Deep Trichophyton rubrum infection presenting with umbilicated papulonodules in a cardiac transplant recipient

摘要

A 49-year-old man attended the Dermatology clinic with a 2 month-history of widespread pruritic erythematous scaling lesions. He also had multiple papulonodules on the right lumbar area for 1 month. The patient had undergone cardiac by-pass operation 2 years ago. One year after this operation, cardiac allograft transplantation was performed because of cardiac failure. His dermatological complaints had first started with change in the colour of the toenails several months before the transplantation. Pruritic erythematous skin lesions had occurred on his inguinal region 6 months after the transplantation and they gradually spread to his back and abdominal region. Similar lesions developed on his right arm and forearm. He did not receive any therapy for these lesions. He had used oral prednisolone, cyclosporin A, mycophenolate mofetil, valacyclovir, nystatin, omeprazol, furasemid, trimethoprim sulphamethoxazole therapies for the cardiac transplantation.