서혜부에 발생한 Itraconazole에 저항성 있는 Trichophyton rubrum에 의한 다발성 피하농양

Dermatophytes usually infect keratinized epithelial structures such as hair and nails. However, they can also cause deep and extensive fungal infections, especially in immunocompromised patients. We report a case with multiple dermal abscesses, which is a rare manifestation of Trichophyton rubrum infection. A 54-year-old man presented with multiple subcutaneous nodules in both inguinal areas with associated tinea cruris. Histopathological findings showed abscesses with fungal hyphae highlighted using Periodic acid-Schiff diastase (PAS-D) staining. Trichophyton rubrum was isolated on a fungal culture of the biopsy specimen obtained from a subcutaneous nodule in the inguinal area. The lesions were resistant to treatment with itraconazole (100 mg twice a day for 6 months); thus, we changed the drug to voriconazole (200 mg twice a day for 3 months). In addition, we extracted the remaining big lesions by incision and drainage. The patient was successfully treated with voriconazole and surgical method. (Korean J Dermatol 2017;55(6):360∼363)