A Case of Superficial Mycoses in a Patient with Systemic Lupus Erythematosus

Author: mycolabadmin
1/23/2025
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Summary

A 52-year-old woman with lupus developed a widespread fungal skin infection that was initially mistaken for worsening lupus symptoms. The infection affected her scalp, face, and nails with two different types of fungi. After six months of treatment with antifungal medications, her symptoms resolved completely with no return of the infection during follow-up.

Background

Superficial mycoses are fungal infections affecting keratinized tissues such as epidermis, hair, and nails, affecting 20-25% of the global population. Patients with systemic lupus erythematosus (SLE) have intrinsic immune defects compounded by long-term immunosuppressive therapy, increasing susceptibility to fungal infections. While deep mycosis is known to occur in SLE patients, extensive superficial mycosis is rarely reported.

Objective

This case report presents a 52-year-old woman with a 10-year history of SLE who developed extensive superficial mycosis over a 2-year period, with initial misdiagnosis as SLE progression. The objective is to highlight the importance of considering fungal infections in immunocompromised SLE patients presenting with rashes and hair loss.

Results

Fungal culture identified Trichophyton tonsurans on the scalp and Candida tropicalis on the face. After 6 months of treatment with terbinafine 0.25g daily and itraconazole 0.2g twice daily (one week per month for three months), the patient’s rash subsided, hair regrew, and fungal microscopy became negative. No recurrence was reported during 6-month follow-up.

Conclusion

Clinicians must maintain high suspicion for fungal infections in SLE patients receiving long-term immunosuppressive therapy. Appropriate diagnosis through fungal culture and selection of systemic antifungal therapy based on infection site and fungal type are essential to prevent disease deterioration. Special attention to immune status and fungal infection risk is necessary in SLE patient management.

Published in:Clinical, Cosmetic and Investigational Dermatology,
Study Type:Case Report,
Source: 10.2147/CCID.S496301, PMID: 39872226