Abstract

Dermatophytosis is a fungal infectious disease triggered by dermatophytes, which produce protease and keratinase to precis keratin, leading to the establishment, incursion, and infection of the stratum corneum of the skin, hair shafts, and nails. Tinea corporis is a communal dermatophytosis that includes smooth skin, except for the scalp, hair, palms, nails, and genital area. 

Trichophyton interdigitale belongs to Trichophyton mentagrophytes complex, which is the common pathogen that caused dermatophytosis. Fungal keratitis, also called keratomycosis, is an infectious disease of cornea. Keratomycosis, also called fungal keratitis, is an infectious disease of the cornea. Little wakefulness and postponed diagnosis of this condition lead to complications that can result in permanent loss of vision, and even necessitate enucleation

Case 

Here, we report a case of simultaneous dermatophytosis and keratomycosis triggered by Trichophyton interdigitale. A 64-year-old man came with wide-ranging erythema all over the body since 3.5 years. He had multiple ringworm lesions on his face, trunk, and limbs. The lesions first appeared within inches of his left eyebrow 4 years ago, and then gradually extended across face, trunk and limbs. Two years ago, he was diagnosed with fungal keratitis at a local hospital. He also had fungal infection of left eye for 2.5 years, and loss of visualisation. These symptoms developed worse in the last month. Dermatological examinations showed widespread erythematous plaques with strong borders and scales, scattered red papules with ulceration, and scabs throughout the body. Conjunctival infection with excretion and loss of vision were noted in left eye. Under direct microscopic examination, hyaline septate hyphae were observed. Fungal culture and internal transcribed spacer sequencing revealed T. interdigitale. Histopathological examination suggested infectious granuloma. A diagnosis of dermatophytosis and keratomycosis caused by T. interdigitale with loss of vision in left eye was made. The patient was asked to start with luliconazole cream (two applications per day). Complete clinical remission was achieved after 1 month. 

Conclusion

In this patient, a case of simultaneous dermatophytosis and keratomycosis caused by T. interdigitale, was reviewed. Early diagnosis and aggressive medical treatment are of the utmost importance to improve therapeutic outcomes.

Suggested Reading

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