Chronic Dermatophyte Infection Recalcitrant to Various Antifungal Agents Therapy.
- Author:
Sei Chung CHUN
1
;
Woo Chul SHIM
;
Eun So LEE
;
Won Hyoung KANG
Author Information
1. Department of Dermatology, Ajou University School of Medicine, Korea.
- Publication Type:Case Report
- Keywords:
Antifungal therapy;
Chronic dermatophyte infection
- MeSH:
Antifungal Agents*;
Arthrodermataceae*;
Econazole;
Exanthema;
Extremities;
Fluconazole;
Fungi;
Griseofulvin;
Humans;
Hypersensitivity;
Hypersensitivity, Delayed;
Immunity, Cellular;
Itraconazole;
Neck;
Skin;
Tinea;
Trichophyton;
Warts
- From:Korean Journal of Medical Mycology
1998;3(1):43-48
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Chronic dermatophyte infection rarely fails to respond to topical or systemic antifungal therapy. Such refractory condition relates to many factors and one of them is the decreased response of delayed type hypersensitivity. A plausible mechanism by which the delayed hypersensitivity response may cause dermatophyte inhibition has been proposed already. Our patient had skin rashes for 6 years. It was diagnosed as tinea corporis and treated with various systemic antifungal agents, such as griseofulvin, itraconazole, fluconazole, terbinafine and topical forms of econazole and terbinafine. But the skin lesions did not resolve completely and reaggravated frequently. Numerous verrucae planar were found on face, neck and both extremities. Trichophyton rubrum was identified by fungus culture study. Laboratory examination showed no response against multi-CMI test, DPCP sensitization and prick test for trichophytons. We challenged the therapy with the combined antifungal agents and immune stimulatory drugs. This case is thought to be a chronic dermatophyte infection due to the defects in the both cell mediated immunity and immediate type hypersensitivity which is crucial for the host defence mechanisms against fungal infection.
