II. Epidemiology
- Rare
III. Pathophysiology
- Dermatophyte Infection (esp. Trichophyton rubrum)
- Complication of Corticosteroid use for Tinea Corporis
- Deep Fungal Infection extending to the Dermis
- Contrast with Tinea Corporis which is limited to the superficial skin
IV. Risk Factors
- Tinea Infection
- Extremity Trauma
- Topical Corticosteroid use
V. Findings
- Pruritic, warm, pink-Red Papules, Nodules and Plaques on the extremities
VI. Diagnosis
- Diagnosis is typically delayed 1-2 months
- Skin biopsy
- Perifollicular Granulomatous inflammation
- Microbial testing does not differentiate deep (Majocchi Granuloma) from superficial (e.g. Tinea Corporis)
VII. Management
- Variable protocols for 1 month or more
- Oral Terbinafine AND
- Topical Ketoconazole