Deep Dermatophytosis

Deep dermatophytosis is a rare fungal infection described for the first time by Hadida and Schousboe. It is a chronic dermatophytic infection of the skin and viscera, mainly described in the Maghreb where it has an autosomal recessive transmission. Immunological studies have revealed a deficiency of cellular immunity leading to dermatophytes tolerance. Commonly, first lesions begin in childhood. Both superficial and deep dermatophytic lesions are possible. A 17 years old male patient with a history of chronic generalized pruritic erythematous-squamous lesions presented for subcutaneous abscesses of scalp and trunk. He underwent multiple antibiotic courses and surgical excisions with persistent relapses. Trichophyton rubrum was identified in skin biopsy and all samples sites. It was found no immunodeficiency within the limits of the blood tests conducted. Search for CARD9 protein deficiency was positive. Treatment based on Terbinafine and surgical drainage with mid improvement