Majocchi Granuloma Treatment & Management

  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD   more...
 
Updated: May 27, 2011
 

Medical Care

Systemic antifungal treatment is preferred in both patients who are immunocompetent and in those who are immunocompromised. Treatment should last at least 4-6 weeks. For example, the administration of systemic terbinafine for 6 weeks is the best treatment option in a patient with a transplanted kidney and Majocchi granuloma.

Oral antifungals are usually necessary because topical agents alone are not effective. For example, systemic antifungal medication is the best option for patients who are immunocompromised.

Physicians should avoid the use of compound products containing a potent topical steroid (see Medical/Legal Pitfalls). To the authors' knowledge, no specific data about treating immunocompromised patients with Majocchi granuloma exist. The treatment of secondary bacterial infections and the removal of any exacerbating factors (eg, topical steroid use, occlusion) are indicated.

Proceed to Medication
 
 
Contributor Information and Disclosures
Author

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Coauthor(s)

Camila K Janniger, MD  Clinical Professor of Dermatology, Clinical Associate Professor of Pediatrics, Chief of Pediatric Dermatology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Camila K Janniger, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

David P Fivenson, MD  Associate Director, St Joseph Mercy Hospital Dermatology Program, Ann Arbor, Michigan

David P Fivenson, MD is a member of the following medical societies: American Academy of Dermatology, Medical Dermatology Society, Michigan Dermatological Society, Michigan State Medical Society, Photomedicine Society, Society for Investigative Dermatology, and Wound Healing Society

Disclosure: Nothing to disclose.

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Lester F Libow, MD  Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Texas Medical Association

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

  1. Wilson JW, Plunkett OA, Gregersen A. Nodular granulomatous perifolliculitis of the legs caused by Trichophyton rubrum. AMA Arch Derm Syphilol. Mar 1954;63(3):258-77. [Medline].

  2. Coelho WS, Diniz LM, Sousa Filho JB, Castro CM. [Case for diagnosis. Granuloma trichophyticum (Majocchi's granuloma)]. An Bras Dermatol. Jan-Feb 2009;84(1):85-6. [Medline].

  3. Majocchi D. Sopra una nuova trichofizia (granuloma tricofitico): Studi clinici e micologici. [A new trichophyton granuloma: Clinical and mycological studies]. Bull R Acad Med Roma. 1883.

  4. Nakajima H. [The pathophysiology and defense mechanism against superficial and subcutaneous fungal infection]. Nippon Ishinkin Gakkai Zasshi. 2005;46(1):5-9. [Medline].

  5. Arenas R, Toussaint S, Isa-Isa R. Kerion and dermatophytic granuloma. Mycological and histopathological findings in 19 children with inflammatory tinea capitis of the scalp. Int J Dermatol. Mar 2006;45(3):215-9. [Medline].

  6. Tateishi Y, Sato H, Akiyama M, et al. Severe generalized deep dermatophytosis due to Trichophyton rubrum (trichophytic granuloma) in a patient with atopic dermatitis. Arch Dermatol. May 2004;140(5):624-5. [Medline].

  7. Cho HR, Lee MH, Haw CR. Majocchi's granuloma of the scrotum. Mycoses. Nov 2007;50(6):520-2. [Medline].

  8. Brod C, Benedix F, Rocken M, Schaller M. Trichophytic Majocchi granuloma mimicking Kaposi sarcoma. J Dtsch Dermatol Ges. Jul 2007;5(7):591-3. [Medline].

  9. Sanchez-Castellanos ME, Mayorga-Rodriguez JA, Sandoval-Tress C, Hernandez-Torres M. Tinea incognito due to Trichophyton mentagrophytes. Mycoses. Jan 2007;50(1):85-7. [Medline].

  10. Patel GA, Schwartz RA. Tinea capitis: still an unsolved problem?. Mycoses. Dec 11 2009;[Medline].

  11. Ansar A, Farshchian M, Nazeri H, Ghiasian SA. Clinico-epidemiological and Mycological Aspects of Tinea Incognito in Iran: A 16-Year Study. Nippon Ishinkin Gakkai Zasshi. 2011;52(1):25-32. [Medline].

