Author: Dr Maneka Gnanasegaram, Dermatology Registrar, Greenlane Hospital, Auckland, New Zealand, 2012.
Majocchi granuloma presents with an irregular red, scaly plaque in which there are follicular papules, pustules and nodules. It is usually found on one lower leg.
Majocchi granuloma is most often caused by Trichophyton rubrum. Sometimes other fungi are found on culture, including:
Associated factors leading to deep follicular infection may include:
Suspicion is raised due to its clinical appearance.
To confirm the diagnosis, scrapings and hair samples may be taken from the affected area for microscopy and fungal culture (mycology). Granulomatous inflammation is found on skin biopsy.
The recommended treatment for Majocchi granuloma is a 4-6 week course of oral antifungal agent.
Topical antifungal agents may not be effective due to deep invasion of fungus into the hair follicle.
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