Deep-seated pustular Trichophyton rubrum

Invasive trichophyton rubrum infection in an immunocompromised host. Case report and review of the literature

Typically confined within the keratinized, epithelial layer of the skin and hence categorized among the dermatophytoses, Trichophyton rubrum infections usually present as superficial, scaling eruptions. In certain clinical settings, however, such as in immunosuppressed hosts, deep local invasion, multivisceral dissemination, and even death due to T. rubrum granulomas have been described. A case of multiple, subcutaneous, neutrophilic abscesses due to T. rubrum in an immunosuppressed renal allograft recipient is described. The pathogenesis, diagnosis, and immunology of invasive T. rubrum infections in immunocompromised hosts are reviewed.

Kerion of the glabrous skin

Five patients had kerion celsi on the glabrous skin. Four of these were farmers, and one was a veterinarian. The lesions occurred on the distal part of the forearm of four patients and in the breast area of one patient, most occurring during the spring months. Several of the lesions were misdiagnosed as bacterial infections or nondermatophytic fungal infections and were treated as such. Our report calls attention to this atypical form of localized inflammatory infection caused by tinea.

Trichophyton violaceum abscesses

Two patients with deep cold abscesses due to Trichophyton violaceum are described. Both have depressed cellular immunity.