Dermatophytic granuloma caused by Microsporum canis in a heart-lung recipient

We present a case of dermatophytic granuloma caused by Microsporum canis in a heart-lung recipient. This 66-year-old man was seen for erythematous pus tules and papules on the forearm. The diagnosis was suspected after histolo gical examination showing an inflammatory infiltrate in the upper dermis wi th giant cells containing intracytoplasmic fungal elements. Cultures of the skin biopsy confirmed the diagnosis identifying M. canis. Our case emphasi zes the possibility of deep dermatophytic infections in immunocompromised p atients. There are only 4 additional reports of M. canis infection responsi ble for invasion of the dermis in such patients. The follicle involvement p robably explains these dermal lesions due to the progression of the dermato phyte from the hair follicle to the dermis. In our observation topical anti fungal therapy alone was unsuccessful and fluconazole seems to be the treat ment of choice for these M. canis invasive dermal cutaneous infections.