title: Tinea faciei by Microsporum gypseum mimicking allergic reaction following cosmetic tattooing of the eyebrows.
abstract: A 63-year-old healthy female patient presented with well defined itchy erythematous lesions on the area of her eyebrows. Her eyebrows had been tattooed two months before her visit to us. The lesions had previously been treated by application of steroid ointment and anti-histamine and steroid tablets by mouth without success. We suspected the lesions to be contact dermatitis caused by some metal element contained in the dye used for tattooing. Treatment was continued for two weeks, but the lesions spread to her cheeks and forehead. No fungal element was found from the lesions by direct microscopy at this stage. The patch-testing to 20 metal substances on her skin showed no allergic reaction. After one more week of treatment, we reexamined the scale taken from the lesions by direct microscopy, and fungal elements were found at that time. Microsporum (M.) gypseum was isolated from the scale taken from the lesions. The lesions cleared after treatment of 11 weeks' oral intake of itraconazole 100mg daily. It was found that the patient was accustomed to sleep with her dog, a Chihuahua. On examination by a veterinarian, no skin lesions were found on the dog. We speculate that the paws of the dog might have carried soil contaminated by M. gypseum, a geophilic fungus, to the area of her eyebrows which had minor trauma after being tattooed.
authors.affiliation: Department of Dermatology, Tokyo Women's Medical University Medical Center East, Japan.
authors.forename: Sumiko
authors.initials: S
authors.lastname: Ishizaki
authors.forename: Mizuki
authors.initials: M
authors.lastname: Sawada
authors.forename: Reiko
authors.initials: R
authors.lastname: Suzaki
authors.forename: Ken
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Junya
authors.initials: J
authors.lastname: Ninomiya
authors.forename: Masaru
authors.initials: M
authors.lastname: Tanaka
authors.forename: Takashi
authors.initials: T
authors.lastname: Harada
authors.forename: Seiji
authors.initials: S
authors.lastname: Kawana
authors.forename: Hinako
authors.initials: H
authors.lastname: Uchida
mesh_terms: D000818:Animals; D003357:Cosmetic Techniques / Q000009:adverse effects*; D003877:Dermatitis, Contact / Q000175:diagnosis*; D003881:Dermatomycoses / Q000175:diagnosis* / Q000209:etiology*; D003937:Diagnosis, Differential; D004285:Dogs / Q000382:microbiology; D005138:Eyebrows; D005148:Facial Dermatoses / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D008864:Microsporum; D008875:Middle Aged; D013653:Tattooing / Q000009:adverse effects*; D014005:Tinea / Q000175:diagnosis* / Q000209:etiology*