A Case of Granuloma Trichophyticum after Left Lung Transplantation

Abstract

A 61-year-old man was diagnosed as having idiopathic pulmonary fibrosis and had started to take oral corticosteroid in 2011. He then underwent a left lung transplantation in August, 2015. Thereafter, immunosuppressive medications were initiated. He visited our outpatient clinic in December, 2015 with a complaint of a non-pruritic brownish macule on his buttocks. With a diagnosis of tinea corporis, we prescribed an anti-fungal cream that improved his lesion promptly. However, multiple small nodules with crust on the top appeared on his buttocks and soles in March, 2016. A skin biopsy,genetic analysis, and fungal culture identified Trichophyton rubrum (T. rubrum) as a causative agent. We finally diagnosed him as having granuloma trichophyticum caused by T. rubrum. The lesions healed after treatment with oral fluconazole for about 2 months. Recently reported cases of granuloma trichophyticum have often included post organ transplantation patients like our case. Since the number of patients undergoing organ transplantation is increasing, dermatologists should keep this fungal infection in mind.