Majocchi granuloma (nodular granulomatous perifolliculitis) is a perifollicular and nodular process caused by infection of the follicle with a dermatophyte fungal species. The disease process occurs when a dermatophyte invades the follicle, causing a granulomatous and/or suppurative reaction in the dermis and/or subcutaneous tissue. Majocchi granuloma is most often caused by Trichophyton rubrum and less commonly by Trichophyton mentagrophytes or Epidermophyton floccosum. These are the same fungal species typically responsible for the superficial dermatophyte infections tinea corporis and tinea pedis. Other dermatophyte species have been implicated as well.

Majocchi granuloma can occur following trauma to the skin or from occlusion of hair follicles. This could be from shaving on the legs as well as the face. Involvement of the buttocks and genital skin has also been reported. The use of topical steroids on unsuspected tinea and immunosuppressed states can also predispose to its development.

This disease is most common in adults between 20 and 35 years old, with a predilection for females. Majocchi granuloma is also more common in females who frequently shave their legs and in those with tinea pedis or onychomycosis.

Majocchi 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.