Azin Ayatollahi, Mahsa Fattahi,
Volume 16, Issue 1 (5-2025)
Abstract
Dermatophytes are keratinophilic fungi responsible for common and benign infections worldwide. However, in immunocompromised patients, they may lead to rare and severe diseases. Severe forms include widespread and/or invasive dermatophytosis, such as deep dermatophytosis and Majocchi’s granuloma. These cases have been reported in individuals with primary immunodeficiencies (such as autosomal recessive CARD9 deficiency) or acquired immunodeficiencies (such as solid organ transplantation, autoimmune diseases treated with immunosuppressive therapies, or HIV infection). The clinical manifestations of these infections are non-specific. Lymph node and organ involvement may also occur. Diagnosis requires mycological and histopathological evidence. There is no consensus on treatment. Systemic antifungal agents, such as terbinafine and azoles (e.g., itraconazole or posaconazole), are effective. However, the long-term outcome and management depend on the site and extent of the infection and the type of underlying immunodeficiency.
