Abstract: Human skin infection caused by Monascus ruber is clinically rare and predominantly occurs in immunocompromised individuals. We report a case of infectious granuloma of the right elbow caused by Monascus ruber infection in an 82-year-old male patient. The patient presented with recurrent generalized erythema and papules accompanied by pruritus for 3 years, with exacerbation over the past 3 months. Papulovesicular skin lesions developed on the right elbow with occasional pruritus. The diagnosis of Monascus ruber infection was confirmed by skin histopathological examination, fungal culture and molecular biological identification. The patient was treated with naftifine ketoconazole cream, and the condition improved after one week of treatment. However, due to failure to adhere to medical advice for maintenance therapy and follow-up visits, the skin lesions persisted and relapsed repeatedly, resulting in failure to achieve radical cure.

Key words: Monascus ruber, fungal infection, infectious granuloma, cutaneous infection