Tinea Corporis Gladiatorum Presenting as a Majocchi Granuloma

Background. Wrestlers are at increased risk of developing cutaneous infections, including fungal infections caused by dermatophytes. Erythematous lesions due to tinea infections can be mistakenly diagnosed as an inflammatory dermatitis and incorrectly treated with potent topical corticosteroid treatments which cause localized skin immunosuppression. This can eventuate in a Majocchi granuloma which then becomes refractory to topical antifungal therapy. To our knowledge, this is the first case of tinea corporis gladiatorum presenting as a Majocchi granuloma. Observations. A 20-year-old wrestler presented with a 4-year history of a large pruritic, scaly erythematous plaque with follicular papules, and pustules on his right forearm. The lesion had the clinical appearance of a Majocchi granuloma. He had been treated with potent topical corticosteroids and topical antifungal therapy. KOH and fungal culture of the lesion were negative. An erythematous scaly lesion in the scalp was cultured and grew Trichophyton tonsurans. Oral Terbinafine therapy was initiated and complete resolution of both lesions occurred within 6 weeks. Conclusion. The purpose of this report is to inform dermatologists that tinea corporis gladiatorum can present as a Majocchi granuloma and needs to be considered in the differential diagnosis of persistent skin lesions in wrestlers.

Outbreak of tinea corporis gladiatorum, a fungal skin infection due to Trichophyton tonsurans, in a French high level judo team

An outbreak of 49 cases of tinea corporis gladiatorum due to Trichophyton tonsurans infection occurred in a high level judo team of 131 members in Orléans, central France, between October 2004 and April 2005. The team was divided into 5 groups: cadet-junior boys (n=44), cadet-junior girls (n=33), male university students (n= 15), female university students (n=21), and a group called ‘pôle technique’ made up of high level judokas who have finished academic study (n=18). The outbreak involved 86% of the cadet-junior boys, but only 6 men in the ‘pôle technique’ (33%) and only 5 of the 69 other team members (7%) (cadet-junior girls and university students). We describe the outbreak and the results of a survey that found a known risk factor for the ‘pôle technique’: sharing an electric hair shaver. Personal hygiene practices were found to be very good among the cadet-junior boys. The high attack rate in this group may be linked to the poor shower facilities in the gymnasium where they practiced that led them to have their showers several hours after the end of daily practice.