(BMJ)—A 9-yo girl and her 3-yo brother presented w/ a 15-day hx of facial rashes that worsened after tx w/ steroids. Parents reported the children had frequent “kissing contact” w/ apparently healthy pet guinea pigs. Exam: red, scaly, annular lesions near mouth. CBC, CMP, C-reactive protein WNL. What’s the dx?
Dermatophyte infxn
Trixacarus caviae infestation
Allergic contact dermatitis
Chlamydia caviae infxn
Impetigo
You are correct. A fungal infxn was suspected, and cx grew Arthroderma benhamiae, a zoophilic dermatophyte belonging to the Trichophyton mentagrophytes species complex. A benhamiae can lead to severe and difficult-to-manage mycosis, w/ a prominent inflammatory component, often w/o the classic “ringworm” of tinea infxn. Both pts were treated w/ topical miconazole bid and PO terbinafine daily x6wk, w/ complete resolution.

Archives of Disease in Childhood 2020;105:836
By switaschek, 14 September, 2020

SBP

By switaschek, 14 September, 2020

inpt

By switaschek, 14 September, 2020

HTN

By switaschek, 14 September, 2020

EtOH