Tinea incognito due to Trichophyton mentagrophytes

Abstract

Tinea incognito is a dermatophytosis of atypical clinical character, usually misdiagnosed and treated with corticosteroids. We report a case of tinea faciei modified by high potency topical corticosteroids in a 54-year-old woman. Deep, intense inflammatory plaque with boggy, pustular surface located on the right cheek was found. Direct microscopy and culture confirmed dermatophytosis and led to the identification of Trichophyton mentagrophytes var. mentagrophytes. Complete resolution occurred after treatment with oral terbinafine.

Tinea Incognito Simulating Herpes Simplex Virus Infection

“…Topical corticosteroids allow fungi to grow readily, and alter the clinical feature of the lesions, because they have immunosuppressive activity5. Regretfully, glucocorticosteroids are extensively used by patients and non-dermatologists, and lead to long-lasting fungal infections1, similar to that which occurred in our case.…”

“…The clinical features of tinea faciei are characterized by various morphology, and because of that, the entity can mimic many other cutaneous disorders1. Moreover, because tinea faciei is relatively uncommon when compared with other forms of superficial fungal infection, it is often misdiagnosed; and treated with glucocorticosteroids, not antifungal agents1.…”

“…Moreover, because tinea faciei is relatively uncommon when compared with other forms of superficial fungal infection, it is often misdiagnosed; and treated with glucocorticosteroids, not antifungal agents1. Imprecise use of topical or oral corticosteroids in tinea faciei can modify their clinical features, and make the correct diagnosis more difficult2; therefore, tinea faciei is one of the considerable examples of tinea incognito1. One retrospective study showed 35.7% cases of tinea incognito among tinea faciei, because of improper diagnosis, and inappropriate therapy3.…”

A case of Tinea incognito diagnosed coincidentally

“…As a result of misdiagnosis, tinea facei is often treated with topical steroids and can lead to a clinical presentation called T. incognito. [1][2][3][4][5][6][7][8][11][12][13][14] Administration of potent topical steroids before microbiological diagnosis is one of the biggest problems in the management of fungal infections. It has been demonstrated that potent topical steroids can increase the numbers of hyphae present on the surface of the skin in fungal infections and change the appearance of the lesions.…”

“…Tinea incognito should be included in the differential diagnosis of suppurative skin infections, especially when they have earlier been treated by local topical corticosteroids without response. [1][2][3][4]7,[11][12][13][14][15][16][17][18] Therefore, in order to prevent unnecessarily use of steroids for the facial infections, we strongly suggest making mycological examination.…”