Dermatitis Artefacta with Superficial Fungal Infection: a Case Report / 대한의진균학회지

ABSTRACT

A 76-year-old female presented with a 2-month history of skin lesions on both her buttocks. The skin lesions showed diffuse, erythematous scattered papules and macules with brown to black crusts. The patient believed that she had skin cancer and that the lesions had to be scrapped. She thus soaked her buttock in sikhye, a traditional Korean beverage, to treat the lesions. Based on patient history, she was diagnosed with dermatitis artefacta at the initial hospital visit. KOH examination was positive for hyphae and fungal cultures of Saccharomyces cerevisiae. She was treated with oral and topical antifungal agents for 6 months. The skin lesions improved at that time; however, she continued to scratch her buttock, and the skin lesions aggravated. Repeat fungal culture of the lesions revealed Candida glabrata, which was confirmed by genetic polymerase chain reaction sequencing. Consequently, she was treated with antifungal agents for 6 months. S. cerevisiae is widely used in baking, brewing, wine making, and biotechnology. S. cerevisiae and C. glabrata are considered relatively non-pathogenic fungal organisms. Here, we report a rare case of dermatitis artefacta combined with superficial infection of non-pathogenic fungal organism.