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