Bonifaz A, Tirado-Sánchez A, Ponce RM

Idioma: Español
Referencias bibliográficas: 71
Paginas: 419-426
Archivo PDF: 101.89 Kb.

RESUMEN

El granuloma de Majocchi o granuloma dermatofítico es una micosis causada por dermatofitos, regularmente del género Trichophyton, predominando T. rubrum en 50%. Se presenta en pacientes inmunocompetentes o inmunodeprimidos. No se sabe cómo se produce la infección, al parecer inicia con trauma físico que guía a alteraciones del folículo piloso y a la introducción pasiva del hongo. Para el desarrollo de la infección se requieren factores predisponentes y desencadenantes, los más importantes son la diabetes y el uso de esteroides. Clínicamente se clasifica en papular perifolicular o superficial en pacientes inmunocompetentes, y en nodular subcutánea o profunda en pacientes con inmunosupresión. Se confirma el diagnóstico por histopatología, encontrando granulomas en dermis media y profunda, con estructuras dermatofíticas en forma de filamentos o esporas. El tratamiento es con antimicóticos sistémicos. Se hace una revisión del tema resaltando los aspectos etiopatogénicos, clínico-patológicos y terapéuticos de la e nfermedad.

REFERENCIAS (EN ESTE ARTÍCULO)

1. 1. Janniger CK. Majocchi’s granuloma. Cutis 1992;50:267-268.

2. Sequeira M, Burdick AE, Elgart GW, Berman B. New-onset Majocchi’s granuloma in two kidney transplant recipients under tacrolimus treatment. J Am Acad Dermatol 1998;38:486-488.

3. Magaña-Lozano M, Bonifaz A. Granulomas dermatofíticos. Dermatol Rev Mex 1988;32:27-33.

4. Tchernogouff A, Pelvine A. Trichophyie chronique de la peau et des phanères chez tous les membres d’une famille. Ann Dermatol Syph 1926;8:403-419.

5. Conti-Díaz I. Granuloma de Majocchi de la barba por Trichophyton rubrum. Med Cut ILA 1974;2:433-436.

6. Harris I, Lewis GM. Trichophyton purpureum Bang as a deep invader of the skin. AMA Arch Derm Syph 1930;32:1-5.

7. Wilson J, Plunkett O, Gregersen A. Nodular granulomatous perifolliculitis of the legs caused by Trichophyton rubrum. Arch Dermatol 1954;69:258-265.

8. Cremer A. A special granulomatous form of mycosis on the lower legs caused by Trichophyton rubrum castellani. Dermatologica 1953;107:28-37.

9. Hadida E. Aspects de la maladie dermatophitique. Alergie Medicale 1959;63: 303-336.

10. Zúñiga A. Granulomas por dermatofitos, comunicación de un caso. Dermatol Rev Mex 1981;25:469-478.

11. Beirana L, Novales J. Tinea universal y granulomatosa por Trichophyton tonsurans. Dermatol Rev Mex 1959;3:4-16.

12. Lavalle P. Granuloma por Epidermophyton floccosum, comunicación de un caso. Dermatol Rev Mex 1968;12:369-370.

13. Villanueva CE, Vargas OA. Granuloma tricofítico tipo Wilson, comunicación de un caso. Rev Centro Dermatol Pascua 1996;5:11-14.

14. Arenas R. Dermatofitosis en México. Rev Iberoam Micol 2002;19:63-67.

15. González-Ochoa A. Granulomas tricofíticos. Memorias Academia Mexicana de Dermatología. México: AMD; 1973.

16. Padilha-Gonòalves A. Granulomatous dermatophytia. Procedings Fifth International Conference on Mycoses Superficial and Subcutaneous Infectious. Caracas, Venezuela. Scien Pub. 396 Washington DC: PAHO; 1980.

17. Smith KJ, Neafie RC, Skelton HG 3rd, Barret TL, Graham JH, Lupton GP. Majocchi’s granuloma. J Cutan Pathol 1991;18:28-35.

18. Grossman ME, Pappert AS, Garzon MC, Silvers DN. Invasive Trichophyton rubrum infection in the immunocompromised host: Report of three cases. J Am Acad Dermatol 1995;33:315-318.

19. Novick NL, Tapia L, Bottone EJ. Invasive Trichophyton rubrum infection in an immunocompromised host: A case report and review of the literature. Am J Med 1987;82:321-325.

20. Thorne E, Fusaro R. Subcutaneous Trichophyton rubrum abscesses: A case report. Dermatologica 1971;142:167-170.

21. Sentamilselvi G, Janaki C, Kamalam A, Thambiah AS. Deep dermatophytosis caused by Trichophyton rubrum: A case report. Mycopathologia 1998;142:9-11.

22. Lowinger-Seoane M, Torres-Rodríguez JM, Madrenys-Brunet N, Aregall- Fusté S, Saballs P. Extensive dermatophytoses caused by Trichophyton mentagrophytes and Microsporum canis in a patient with AIDS. Mycopathologia 1992;120:143-146.

