Boral Hazal, Durdu Murat, Ilkit Macit
Division of Mycology, Department of Microbiology, Faculty of Medicine, University of Çukurova, Adana, Turkey.
Department of Dermatology, Faculty of Medicine, Başkent University Adana Hospital, Adana, Turkey.
Infect Drug Resist. 2018 May 22;11:751-760. doi: 10.2147/IDR.S145027. eCollection 2018.
Majocchi's granuloma (MG) is a rare fungal infection of the dermis that is mainly caused by dermatophytes (in ≥95% of cases); the most frequently identified cause is anthropophilic . In the rest of the cases, the causes are non-dermatophytic fungi such as species. This review aimed to provide information about the current perspectives on MG regarding its clinical characteristics, predisposing factors, laboratory diagnosis, and treatment strategies. Although the lower extremities were reported to be the most common site of infection, facial involvement has been predominant in the past 5 years. Our literature research showed that the most common predisposing factor (55%) is the use of topical steroid creams without potassium hydroxide examination during treatment of erythematous squamous dermatoses. A reliable diagnosis of MG is based on histopathological examination, including fungal culture and molecular analyses. MG should be treated not only with topical agents but also with systemic antifungal agents that are continued until the lesions are completely resolved. In systemic treatment, the most preferred drug is terbinafine, because of its efficacy, side effects, and safety.
马约基氏肉芽肿(MG)是一种罕见的真皮真菌感染,主要由皮肤癣菌引起(≥95%的病例);最常见的病因是亲人性的。在其余病例中,病因是如某些菌种等非皮肤癣菌真菌。本综述旨在提供有关MG目前在临床特征、易感因素、实验室诊断和治疗策略方面的观点的信息。尽管据报道下肢是最常见的感染部位,但在过去5年中面部受累占主导地位。我们的文献研究表明,最常见的易感因素(55%)是在治疗红斑鳞屑性皮肤病时使用不含氢氧化钾检查的外用类固醇乳膏。MG的可靠诊断基于组织病理学检查,包括真菌培养和分子分析。MG不仅要用外用药物治疗,还需要用全身性抗真菌药物治疗,持续用药直至病变完全消退。在全身治疗中,由于其疗效、副作用和安全性,最优选的药物是特比萘芬。