Chronic mucocutaneous candidiasis associated with malignant thymoma.

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A 48-year-old man noted itchy erythematous lesions on his face, trunk and extremities in August 1984. He was treated with topical and systemic steroid by a local dermatologist for about a month; however, the lesions spread further and in addition nodules with a thick crust developed on his face. Upon his initial visit to our hospital in October 1984, physical examination revealed many walnut sized nodules, papules and erythema with scales and crusts, especially on his face. His oral mucous membrane was covered with white plaques. There were many annular erythemas with pityroid scales on his trunk and extremities. All his toenails were thickened and discolored. His soles were also thickened with fissuring lesions. Candida albicans was cultured from the affected skin and mucosal lesions. Trichophyton mentagrophytes was cultured from his soles and toenails. Biopsy of the nodule on his forehead revealed hyperkeratotic granulomatous lesions with numerous fungal elements. A chest x-ray showed a tumor shadow on his left lung. On detailed examination, it was confirmed as a malignant thymoma. After an oral dosage of 200mg of ketoconazole for six weeks, the cutaneous lesions almost disappeared. However, the thymoma developed further despite medication. He died of dyspnea in October 1985. This case corresponds to the CMCC-Thymoma Syndrome, which Kirkpatrick described in 1979.
日本医真菌学会の論文