We report a rare case of vulvar Majocchi granuloma and kerion formation secondary to Trichophyton in an immunocompetent woman. The patient responded well to oral terbinafine and a short course of oral corticosteroids with a slow taper. Resolution of deep dermatophytosis requires prompt pathogen identification and treatment to avoid scarring and hair loss. Herein, we aim to increase clinical awareness and early recognition of this atypical presentation of a Majocchi granuloma with kerion formation.

Submitted as: (mark with X) X_Case Report _Case Presentation _Photo Vignette _Letter Authors declare that the contents of this article are their own original unpublished findings. Title: The use of systemic corticosteroids in debilitating sycosis barbae, sycosis barbae fulminans Authors: Kathleen R Krivda MD, Uzoamaka J Okoro MD, Nicholas F Logemann DO Affiliations: Department of Dermatology, Walter Reed National Military Medical Center, Bethesda, Bethesda, Maryland, USA Corresponding Author: Kathleen Krivda MD, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda MD 20889, Tel: 240-751-3823, Email: kathleenkrivda@gmail.com Abstract (no more than 200 words):

Majocchi granuloma (MG) is a rare dermal and subcutaneous fungal infection. We report a rare case of MG on the face of a six-year-old child caused by Trichophyton mentagrophytes after long term use of topical corticosteroids and other inadequate topical medications. He was treated with griseofulvin 25 mg/kg/day for 35 days unsuccessfully and successful treatment was obtained with terbinafine.