[Dermatomycosis caused by Trichophyton verrucosum in mother and child]

[Scarring tinea profunda in the pubic area due to Trichophyton verrucosum]

A 22-year-old female veterinary student developed a severe inflammatory fungal infection of the pubic area 2 months after practical training in obstetrics at a cattle farm. Fungal culture revealed a slowly growing white dermatophyte, first differentiated as Trichophyton mentagrophytes. Because of the unusual location, molecular species differentiation was performed identifying Trichophyton verrucosum. Although the patient was treated with systemic antifungals, the infection resulted in scarring alopecia.

Perniosis-like tinea corporis caused by Trichophyton verrucosum in cold-exposed individuals

Trichophyton verrucosum is a zoophilic infectious agent causing 98% of the dermatophytic infections of cattle. Transmission to humans has, until recently, been rare. One reason for an increase of infection in humans and animals seems to be the decrease in immunisation of cattle. We report on three cases of pertinent human infections with disseminated, sharply defined, bluish red, partly oedematous nodules and plaques in particular not only on the thighs, but also on the trunk and arms. Two of our patients work with farm animals. The third one works as an assistant in a butcher shop, but lives on a cow farm. All three patients are often exposed to the cold. In all three cases T. verrucosum was detected by culture. Tinea corporis was histologically confirmed in two patients. Based on the microbiological results, we began a combined systemic and local antimycotic therapy with fluconazole 50 mg day(-1) in two patients, itraconazole 100 mg day(-1) in one patient p.o. combined with topical ciclopiroxolamine. All patients were cured. Dermatophytosis caused by T. verrucosum can, under certain circumstances, such as frequent exposure to cold or a long-term corticosteroid therapy, mimic the characteristic clinical picture of perniosis, as we demonstrate here.

Deep mycosis caused by Trichophyton mentagrophytes in a diabetic patient

We report on a 65-year-old diabetic patient, who developed a deep fungal infection in the beard region after initial therapy with systemic antibiotics and topical corticosteroids. We were able to isolate Trichophyton mentagrophytes and treated him successfully with terbinafine 250 mg day(-1) orally in combination with topical ciclopirox and polyhexanide. In follicular inflammation in diabetics, deep mycosis has to be considered and mycologic diagnostics should be performed before starting any other treatment.