Ulcerative Tinea Corporis in an Immunosuppressed patient

Main Article Content

Lizy M Paniagua Gonzalez
Alison Lowe
Michael Wilkerson


immunosuppression, mycosis, tinea corporis


Worldwide, Trichophyton rubrum is the most common cause of dermatophytosis. Infection is classically superficial, limited to the cornified layers of the skin, and may be accompanied by varying degrees of inflammation. Dermatophyte invasion is limited by multiple host factors, including sebum production, an intact skin barrier, and immunocompetence. We describe a 65 year old gentleman with a history of diabetes mellitus, hypertension, nephrogenic systemic fibrosis, and immunosuppressed status due to renal transplant who presented with a non-healing ulcer of the left dorsal hand. Further examination revealed palmar erythema and scale as well as annular erythematous plaques with peripheral scale on his bilateral knees. Laboratory testing yielded the diagnosis of tinea corporis, with bacterial superinfection of the left dorsal hand. The patient was started on systemic antimicrobials with complete healing of the ulcer along with total clearance of the rash. This case highlights an unusual presentation of invasive Trichophyton rubrum in the setting of immunosuppression and nephrogenic systemic fibrosis.


1. Budihardja, D., Freund, V., Mayser, P. Widespread erosive tinea corporis by Arthroderma benhamiae in a renal transplant recipient: case report. Mycoses. 2010;53(6):530-532.

2. Grossman, M.R., Pappert, A.S, Garzon, M., Silvers, D.N. Invasive Trichophyton rubrim infection in the immunocompromised host: Report of three cases. J Am Acad Dermatol. 1995;33:315-8.

3. Lillis, J.S., Dawson, E.S., Chang, R., White, C.R. Disseminated dermal Trichophyton rubrum infection- an expression of dermpatophyte dimorphism? J Cutan Pathol. 2010;37:1168-1169

4. Sclvi, G.S, Kamalam, A., Ajithados, K., Janaki, C., Thambiah, A.S. Clinical and mycological features of dermatophytosis in renal transplant recipients. Mycoses. 1999;42:75-78.

5. Nir-Paz, R., Elinav, H. Pierard, G.E., Walker, D., Maly, A., et.al. Deep Infection by Trichophyton rubrum in an Immunocompromised Patient. J. of Clin Mircrobiol. 2003;41(11):5298-5301.

6. Smith, K.J., Welsh, M., Skelton, H. Trichophytum rubrum showing deep dermal invasion directly from epidermis in immunosuppressed patients. British J. of Dermatol. 2001;145:344-348.

7. Seckin, D., Arikan, S., Haberal, M. Deep Dermatophytosis caused by Tichophyton rubrum with concomitant disseminated nocardiosis in renal transplant recipient. J Am. Acad Dermatol. 2004;51:5101-5104.

8. Marconi, V.C., Kradin, R., Marty, F.M., Hospenthal, D.R., Kotton, C. Disseminated dermatophytosis in a patient with hereditary hemochromatosis and hepatic cirrhosis: case report and review of the literature. Med Mycol. 2010; 48(3):518-527.

Most read articles by the same author(s)