Journal of Micology Subdivision

A case of Tinea Corporis due to Tricophyton

Tonsurans that Manifested As Impetigo

Harunari Shimoyama Chikako Nakashima

Midori Hase Yoshihiro Sei
Department of Dermatology, Teikyo University School of Medicine, Mizonokuchi Hospital
(2016) E: 59, E: 61

Read by: Astri Melistri

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 Introduction

Tricophyton Tonsurans was first brought

from abroad to Japan trought
International sport combat competition.
Following an epidemic among friends
and families of combat sports
participants, a disease become more
prevalent nationwide.

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 Introduction

Diagnosis is difficult since this disease

presents various clinical feature
Recently we encountered a case of
tinea corporis presenting with peculiar
clinical features and having impetigo
like clinical feature

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 Case Report

Male patient
41 years old
Complaining an itchy eruption in the
forearm
As history of present illness and eruption
associated with slight itch had appeared
on the right forearm 4 months earlier
He had visited two local hospital but
since it tested as negative fungal
examination, steroid ointment was
prescribed
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 Case Report

His symptoms did not improve so he come to

our department
On examination, an oval soybean sized
erythematous infiltrated lesion with scales and
crust was found almost on the central part of
extensor surface of the right forearm and it
showed partial erosion with yellow crust
attached.
Fungal element were confirmed from the scales
trough KOH examination
No fungal element were found in the villous
hair.
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Case Report

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Case Report

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Case Report

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 Case Report

Mycological Examination: The fungal culture

erupted positive while a hairbrush culture method
from the scalp indicated negative result. Growth
of colony with white fluffy surface and reddish
brown color on the reverse side was observed on
mycosel agar.
Microscopic morphology teardrop and club
shaped microconidia, which were not stained by
lactophenol cotton blue were observed along the
hyphae and short conidiospore.
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 Case Report

DNA sequence analysis of the internal

transcribed spacer was spacer was performed.
ITS Tricophyton Tonsurans
Treatment: Initiated with oral terbinafine 125
mg
The eruption improved following a four week
oral administration of terbinafine. It has no
recurrence.

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Discussion

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 Discussion

The former has three clinical types (seborrheic

type, black dot ringworm type, and kerion celsi
type); whereas the latter includes the tinea
circinata type, eczema marginatum type and
plague like type and remarkable feature is that
is an endothrix type dermatophyte that can
easily invade the hair.

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Discussion

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 Discussion

In our case, the eruptiomn appeared on the

extensor surface on the right forearm, which is
considered as a site where minor trauma can
easily occur . We assumed it occurred because
of rubbing with the sleeve of the judo uniform.
Both forearm of judo playing males are usually
hairy, the strong affinity of the hair tissue is
considered one of the causes for disease
formation.

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 Discussion

The eruption in our case was an impetigo like

lesion not typical lesion tinea circinata

The clinical types of tinea corporis are classified

differently by different textbook.

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 Discussion

In our case, it is unclear whether a granuloma

was formed because skin biopsy was not
performed.

We choose systemic therapy with terbinafine

because of the ability of this fungus to easily
invade hair in the early stage of the infection and
history of incorrect administration of steroi
ointment.

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Thank You

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