Trichophyton rubrum suppurative tinea of the bald area of the scalp

Abstract

An 83-year-old man presented with an approximately 1-year history of an extensive inflammatory purulent crusted lesion in the bald area of the scalp diagnosed as tinea caused by Trichophyton rubrum. The scalp biopsy specimen showed suppurative folliculitis with perifollicular abscesses in upper dermis, and periodic acid-Schiff-positive fungal elements within the hair follicles and in the hyperkeratotic horny layer. The infection probably spread from diseased fingernails. A cure of the scalp lesion was achieved 2 months after starting daily oral treatment with 250 mg terbinafine. To our knowledge, the case presented is the first in which a suppurative abscess-forming T. rubrum infection of the bald area of the scalp in an immunocompetent man has been described.