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A 45-year-old man presented with pruritic skin lesions of atypical morphology located on his left foot referring flares of improvement after the use of topical corticosteroids with subsequent worsening after its discontinuation. A final diagnosis of dermatophytosis was reached through a skin biopsy, healing utterly after receiving antifungal therapy. Tinea incognito corresponds to fungi infections without the classical clinical symptoms mostly due to the improper use of topical corticosteroids, a situation that often misleads the physician. Its diagnosis may be a challenge and it requires a proper medical history, fungi cultures and occasionally, a skin biopsy. It should be borne in mind in those skin pathologies with an aberrant morphology despite several cycles of topical treatments because of the simplicity of the treatment and the high probability of recovery Keywords: Tinea incognito; Skin infections; Dyshidrotic eczema modified. The classical border would be blurred and the erythema as well as other signs of inflammation would disappear, misleading both the patient and the physician into thinking that the problem is solved. However, the local immunosuppression caused by this treatment help the fungi to proliferate, worsening the situation after the discontinuation of it, because it is likely that all the symptoms reappear beyond the borders of the original plaque. Corticosteroids have been made responsible for the majority of the cases of tinea incognito, but there have been several reports in which calcineurin inhibitors were involved [5]. Case PresentationA 45-year-old man with no medical history of interest, nonsmoker, presented with pruritic skin lesions located on both sides of his left foot. The lesions had begun 6 months before when he was diagnosed of dyshidrotic eczema beginning a treatment consisting in potent topical corticosteroids. After that, they disappeared almost completely, but they got worse when the treatment was stopped, so he resumed it several times after with the same result.During the physical examination, multiple erythematosus millimetric papules could be appreciated on both sides of the left foot (Figure 1), some of which converged forming plaques with minimum scaling on the surface as well as minute pustules on their periphery (Figure 2). No other dermatologic findings could be seen elsewhere. The DiagnosisA differential diagnosis between relapsing dyshidrotic eczema, palmoplantar pustulosis, allergic contact dermatitis and fungal infection was outlined based on the appearance of the skin lesions, its location, and the partial response to the treatments applied.A skin biopsy was carried out showing an epidermal hyperplasia, with some polymorphonuclear neutrophils in the stratum corneum ( Figure 3A). The Periodic acid-Schiff stain revealed fungi hyphae ( Figure 3B), reaching a final diagnosis of dermatophytosis. DiscussionDermatophytoses are a group of skin infections caused by fungi of three genera -Trycophyton, Microsporum and Epidermophyton. The most common pathogens ...

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