Mycetoma of the scalp and the nape in Dakar

Between 1984 and 1996, 163 cases of mycetoma were seen at the Clinic of Dermatology, Le Dantec Hospital, Dakar, Senegal. Six of the 163 cases (3.7%) involved the head and the neck. Clinically mycetoma was suspected in only two cases. The diagnosis was confirmed by histopathology, eumycotic white grains were found in all biopsies. The morphology of the grains in two cases (one of the scalp and one of the neck) was caracteristic of the Pseudallescheria boydii-Acremonium-Fusarium group. An Acremonium sp. was isolated by culture of grains of the neck mycetoma. The histological examination of the four remaining cases, involving the scalp, revealed granules conforming to the description of dermatophytic grains. Culture of granules yield Microsporum langeronii in one of these four patients, a women who had a neighboring microscopic tinea capitis due to the same agent. Scalp and neck mycetoma are rare. The majority of dermatophytic mycetoma were observed in black Africans.