Introduction:
Dermatophyte infections are characterized by local invasion of superficial keratinized structures such as skin, hair, and nails by members of the genera Trichophyton , Microsporum , andEpidermophyton .1,2 Organisms from these genera infect keratinocytes via arthrospores released from hyphae. Following attachment to keratinocytes, these arthrospores germinate, and establish infection in the stratum corneum of the skin.2 These infections clinically manifest as annular plaques with a collarette of scale. In humans, these infections are limited to the superficial layers of the skin due to the keratinophilic nature of the organism as well as intact cell mediated immunity limiting spread of the infection to deeper tissues.1,3,4 Uncommonly, when cell mediated immunity is impaired, these organisms can invade down the hair follicle resulting in Majocchi granuloma. Rarely deeper invasion may extend into the dermis and subcutaneous tissue.5,6 With an increasingly large variety of immunosuppressive medications on the market to treat patients with autoimmune conditions, malignancies, and solid organ transplants, there is an increasing population of immunosuppressed patients who may be at risk for invasive dermatophyte infections. This case presents a patient with recurrent tinea corporis who developed angioinvasive dermatophytosis in the setting of ongoing immunosuppressive treatment for chronic lymphocytic leukemia (CLL) and immune thrombocytopenia purpura (ITP).