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9 May 2025
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Beyond the surface: an uncommon case of Microsporum gypseum subcutaneous mycosis induced by an insect bite

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Deep cutaneous and subcutaneous infections caused by dermatophytes are exceptionally uncommon, typically occurring through traumatic inoculation. This clinical report details the complex dermatological journey of a young, immunocompetent 24-year-old girl who reported a rare case of a subcutaneous mycosis caused by Microsporum gypseum. The patient presented with an annular erythematous plaque with centered papules on her left hand, which she referred to as stemming from an insect bite. Initial evaluation at another hospital included a biopsy, which resulted in a preliminary diagnosis of pyoderma gangrenosum. Appropriate treatment with topical steroids and later oral cyclosporine provided no response, leading clinicians to perform a new biopsy and cultural examination; the patient was diagnosed with epidermomycosis and pustular folliculitis caused by Microsporum gypseum, a geophilic dermatophyte. In our patient’s case, terbinafine proved effective, resulting in complete remission. This article aims to emphasize the importance of considering rare conditions such as subcutaneous epidermomycosis when the patient’s medical history provides suggestive clues, particularly if the clinical manifestation aligns with the hypothesis.

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Ajello L. The dermatophyte, Microsporum gypseum, as a saprophyte and parasite. J Invest Dermatol 1953;21:157-71. DOI: https://doi.org/10.1038/jid.1953.86
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Carrasco-Zuber JE, Navarrete-Dechent C, Bonifaz A, et al. Cutaneous Involvement in the Deep Mycoses: A Literature Review. Part I—Subcutaneous Mycoses. Actas Dermosifiliogr 2016;107:806-15. DOI: https://doi.org/10.1016/j.adengl.2016.05.026
Maronese CA, Pimentel MA, Li MM, et al. Pyoderma Gangrenosum: An Updated Literature Review on Established and Emerging Pharmacological Treatments. Am J Clin Dermatol 2022;23:615-34. DOI: https://doi.org/10.1007/s40257-022-00699-8

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Beyond the surface: an uncommon case of Microsporum gypseum subcutaneous mycosis induced by an insect bite: None. (2025). Dermatology Reports. https://doi.org/10.4081/dr.2025.10266