Tinea Incognito

Ive, F. A.; Marks, R.

doi:10.1136/bmj.3.5611.149

Cited by 158 publications

(94 citation statements)

References 4 publications

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“…Cases of tinea treated by corticosteroids are known as tinea incognito or steroid-modified tinea. 23 In the case presented here, the clinical picture was not grossly altered because the patient stopped using any drug days before the examination, then by allowing time for the lesion to partly resume its original appearance. The history was, however, typical.…”

Section: Discussionmentioning

confidence: 91%

Topical Corticosteroids: Clinical Examples of Abuses

1995

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Topical corticosteroids became available for use in 1952 when compound F or hydrocortisone was introduced. Modification of the basic corticosteroid molecule, e.g. by hallogenation or the optimization of the vehicle, enhances their effectiveness, the former by raising the potency 1 and the latter by increasing the percutaneous absorption. Case ReportsCase 1: A four-month-old female, product of a full term spontaneous vaginal delivery, presented to King Fahd Hospital of the University, Al Khobar, Saudi Arabia with generalized body swelling of two months' duration. The infant was normal up to the age of two months when she developed skin lesions in the face and diaper area. She was treated with clobetasol propionate 0.05% (dermovate cream) three to four times daily. After the lesions had healed, the mother continued to use the drug as a routine application to the napkin area. A total of eight tubes were consumed in a period of two months. Upon arrival at the hospital, the baby had an attack of generalized tonic-clonic convulsions with rolling of the eyes. Her vital signs on admission were temperature 38°C, pulse rate 180, blood pressure 120/100 mm/Hg and respiratory rate 54/min. She was comatose, responding only to painful stimuli. There was swelling of the trunk, fullness of the face, enlargement of the neck and a buffalo hump (Figure 1). Additionally, there were erythematous and acneiform lesions on the face and ecchymoses of the diaper area. Examination of the CNS showed hypertonia, brisk tendon reflexes and an upgoing plantar sign. The rest of the physical examination was within normal limits. CT scan of the brain showed cerebral and ventricular hemorrhage. Her morning serum Cortisol level was 3.4 μg/dL (normal value 8-28 μg/dL). Case 2: A 32-year-old male presented to the dermatology clinic, King Fahd Hospital of the University, with a three month history of an itchy skin lesion in the left groin. Before his referral to us, the patient was prescribed the following drugs over a period of two months: three tubes of betamethasone 0.05% dipropionate cream (diprosone), two tubes of flucinolone acetonide 0.025% cream (synalar) and two tubes of triamcinolone acetonide 0.1%, nystatin

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Section: Discussionmentioning

confidence: 91%

Topical Corticosteroids: Clinical Examples of Abuses

1995

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“…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. 1,5,8 Some physicians believe that they can diagnose even only by visual appearances without KOH and culture examinations. Although simple microscopic examination by KOH preparations of skin scrapings and culture may immediately solve the problem, especially when they have been treated earlier by local topical corticosteroids but no cure was established.…”

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

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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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“…Tinea inkognito ilk kez 1968 yılında Ive ve Marks 3 tarafından 14 olguluk bir olgu serisinde tanımlanmıştır. Bu olguların tümünde, tanı öncesinde steroid kullanım öyküsü olduğu ve dermatofit enfeksiyonlarının alışılmış klinik görünümünden farklı olduğu belirtilmiştir 3 . Tinea inkognito en sık egzema benzeri klinik görünüm ile prezente olurken bir çok dermatozu taklit edebilmektedir.…”

Section: Introductionunclassified