Majocchi’s Granuloma: An Atypical Clinical Presentation in a Child

Introduction: Majocchi’s granuloma (MG) is a rare fungal infection of the dermis, mainly caused by dermatophytes (most commonly Trichophyton rubrum). Classically observed in adults, it is most often found on the lower limbs. We report a case of Majocchi granuloma of the face in a child.

Observation: 08-year-old child presented with skin lesions that changed appearance over time, located on the right temporal region and extending to the cheek. Initially, these were infiltrated lesions with a scaly-crusty surface, which later became papular and pustular. These lesions were secondary to trauma to the face, and had resisted all topical self-medication by the parents with corticoids and antifungals. Mycological examination of the scales identified Trichophyton mentagrophytes. Histopathology did not identify a granuloma, but rather a lymphocytic inflammatory dermal infiltrate. The diagnosis of Majocchi’s granuloma was retained. Treatment with terbinafine tablets resulted in complete healing without recurrence.

Conclusion: The diagnosis of Majocchi’s granuloma is often difficult. It should be considered in the presence of localized lesions resembling superficial mycosis, but which are resistant to well-administered topical treatment.

Keywords: Majocchi, Face, Child, Trichophyton mentagrophytes, Terbinafine.