Multiple seborrheic keratosis‐like lesions of mycosis fungoides masquerading as the Leser–Trèlat sign
Abstract
chomycosis in her toenails led us to postulate that the infection into the deep dermis could have occurred through the adjacent hair follicles. The standard treatment for deep dermal dermatophytosis has not completely been established. Most patients received systemic antifungal therapy, including itraconazole, terbinafine, fluconazole, amphotericin B, micafungin and griseofulvin. In the present case, the patient was diagnosed with dermatophyte abscesses caused by T. rubrum. She showed a significantly high level of serum b-D-glucan, and p.o. administration of fosravuconazole was effective. Fosravuconazole, a water-soluble prodrug of ravuconazole, has been demonstrated to be rapidly converted to ravuconazole in vivo after p.o. administration. Similar to itraconazole, ravuconazole is highly active in vitro against T. rubrum. Ravuconazole has twofold higher bioavailability and threefold greater half-life compared with itraconazole. Our case suggests that fosravuconazole has clinical usefulness as a new therapeutic option for deeper dermal dermatophytosis with its advantages of high drug concentrations and long half-life.
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