Tinea incognito in Italy: a 15‐year survey

Romano, Clara; Maritati, E; Gianni, C.

doi:10.1111/j.1439-0507.2006.01251.x

Cited by 80 publications

(109 citation statements)

References 10 publications

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“…In a large Italian study, Romano et al [11] stated that the most frequent skin pathologies mimicking tinea incognita are eczema, impetigo, lupus erythematosus, rosacea and psoriasis. They sug- gest that a mycological examination should be performed in every atypical presentation of the above diseases.…”

Section: Discussionmentioning

confidence: 99%

Tinea Incognita following the Use of an Antipsoriatic Gel

Starace

Alessandrini

Piraccini

2015

Skin Appendage Disord

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Tinea incognita is a dermatophyte infection of the skin whose clinical presentation has been modified by the misuse of steroids or, as has been described recently, calcineurin inhibitors. We report a case of pustular psoriasis treated with an antipsoriatic cream, composed of topical steroids and a vitamin D3 derivative, which gave rise to a tinea incognita. Our case underlines that clinical features of fungal infection can be modified by the increasing use of self-prescribed topical therapies, usually applied to treat incorrectly ‘self-diagnosed' diseases. Moreover, we suggest that a mycological examination should be performed in every atypical presentation of skin lesion, and to rule out tinea pedis, in any disease of the feet that requires topical application of steroids.

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Section: Discussionmentioning

confidence: 99%

Tinea Incognita following the Use of an Antipsoriatic Gel

Starace

Alessandrini

Piraccini

2015

Skin Appendage Disord

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

A case of Tinea incognito diagnosed coincidentally

Şatana¹

2011

Jmid

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Tinea incognito is a dermatophytosis of atypical clinical character, usually misdiagnosed and treated with corticosteroids. A 17-year-old girl had erythematous papules and pustules on her face, diagnosed earlier as allergy and mistreated by topical corticosteroids and antihistamines. Facial lesions had only been investigated by bacteriological methods. Propionibacterium acnes was isolated on blood agar. Culture plates of the patient were inadvertently kept in the laboratory for approximately two weeks until the growth of white powdery colonies, which were identified as Trichopyton mentagrophytes complex. Epithelial scrapings were collected again and reinvestigated by mycological methods; after two weeks T. mentagrophytes complex was isolated once again on culture media. Thus, the case was diagnosed accidentally as Tinea incognito. It was realized that the patient previously was misdiagnosed and mistreated by topical steroids. J Microbiol Infect Dis 2011; 1(2): 84-86Key words: Tinea incognito, dermatophyte, T. mentagrophytes Kazara tanı alan bir Tinea incognito olgusu ÖZETTinea incognito atipik klinik özellikleri olan bir dermatofitoz olup genellikle yanlış tanı alır ve yanlışlıkla kortikosteroitlerle tedavi edilir. Yüzünde eritematöz papül ve püstüller bulunan 17 yaşındaki kadın hasta, başlangıçta allerji sanılıp yanlışlıkla topikal kortikosteroitlerle tedavi edildi. Yüzdeki lezyonlar yalnızca bakteriyolojik yöntemlerle incelendi. Kanlı agarda Propionibacterium acnes izole edildi. Hastanın kültür plaklarının laboratuvarda kazara iki hafta bekletilmesi sonucunda, beyaz pudra gibi kolonilerin oluştuğu gözlendi ve bu kolonilerin Trichopyton mentagrophytes kompleks olduğu anlaşıldı. Hastadan tekrar deri kazıntı örneği alındı ve mikolojik metotlarla incelenerek iki hafta sonraki kültür ortamında T. mentagrophytes kompleksi yeniden izole edildi. Böylece olgu kazara Tinea incognito olarak tanı almış oldu. Hastanın önceden yanlış tanı aldığı ve yanlış olarak topikal steroid ile tedavi edildiği.anlaşıldı. Anahtar kelimeler: Tinea incognito, dermatofit, T. mentagrophytesTinea incognito is usually caused by T. rubrum, T. mentagrophytes, Epidermophyton flocosums, Microsporum canis, and M. gypseum.

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“…Some medications such as steroids, antivirals, antibiotics and antihistamines, that are not able to eradicate fungal infections, can also cause atypical clinical manifestations [4]. Indeed, the most important factor influencing the clinical appearance seems to be prolonged use of steroids, especially topical steroids [5,6]. As a result, patients may face delayed diagnosis and prolonged healing time, as well as economic impact.…”

Section: Introductionmentioning

confidence: 99%

Cost analysis of inappropriate treatments for suspected dermatomycoses

Fiammenghi¹,

Patalano²,

Conte³

et al. 2015

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Superficial mycoses are estimated to affect more than 20-25% of the world's population with a consistent increase over the years. Most patients referred to our clinic for suspected dermatomycoses have already been treated with pharmacotherapy, without a previous mycological examination and many show changes in the clinical manifestations. Indeed, some medications, such as steroids, antiviral, antibiotics and antihistamines are not able to erase a fungal infection, but also they can cause atypical clinical manifestations. The consequences of inappropriate treatment include delayed diagnosis, prolonged healing time, and additional costs. The aims of this study were (1) to evaluate the incidence of increased costs attributable to inappropriate therapy sustained by the National Health Service and patients and (2) to highlight the importance of mycological evaluation before starting treatment, in order to improve diagnostic accuracy. An observational retrospective and prospective study was performed from September 2013 to February 2014, in 765 patients referred to our center (University Hospital " Federico II") in Naples, Italy, for suspected mycological infection. The following treatments (alone or in combination) were defined as inappropriate: (1) cortisone in a patient with at least one positive site; (2) antifungals in (a) patients with all negative sites or (b) ineffective antifungal treatment (in terms of drug chosen, dose or duration) in those with all positive sites; or (3) antibiotics; (4) antivirals or (5) antihistamines, in patients with ≥ 1 positive site. Five hundred and fifty patients were using medications before the assessment visit. The total amount of avoidable costs related to inappropriate previous treatments was € 121,417, representing 74% of the total treatment costs. 253/550 patients received drugs also after the visit. For these patients, the cost of treatment prescribed after mycological testing was € 42,952, with a decrease with respect to the total consumption of drugs at the time of access to the Mycology Laboratory of € 34,781. Thus, our cost analysis shows that it is important to obtain a reduction of costs for pathologies that need to be confirmed by examinations before starting treatment.

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Tinea incognito in Italy: a 15‐year survey

Cited by 80 publications

References 10 publications

Tinea Incognita following the Use of an Antipsoriatic Gel

Tinea Incognita following the Use of an Antipsoriatic Gel

A case of Tinea incognito diagnosed coincidentally

Cost analysis of inappropriate treatments for suspected dermatomycoses

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