title: First case of subcutaneous dermatomycoses in a Tunisian renal transplant patient.
abstract: BACKGROUND
  Dermatophytes are keratinophilic and usually infect the corneal layer of the epidermis and appendages On the occasion of immunosuppression, such as solid organ transplant, they can invade deeper tissues or cause an infection of the skin and subcutaneous disseminated.
  
  
  OBJECTIVE
  To report the first observation of subcutaneous dematophytosis in a Tunisian renal transplant patient.
  
  
  METHODS
  A 29-year-old man had an erythematous lesion of 2 cm at the front of the left leg. He was treated with prednisone and tacrolimus. The skin lesion was has been neglected. The outcome was the occurrence of oozing whose mycological examination showed numerous hyphae and culture was positive for Microsporum canis. Initial treatment was voriconazole, but an interaction with tacrolimus has shortened the duration of treatment to 1 month. Three months later, the lesion became deeper, and then a biopsy was performed. The mycological examination showed the same appearance, previously described. The patient was put on fluconazole by adjusting the doses of tacrolimus and then underwent surgical excision of the lesions. The evolution after 4 months of antifungal treatment was favorable.
  
  
  CONCLUSIONS
  The increasing incidence of immunosuppressive therapy has given rise to unusual clinical forms of invasive and sometimes serious fungal agents whose pathogenicity is usually limited. Clinicians should be mindful of superficial fungal infections of the skin in a renal transplant patient.
authors.affiliation: Department of Internal Medicine, Charles Nicolle Hospital, Tunis, Tunisia.
authors.forename: Sonia
authors.initials: S
authors.lastname: Trabelsi
authors.forename: Amira
authors.initials: A
authors.lastname: Aouinet
authors.forename: Ezzeddine
authors.initials: E
authors.lastname: Abderrahim
authors.forename: Taieb
authors.initials: T
authors.lastname: Ben Abdallah
authors.forename: Adel
authors.initials: A
authors.lastname: Khedher
authors.forename: Samira
authors.initials: S
authors.lastname: Khaled
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D003881:Dermatomycoses / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation; D008297:Male; D008864:Microsporum / Q000302:isolation & purification; D014416:Tunisia
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole