A Case Report of Majocchi's Granuloma Associated with Combined Therapy of Topical Steroids and Adalimumab

Medicine
Wan-Yi Chou, Chih-Jung Hsu

Abstract

Currently, tumor necrosis factor alpha (TNF-alpha) inhibitors are widely used for many autoimmune disorders. However, they cause an immunocompromised status that sometimes leads to many cutaneous side effects including atypical infections. Herein, we report the first case of adalimumab-related Majocchi's granuloma.A 43-year-old Taiwanese male patient with chronic plaque-type psoriasis developed numerous tender nodules 1 month after adalimumab injection. The nodules responded poorly to bacterial folliculitis treatment. After repeated skin biopsies for pathology and tissue fungal culture, Majocchi's granuloma was confirmed. Adalimumab was withheld, and 12 weeks of terbinafine treatment was given. On completion of treatment, the nodular skin lesions and dystrophic nail lesions improved dramatically.The information, including time span, clinical features, histological findings, and improvement following withdrawal of adalimumab and treatment with an oral antifungal agent, indicates that Majocchi's granuloma was adalimumab-related. Psoriasis patients are more susceptible to dermatophyte infection due to local and systemic immunosuppressant therapy. It is important to perform a thorough examination for latent dermatophyte infection, ...Continue Reading

References

Nov 8, 2003·Journal of Clinical Microbiology·Ran Nir-PazItzhack Polacheck
Jan 25, 2005·American Journal of Clinical Dermatology·Zulal Erbagci
Jul 14, 2005·Expert Opinion on Drug Safety·Noah Scheinfeld
Mar 22, 2007·Journal of Cutaneous Medicine and Surgery·Abigail L LowtherStephen C Somach
Sep 29, 2007·Indian Journal of Medical Microbiology·S DasS N Bhattacharya
Oct 30, 2009·The New England Journal of Medicine·Erik-Oliver GlockerBodo Grimbacher
Oct 30, 2009·Southern Medical Journal·Joaquín Borrás-BlascoElvira Casterá
Jan 29, 2011·Transplant Infectious Disease : an Official Journal of the Transplantation Society·F A RomeroR R Razonable
Apr 21, 2012·Journal of Cutaneous Pathology·Elena B HawrylukRosalynn M Nazarian
Jul 24, 2012·Current Opinion in Microbiology·Desa Lilic
Oct 9, 2012·Folia Histochemica Et Cytobiologica·Aldona PietrzakGrażyna Chodorowska
Jan 11, 2013·The New England Journal of Medicine·John J O'SheaLouis M Staudt
Jun 27, 2013·Experimental Dermatology·Maike MoseClaus Johansen
Sep 17, 2013·Journal of the European Academy of Dermatology and Venereology : JEADV·K M G KlaassenM C Pasch
Oct 18, 2013·The New England Journal of Medicine·Fanny LanternierAnne Puel
Jan 29, 2014·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Laura S LourdesFrederic J Kaye
Apr 2, 2014·Dermatology : International Journal for Clinical and Investigative Dermatology·Aditya K GuptaWilliam C Brintnell

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biopsy
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