Tinea blepharo-ciliaris in a 13-year-old girl caused by Trichophyton benhamiae

Tinea blepharo-ciliaris is a rare form of dermatophyte infection which involves eyelids and associated eyelashes. We report a 13-year-old girl with type I diabetes mellitus who had right eyelid swelling and eyelash loss for two weeks. The lesions were presented as erythematous patches with scales and tiny pustules on the right upper and lower eyelids with broken eyelashes. Two additional annular erythematous patches with scaly active borders were found on her right forearm and right thigh. Microscopic examination of broken eyelashes demonstrated many chains of arthroconidia and hyaline hyphae in an endothrix invasion pattern. Fungal cultures of right eyelid scales, eyelashes, and right thigh lesions all grew Trichophyton benhamiae, which was diagnosed by both morphological characters and sequencing of internal transcribed spacer region of the ribosomal DNA. The patient had a contact history with rabbits. To the best of our knowledge, this is the first case of tinea blepharo-ciliaris caused by T. benhamiae, and also the first formal report of infection by this fungus in Taiwan.