A case of granulomatous follicular dermatophytosis of the legs.

Deep dermatophytoses are rare clinical entities, acute or chronic, charecterised by dermis infection, generally due to zoophilic dermatophytes in immunocompetent patients and anthropophylic dermatophytes in immunocompromised patients. These agents cause an inflammatory reaction into the most superficial dermis layers, with granulomatous-like reaction. Clinical features are follicular papules or boils and subcutaneous nodular plaques characterized by groups of firm or fluctuant nodules. The authors describe a case of follicular granulomatous dermatophytosis of the legs and consider the clinical, histological, diagnostic and therapeutic features. A 46-year old female patient, in good general conditions, presented since 10 months erythematous papules and nodules with pustular lesions, placed in follicular and perifollicular area. The patient complained of itchiness and pain when touched. The lesions have been treated with topical and systemic corticosteroids for 8 months. Mycological colture grew Microsporum canis. Histopathologic study demonstrated multiple perifollicular hyphae and spores with a neutrophilic infiltrate and a nodular granulomatous perifolliculitis. Culture and skin biopsy confirmed the diagnosis of follicular granulomatous dermatophytosis, according to Pinetti’s classification.