Trichophyton rubrum dermatophytosis in a patient under chronic use of systemic corticoids: an exuberant presentation*

A 71-year-old female white patient had a 6-month history of annular, non-pruritic, erythematous plaques, measuring up to 12 cm in diameter, on her face, scalp, neck and arms. (Figure 1). On examination, the patient had Cushingoid features. She reported having an unspecifi ed endocrinopathy, for which she had been on continuous use of prednisone (25 mg/day) for 6 years. To make the diagnosis, we performed direct examination, fungal culture and histopathological analysis. Direct examination showed hyaline septate hyphae. Mycological culture of the scalp lesion revealed growth of Tricophyton rubrum. Histopathological analysis showed the presence of spores and fi laments in the stratum corneum. (Figure 2). The patient was treated with griseofulvin (500 mg/ day) for 60 days. Griseofulvin is known to have a good action against dermatophytes. There was complete resolution of the lesions. (Figure 3) Tinea corporis is a cutaneous fungal infection that most commonly occurs on the trunk and the extremities. It is generally restricted to the stratum corneum. Trycophyton rubrum is the most prevalent pathogen involved in tinea corporis. It acts as an opportunistic agent in patients with hypercortisolism.1 Hypercortisolism may occur due to prolonged exposure to high levels of topical or systemic glucocorticoids, even in so-called non-immunosuppressive doses of the drug. In fact, the most common cause of