Majocchi's Granuloma - Symptoms, Causes & Treatment
Medically reviewed by Dr. Anand S. Urhekar, MD, MD Pathology, Clinical Advisor · Last updated July 2026
A deep dermatophyte infection in which fungus invades hair follicles and surrounding dermis, producing firm red papules, pustules and nodules — most often on shaved legs or after topical steroid use on unrecognised ringworm. Because the fungus sits below the epidermis, topical antifungals cannot reach it.
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Quick Answer
Majocchi's granuloma is a deep follicular fungal infection producing firm red bumps and nodules, typically on shaved legs or where steroid cream was applied to ringworm. Topical antifungals fail because the fungus is below the skin surface. Treatment is oral terbinafine or itraconazole for four to eight weeks, guided by fungal culture or biopsy.
Symptoms
- Firm red papules, pustules or nodules grouped in a patch
- Often on the lower legs, forearms or scalp
- May be tender
- Slow progression over weeks
- History of topical steroid applied to a scaly rash
Causes & Risk Factors
- Dermatophyte fungi, usually Trichophyton rubrum
- Follicular trauma from shaving or waxing
- Topical corticosteroid use over ringworm
- Immunosuppression
Treatment & Management
- Oral terbinafine or itraconazole for 4–8 weeks
- Stopping topical corticosteroids
- Fungal culture or skin biopsy for confirmation
- Treating any coexisting athlete's foot or nail infection
- Avoiding shaving affected areas while active
When to See a Doctor
See a doctor for persistent grouped red bumps on the legs that worsened with steroid cream, or any 'folliculitis' failing to respond to antibiotics.
Frequently Asked Questions
Why won't antifungal cream clear it?
The fungus has invaded the hair follicle and dermis, below the reach of topical treatment. Oral antifungals distributed through the bloodstream are required.
Did steroid cream cause this?
Steroid applied to an unrecognised ringworm patch suppresses the local immune response and allows the fungus to invade deeper, which is a classic route to Majocchi's granuloma.
Medical References
Information on this page is sourced from and verified against reputable medical resources:
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Medical Disclaimer: This information is for educational purposes only and is not intended as medical advice. The content on this page should not be used to diagnose or treat any health problem. Always consult with a qualified healthcare professional for proper medical evaluation, diagnosis, and treatment of your condition.