23. Blanchet-Bardon C, Badillet G, Guigue G, Pelbois G, Khouidmi N, Puissant A. Trichophyton violaceum trichophytosis associated with deep cutaneous granulomas caused by Dematiaceae. Ann Dermatol Venereol 1982;109:751-752.

24. Ravaghi M. Superficial and deep granulomatous lesions caused by Trichophyton violaceum. Cutis 1976;17:976-977.

25. Chen HH, Chiu HC. Facial Majocchi’s granuloma caused by Trichophyton tonsurans in an immunocompetent patient. Acta Derm Venereol 2003;83:65-66.

26. Hadacek BM, Nassif A, Roux A, Desplaces N, Huerre M, De Bievre C, et al. Trichophyton tonsurans dermatophyte granuloma in an HIV-1 infected patient. Br J Dermatol 1999;140:762-763.

27. McNamara RJ. Trichophyton tonsurans granuloma in the scalp of an adult. Cutis 1977; 20: 55-57.

28. Liao YH, Chu SH, Hsiao GH, Chou NK, Wang SS, Chiu HC. Majocchi’s granuloma caused by Trichophyton tonsurans in a cardiac transplant recipient. Br J Dermatol 1999;140:1194-1196.

29. Lestringant GG, Lindley SK, Hillsdon-Smith J, Bouix G. Deep dermatophytosis to Trichophyton rubrum and T. verrucosum in an immunosuppressed patient. Int J Dermatol 1988;27:707-709.

30. Elewski BE, Sullivan J. Dermatophytes as opportunistic pathogens. J Am Acad Dermatol 1994;30:1021-1022.

31. King D, Cheever LW, Hood A, Horn TD, Rinaldi MG, Merz WG. Primary invasive cutaneous Microsporum canis infections in immunocompromised patients. J Clin Microbiol 1996;34:460-462.

32. Barson WJ. Granuloma and pseudogranuloma of the skin due to Microsporum canis. Arch Dermatol 1985;121:895-897.

33. Allen DE, Snyderman R, Meadows L, Pinell SR. Generalized Microsporum audouinii infection and depressed cellular immunity associated with a missing plasma factor required for lymphocyte blastogenesis. Am J Med 1977;63:991- 1000.

34. Pereiro-Miguens M. Granulomatous mycosis caused by M. gypseum. Actas Dermosifiliogr 1976;67:151-158.

35. Luscombe H, Bingul O. Nodular granulomatous perifoliculitis caused by Microsporum gypseum. Arch Dermatol 1964;89:274-276.

36. Chen AW, Kuo JW, Chen JS, Sun CC, Huang SF. Dermatophyte pseudomycetoma: A case report. Br J Dermatol 1993;129:729-732.

37. Baylet R, Camain R, Juminer B, Faye I. Microsporum ferrugineum ota, 1921, agent de mycétomes du cuir chevelu en Afrique noire. Pathol Biol (Paris) 1973; 21:5-12.

38. Seddon ME, Thomas MG. Invasive disease due to Epidermophyton floccosum in an immunocompromised patient with Behçet’s syndrome. Clin Infect Dis 1997;25:153-154.

39. Gupta AK, Groen K, Woestenborghs R, De Doncker P. Itraconazole pulse therapy is effective in the treatment of Majocchi’s granuloma: A clinical and pharmacokinetic evaluation and implications for possible effectiveness in tinea capitis. Clin Exp Dermatol 1998;23:103-108.

40. Radentz WH, Yanase DJ. Papular lesions in an immunocompromised patient. Trichophyton rubrum granulomas (Majocchi’s granuloma). Arch Dermatol 1993;129:1189-90,1192-1193.

41. Voisard JJ, Weill FX, Beylot-Barry M, Vergier B, Dromer C, Beylot C. Dermatophytic granuloma caused by Microsporum canis in a heart-lung recipient. Dermatology 1999;198:317-319.

42. Burg M, Jaekel D, Kiss E, Kliem V. Majocchi’s granuloma after kidney transplantation. Exp Clin Transplant 2006;4:518-520.

43. Demidovich CW, Kornfeld BW, Gentry RH, Fitzpatrick JE. Deep dermatophyte infection with chronic draining nodules in an immunocompromised patient. Cutis 1995;55:237-240.

44. Meinhof W, Hornstein OP, Scheiffarth F. Multiple subcutaneous Trichophyton rubrum abscesses. Pathomorphosis of a generalized superficial tinea due to impaired immunological resistance. Hautarzt 1976;27:318-327.

45. Akiba H, Motoki Y, Satoh M, Iwatsuki K, Kaneko F. Recalcitrant trichophytic granuloma associated with NK-cell deficiency in a SLE patient treated with corticosteroid. Eur J Dermatol 2001;11:58-62.

46. Ueda-Furukawa M, Kitano Y, Hashimoto K. Trichophytic granuloma associated with bullous pemphigoid. J Dermatol 1988;15:339-341.

