Tinea barbae represents a very rare dermatophytosis. We report on a tinea barbae profunda following a journey to Southeast Asia. After travel to Thailand, a businessman was affected by a foudroyant proceeding abscessing infection of the upper lip and beard area. The initial therapy with oral acyclovir and oral ciprofloxacin, which later was changed to ampicillin plus sulbactam, intravenously, was unsuccessful. In a biopsy sample, histologically, with Grocott-Gomori's methenamine silver stain, fungal mycelium was apparent in the tissue. Thereupon, terbinafine 250 mg was given for 4 weeks, topically, a 1% ciclopiroxolamine-containing cream. In fungal culture, T. mentagrophytes were found to grow. Meanwhile, the patient's German wife suffered from a tinea faciei. From skin scrapings from the cheek, T. mentagrophytes was also cultivated. This zoophilic dermatophyte was identical with other zoophilic strains of T. mentagrophytes currently found in Germany, which were also acquired in Thailand. The patient had contact with Thai female sex workers who must be considered as a source of infection of the dermatophytosis. There was no animal contact, neither in Thailand, nor in Germany. The infection chain of the dermatophytosis from Thailand probably reached from a female sex worker via the here described patient to his wife in Germany. This pathway of infection has been known for 1 or 2 years, but until now, in Germany, Switzerland, and Austria exclusively via pubogenital infections (tinea genitalis profunda) due to T. mentagrophytes after journeys to Southeast Asia. For treatment, oral antifungal agents should be used, first of all terbinafine, alternatively fluconazole or itraconazole.

The high return rate of this survey allows a relatively precise description of the current diagnostic methods used in German dermatology departments. Standard diagnostic tests are available nationwide and in bullous pemphigoid and pemphigus, the antigen-specific detection of autoantibodies is routinely performed in half of the departments. Rare disorders may be diagnosed by cooperation with some specialized centers.

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Zusammenfassung Letzten Sommer w?hrend einer l?ngeren Hitzeperiode stellte sich ein Mann mit juckendem, papul?sem, teils urtikariellem Exanthem in unserer Rettungsstelle vor. Am Tag zuvor war er Angeln an der Koberbach-Talsperre (Sachsen) und beim Pflanzenentfernen vom Uferbereich mit dem ganzen K?rper im Wasser gewesen. In Zusammenschau der Anamnese, Klinik und Histologie stellten wir die Diagnose einer Zerkariendermatitis. Die ?Badedermatitis? ist eine weltweit verbreitete Erkrankung, verursacht durch Infestation von Zerkarien aufgrund von Baden in zerkarienverseuchten Gew?ssern. Es entstehen juckende, papul?se Hautver?nderungen, bei wiederholter Exposition mit m?glicher Generalisation. Aufgrund der meist guten Wasserqualit?t in unseren Naturgew?ssern bzw. regelm??igen Kontrollen durch das Umweltamt kommt es heutzutage selten zum Auftreten dieser Erkrankung.