Majocchi Granuloma Of The Upper Lip, A Dermatophyte Infection: A Case Report | 51380
Journal of Infectious Diseases & Therapy
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Background: Majocchi granuloma is an uncommon condition in which the dermatophyte invades the dermis and subcutaneous
tissue. Trichophyton rubrum is the most frequent etiologic agent. The upper lip was chronically ulcerated and painless. Biopsy of the
lesion on the upper lip exhibited fungal forms in the dermis. KOH preparation was negative.
Case presentation: A 28-years-old male from Agaw ethnicity, Ethiopia referred from rural health centre for the painless non healing
ulcer of the upper lip of eleven years. It was reddish circular and indurated measuring 8 by 6 mm. The lower lip was also dry and
peeling. He also had onychomycosis of the right thumbnail untreated for the past 18 years. After dermatologic consultation biopsy
was taken and KOH was prepared from both lesions. KOH was done twice and were non-revealing from the lip lesion. Biopsy
revealed different morphologic variations including yeast forms, bizarre hyphae, mucinous coatings and the Splendore-Hoeppeli
phenomenon. After three weeks tissue culture results revealed Trichophyton rubrum. Terbinafine 250 mg/day for five weeks resulted
in complete resolution of both the granuloma and the onychomycosis.
Conclusion: Varied presentation of such fungal diseases warrants early diagnostic intervention using biopsy and tissue culture to
help detect such cases.