47. Sherwin WK, Ross TH, Rosenthal CM, Petrozzi JW. An immunosuppressive serum factor in widespread cutaneous dermatophytosis. Arch Dermatol 1979;115:600-604.

48. Svejgaard E. Immunologic investigations of dermatophytes and dermatophytosis. Semin Dermatol 1985;4:201-221.

49. Marsh TW, Artis WM. Host defence mechanisms and the superficial fungus infections. Dermatol Clin 1984;2:67-79.

50. Tagami H, Kudoli K, Takematsu H. Inflammation and immunity to dermatophytosis. Dermatologica 1989;179(Suppl 1):1-8.

51. Stenderup A, Schonheyder H. Mycoses complicating AIDS. Microbiol Sci 1984;1:219-223.

52. Lacayo G, Latapi F, Ravelo P. Granuloma tricofítico universal de Majocchi, estudio de un caso y su evolución 20 años después. Dermatol Rev Mex 1980; 24:23-31.

53. Chang SE, Lee DK, Choi JH, Moon KC, Koh JK. Majocchi’s granuloma of the vulva caused by Trichophyton mentagrophytes. Mycoses 2005;48:382-384.

54. Feng WW, Chen HC, Chen HC. Majocchi’s granuloma in a 3-year-old boy. Pediatr Infect Dis J 2006;25:658-659.

55. Hironaga M, Okazaki N, Saito K, Watanabe S. Trichophyton mentagrophytes granulomas. Unique systemic dissemination to lymph nodes, testes, vertebrae, and brain. Arch Dermatol 1983;119:482-490.

56. Bojórquez MA, Arenas R, Molina de Soschin D, Vega-Memije E. Granuloma tricofítico y querión de Celso: Datos clínicos e histológicos de nueve casos. Dermatologia Rev Mex 2002;46:15-22.

57. Arenas R, Toussaint S, Isa-Isa R. Kerion and dermatophytic granuloma. Mycological and histopathological findings in 19 children with inflammatory tinea capitis of the scalp. Int J Dermatol 2006;45:215-219.

58. Razzaque A, Douglas A. Delayed-type hipersensibity skin testing. Arch Dermatol 1983;119:934-945.

59. Bonifaz A, Ramírez-Tamayo T, Saúl A. Tinea barbae (tinea sycosis): Experience with nine cases. J Dermatol 2003;30:898-903.

60. Seki Y, Otsuka F, Ohara K, Takizawa K, Ishibashi Y. Surgical treatment of a deep fungal infection of the skin by Trichosporon cutaneum. J Dermatol 1987;14:77-80.

61. Otsuka F, Seki Y, Takizawa K, Ohara K, Ishibashi Y. Facial granuloma associated with Trichosporon cutaneum infection. Arch Dermatol 1986;122: 1176-1179.

62. Hirsh AH, Schiff TA. Subcutaneous phaeohyphomycosis caused by an unusual pathogen: Phoma species. J Am Acad Dermatol 1996;34:679-680.

63. Baker RL, Para MF. Sucessful use of ketoconazole for invasive cutaneous Trychophyton rubrum infection. Arch Intern Med 1984;144:615-617.

64. Gong JQ, Liu XQ, Xu HB, Zeng W, Li XF. Deep dermatophytosis caused by Trichophyton rubrum: Report of two cases. Mycoses 2007;50:102-108.

65. Tejasvi T, Sharma VK, Sethuraman G, Singh MK, Xess I. Invasive dermatophytosis with lymph node involvement in an immunocompetent patient. Clin Exp Dermatol 2005;30:506-508.

66. Gupta AK, Prussick R, Sibbald RG, Knowles SR. Terbinafine in the treatment of Majocchi’s granuloma. Int J Dermatol 1995;34:489.

67. Guzmán-Ramírez A, Servín-Vázquez LA, Mena-Cedillos CA, Salgado- Jiménez MA, Bonifaz A. Granuloma de Majocchi asociado a síndrome de Cushing por medicamentos. Bol Med Hosp Infant Mex 2000;57:512-516.

68. Nolting C, Vennewald I, Seebacher C. Tinea follicularis presenting as trichophytic Majocchi granuloma. Mycoses 1997;40(Suppl 1):73-75.

69. Brod C, Benedix F, Röcken M, Schaller M. Trichophytic Majocchi granuloma mimicking Kaposi sarcoma. J Dtsch Dermatol Ges 2007;5:591-593.

70. Rajpara V, Frankel S, Rogers C, Nouri K. Trichophyton tonsurans associated tinea corporis infection with the development of Majocchi’s granuloma in a renal transplant patient. J Drugs Dermatol 2005;4:767-769.

71. Benedict LM, Kusne S, Torre-Cisneros J, Hunt SJ. Primary cutaneous fungal infection after solid-organ transplantation: Report of five cases and review. Clin Infect Dis 1992;15:17-21.