AI Article Synopsis
- Candidal granuloma is a rare deep skin infection caused by the fungus Candida albicans, with this case presenting a 69-year-old woman who had a painful skin lesion on her hand for 3 years.
- Examination showed a large, reddish plaque with crusts, and biopsies confirmed the presence of yeast cells and hyphae, ultimately identifying Candida parapsilosis as the pathogen.
- The patient was successfully treated with itraconazole and terbinafine, leading to complete resolution of symptoms, emphasizing the need to consider fungal infections in chronic skin lesions, especially in those with weakened immune systems.
Article Abstract
Candidal granuloma is an uncommon type of deep chronic cutaneous candidiasis. Candida albican is the most common causative pathogen for candidal granuloma. We report herein the original case of a 69-year-old Chinese woman presented with a 3-year of painful cutaneous lesion on the back of left hand. Physical examination revealed a 4 × 5 cm large infiltrative reddish plaque with unclear boundaries. The yellow-white crusts were observed on the uneven surface of plaque. Histopathological examination of biopsy tissue revealed that yeast cells and the horizontal section of hyphae in the dermis by hematoxylin eosin staining and periodic acid-Schiff staining. Finally, the pathogen was identified as Candida parapsilosis by mycological examination and molecular identification. The patient was treated with itraconazole oral 200 mg twice daily combined with topical terbinafine hydrochloride cream for 2 months. The lesions were fully resolved and no recurrence was observed. Since the cutaneous infection caused by C. parasilosis were rarely reported, we also reviewed all 11 cases of cutaneous infection caused by C. parapsilosis in the PubMed. Our study highlighted that chronic unilateral infiltrated plaques or ulcers should be aware of the occurrence of fungal granuloma including candidal granuloma especially in immunocompromised patients.
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