ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferencesView all Images (9)
Majocchi granuloma - Cellulitis
See also in: Overview
Print
Other Resources UpToDate PubMed

Majocchi granuloma - Cellulitis

See also in: Overview
Print Images (9)
Contributors: Tara Mahar MD, Art Papier MD
Other Resources UpToDate PubMed

Synopsis

Majocchi's granuloma, or nodular granulomatous perifolliculitis, is a perifollicular and nodular process caused by infection of the follicle with dermatophyte fungal species. Majocchi's granuloma is most often caused by Trichophyton rubrum or Trichophyton mentagrophytes, the fungal species typically responsible for the superficial dermatophyte infections tinea corporis or tinea pedis. Other dermatophyte species have been implicated as well.

The disease process occurs when a dermatophyte invades the follicle causing a granulomatous and/or suppurative reaction. Predisposing factors include trauma and immunosuppression. Depending on the cause, there are differing clinical presentations.

Majocchi's granuloma can occur from shaving and has been seen on the legs as well as the face. Occlusion of the skin or simple trauma can also predispose to Majocchi's granuloma. A second deeper and more nodular form has also been reported in transplant patients and immunocompromised patients.

Majocchi's granuloma is often distinct from cellulitis in the finding of papules or pustules within an erythematous plaque. This diagnosis should be given careful consideration with cases of suspected cellulitis in the immunosuppressed.

Majocchi-like granulomas, deep ulcerated fungal infections, severe tinea capitis and corporis, and fungal nail involvement are characteristic of an inherited deficiency of CARD9 (caspase recruitment domain-containing protein 9), an inflammatory cascade-associated protein. The disorder is autosomal recessive and is most common in North Africa countries including Algeria, Morocco, and Tunisia. The infections usually begin in childhood and are caused by T. rubrum and Trichophyton violaceum. Lymphadenopathy, high IgE antibody levels, and eosinophilia are common, and the disorder can be fatal.

Codes

ICD10CM:
B35.8 – Other dermatophytoses

SNOMEDCT:
214600002 – Majocchi's granuloma

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

Subscription Required

References

Subscription Required

Last Updated: 12/04/2013
Copyright © 2018 VisualDx®. All rights reserved.
Majocchi granuloma - Cellulitis
See also in: Overview
Print 9 Images
View all Images (9)
(with subscription)
Majocchi granuloma : Arm, Face, Leg, Pustules, Scaly plaques
Clinical image of Majocchi granuloma
Copyright © 2018 VisualDx®. All rights reserved.