Invasive Dermatophytoses: Clinical Presentations, Diagnosis, and Treatment


Durdu M., İlkit M. M.

in: Dermatophytes and Dermatophytoses, Jean-Philippe BoucharaPietro NenoffAditya K. GuptaVishnu Chaturvedi, Editor, Springer, London/Berlin , Zug, pp.65-86, 2021

  • Publication Type: Book Chapter / Chapter Research Book
  • Publication Date: 2021
  • Publisher: Springer, London/Berlin 
  • City: Zug
  • Page Numbers: pp.65-86
  • Editors: Jean-Philippe BoucharaPietro NenoffAditya K. GuptaVishnu Chaturvedi, Editor
  • Çukurova University Affiliated: Yes

Abstract

If not adequately treated, superficial dermatophytic infections may invade

the dermis and subcutaneous tissue, resulting in invasive dermatophytoses.

Invasive dermatophytic infections are broadly classified into Majocchi’s

granuloma, deep dermatophytosis, disseminated dermatophytosis, and

mycetoma and pseudomycetoma. Most pseudomycetomas and mycetomas

develop in immunocompetent individuals, while deep dermatophytosis and

disseminated dermatophytosis usually develop in immunosuppressed

individuals. Genetic tests for CARD9 and STAT3 mutations should be

performed in patients with recurrent deep dermatophytosis. Majocchi’s

granuloma can occasionally be clinically indistinguishable from deep and

disseminated dermatophytosis. Mycetoma should be considered if

tumefactive tumoral lesions and sinuses are observed. In addition to

histopathology, laboratory and imaging methods are used to differentiate

different types of invasive dermatophytoses. Systemic antifungals constitute

the first-line treatment of Majocchi’s granuloma, deep dermatophytosis, and

disseminated dermatophytosis. However, surgery is the preferred treatment

approach for pseudomycetoma

and mycetoma.