A dairy farmer is referred urgently for expanding lesions on his chest. He abraded the left side of his chest 3 weeks earlier while working in his barn. Subsequently the area enlarged and became hot and tender. The patient has a low grade fever and elevated white count. He did not improve after 72 hours of Intravenous Cloxacillin.
When seen by the Dermatology service, A KOH scraping, of the edge of one lesion was loaded with hyphae.
Culture grew Trichophyton verrucosum.
The patient was treated with oral terbinafine 250 mgs daily and cleared over the next 4 weeks.
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