This 6-year-old boy was admitted to the hospital for parenteral treatment of a progressive cellulitis which did not respond initially to topical ketoconazole cream, triamcinolone cream, and then oral cephalexin. The initial ring continued to progress, and he developed a concentric ring around the first lesion. An x-ray of the left calf lesion showed a curvilinear opacity corresponding to the outer ring of the cutaneous plaque. He was treated with intravenous antibiotics with rapid decrease in the surrounding erythema. He was diagnosed with Majocchi granuloma and discharged on oral clindamycin and griseofulvin. One week later the lesion had resolved with minimal residual scale. Other authors who contributed to this case include Tregony C Simoneau MD, Timothy A Sanders MD PhD, and Robert Sidbury MD.
10 cm concentric annular plaques with coalescing peripheral papules and pustules and central scale