A Case of Tinea Barbae due to Trichophyton mentagrophytes Presenting as a Tumor.

Abstract

I report a case of tinea barbae presenting as a tumor in the philtrum of a man in his thirties with comorbid alcoholic liver disease. The patient also had tinea on the auricles, neck, and feet, with direct microscopy confirming the presence of dermatophytes at all sites. A history of multiple pet ownership was noted. The causative organism in the philtrum was identified as the zoophilic fungus Trichophyton mentagrophytes, while the tinea on the feet was caused by the anthropophilic fungus Trichophyton interdigitale ITS genotype II. Despite abnormal liver enzymes, the patient was cured after a three-month course of oral terbinafine following cessation of alcohol intake. This case, encountered by the author approximately 20 years ago, was initially identified as Arthroderma vanbreuseghemii using PCR-RFLP analysis of the ITS region of rRNA genes. Recent sequencing analysis of preserved strains reidentified the organism as T. mentagrophytes. The alignment of this strain showed a query cover of 100% and a percent identity (Per.ident) of 99.84%, matching with T. mentagrophytes ITS genotype VII. As a dermatologist, it is crucial to continuously monitor the evolving taxonomy of fungi and its clinical implications.