caused by Trichophyton rubrum : report of two cases. Mycoses. 2007;50:102–8.[link.springer.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology The pathophysiology of the fungal infection and defense mechanisms against superficial dermatomycosis has been studied. [7] Two series of experimental infections of T mentagrophytes were made on the forearm of a male volunteer with topical[emedicine.medscape.com]
  • Pathophysiology The pathophysiology of the fungal infection and defense mechanisms against superficial dermatomycosis has been studied. [6] Two series of experimental infections of T mentagrophytes were made on the forearm of a male volunteer with topical[emedicine.medscape.com]
  • [The pathophysiology and defense mechanism against superficial and subcutaneous fungal infection]. Nippon Ishinkin Gakkai Zasshi. 2005. 46(1):5-9. [Medline]. Arenas R, Toussaint S, Isa-Isa R. Kerion and dermatophytic granuloma.[emedicine.medscape.com]

Prevention

  • Abstract BACKGROUND: Solid organ transplant recipients are at an increased risk for infections because of long-term immunosuppression to prevent graft rejection.[zora.uzh.ch]
  • It provides a comprehensive review of the epidemiology, diagnosis, and management of opportunistic infections and presents strategies for infection prevention and control.[books.google.com]
  • Hofbauer Abstract Background: Solid organ transplant recipients are at an increased risk for infections because of long-term immunosuppression to prevent graft rejection.[jdcr.eu]
  • There is no known preventive for granuloma inguinale, although it is rare where sanitary living conditions prevail. The drainage from lesions may be infectious and handwashing and basic cleanliness are required.[medical-dictionary.thefreedictionary.com]

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