Atypical Presentation of Trichophyton tonsurans Mimicking Non-Healing Ulcer: A Case Report

Dermatophytosis is superficial cutaneous fungal infection of skin, hair, and nails. Trichophyton tonsurans is an anthropophilic cosmopolitan dermatophyte most frequently associated with Tinea capitis. A 58-year-old female presented with non-healing ulcers of 6-month duration on left leg, mimicking squamous cell carcinoma and atypical mycobacterial infection. Skin biopsy was taken and preparation of 10% KOH revealed plenty of thin hyaline septate hyphae. Fungal culture on SDA with and without antibiotics showed whitish suede like fungal growth with central furrows. The fungus was identified as Trichophyton tonsurans. Antifungal treatment was started and patient improved drastically after 3–4 weeks of treatment. We conclude that for all cases of non-healing ulcers, a suspicion of fungal infection must be kept and skin biopsy should be sent for fungal culture.