  12. Akiba H, Motoki Y, Satoh M, Iwatsuki K, Kaneko F. Recalcitrant trichophytic granuloma associated with NK-cell deficiency in a SLE patient treated with corticosteroid. Eur J Dermatol. Jan-Feb 2001;11(1):58-62. [Medline].

  13. Alteras I, Feuerman EJ, David M, Shvili D. Unusual aspects of granulomatous dermatophytosis. Mycopathologia. May 30 1984;86(2):93-7. [Medline].

  14. Carter RL. Majocchi's granuloma. J Am Acad Dermatol. Jan 1980;2(1):75. [Medline].

  15. Chen HH, Chiu HC. Facial Majocchi's granuloma caused by Trichophyton tonsurans in an immunocompetent patient. Acta Derm Venereol. 2003;83(1):65-6. [Medline].

  16. Elgart ML. Tinea incognito: an update on Majocchi granuloma. Dermatol Clin. Jan 1996;14(1):51-55. [Medline].

  17. Gill M, Sachdeva B, Gill PS, Arora B, Deep A, Karan J. Majocchi's granuloma of the face in an immunocompetent patient. J Dermatol. Oct 2007;34(10):702-4. [Medline].

  18. Gupta AK, Prussick R, Sibbald RG, Knowles SR. Terbinafine in the treatment of Majocchi's granuloma. Int J Dermatol. Jul 1995;34(7):489. [Medline].

  19. Gupta S, Kumar B, Radotra BD, Rai R. Majocchi's granuloma trichophyticum in an immunocompromised patient. Int J Dermatol. Feb 2000;39(2):140-1. [Medline].

  20. Hirschmann JV, Raugi GJ. Pustular tinea pedis. J Am Acad Dermatol. Jan 2000;42(1 Pt 1):132-3. [Medline].

  21. Ive FA, Marks R. Tinea incognito. Br Med J. Jul 20 1968;3(5611):149-52. [Medline].

  22. Jacobs PH. Majocchi's granuloma (due to therapy with steroid and occlusion). Cutis. Jul 1986;38(1):23. [Medline].

  23. Janniger CK. Majocchi's granuloma. Cutis. Oct 1992;50(4):267-8. [Medline].

  24. Lepage JC. Source of Majocchi's granuloma. J Am Acad Dermatol. Feb 1983;8(2):260. [Medline].

  25. Liao YH, Chu SH, Hsiao GH, Chou NK, Wang SS, Chiu HC. Majocchi's granuloma caused by Trichophyton tonsurans in a cardiac transplant recipient. Br J Dermatol. Jun 1999;140(6):1194-6. [Medline].

  26. Meinhof W, Hornstein OP, Scheiffarth F. [Multiple subcutaneous Trichophyton rubrum abscesses. Pathomorphosis of a generalized superficial tinea due to impaired immunological resistance]. Hautarzt. Jul 1976;27(7):318-27. [Medline].

  27. Nolting C, Vennewald I, Seebacher C. [Tinea follicularis presenting as trichophytic Majocchi granuloma]. Mycoses. 1997;40 Suppl 1:73-5. [Medline].

  28. Radentz WH, Yanase DJ. Papular lesions in an immunocompromised patient. Trichophyton rubrum granulomas (Majocchi's granuloma). Arch Dermatol. Sep 1993;129(9):1189-90, 1192-3. [Medline].

  29. Reynolds RD, Boiko S, Lucky AW. Exacerbation of tinea corporis during treatment with 1% clotrimazole/0.05% betamethasone diproprionate (Lotrisone). Am J Dis Child. Nov 1991;145(11):1224-5. [Medline].

  30. Sequeira M, Burdick AE, Elgart GW, Berman B. New-onset Majocchi's granuloma in two kidney transplant recipients under tacrolimus treatment. J Am Acad Dermatol. Mar 1998;38(3):486-8. [Medline].

  31. Smith KJ, Neafie RC, Skelton HG 3rd, Barrett TL, Graham JH, Lupton GP. Majocchi's granuloma. J Cutan Pathol. Feb 1991;18(1):28-35. [Medline].

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.