Dermatophytic disease in a Tunisian family

: Dermatophytic disease is a rare chronic infection caused by common dermatophytes and characterized by cutaneous and subcutaneous invasion. It is observed mainly in North Africa where it is presumably inherited via an autosomal recessive trait. Cellular immunodeficiency could account for the chronic nature of the disease and for its refractoriness to drug treatment. The purpose of this report is to describe the occurrence of dermatophytic disease in three sisters of consanguineous parents in a rural region of northern Tunisia. To our knowledge, this is the first familial case reported in Tunisia. The most salient features in these patients were early age of disease onset in three females, isolation of Microsporum canis at the beginning of the disease, relatively favorable course with long remissions in two cases, and absence of visceral involvement. Various drugs including antifungal agents and immunostimulants were used for treatment with disappointing results. Surgical excision associated with antifungal agents appeared to be effective in our patients. Dermatophytic disease remains a severe disease due to the possibility of potentially life-threatening visceral involvement.