Tinea Incognito: Case Report

Khalid Al Hawsawi*, Sumayah Alshehri, Nouf Al Muawad, Rwan Gaafar, Khloud Alsadi, Maather Alhajaji and Samar Alwafi

Tinea Incognito: Case Report.

Herein we present a 15-year-old boy presented with 8 months history of persistent
mildly itchy skin lesions on his face. Patient used many topical treatments including
steroid, but no improvement.

Skin examination showed multiple well defined scaly patches and plaques on
his face. Potassium hydroxide microscopic examination and fungal culture revealed
dermatophytes fungi.

Tinea incognito is the term given to a dermatophyte infection with atypical appearance due
to improper use of steroids or calcineurin inhibitors. It was first coined by Ive and Marks.

Patient used many topical treatments including steroid, but no improvement.
Past medical history and systemic review were all unremarkable.

Family history revealed history of atopic dermatitis in one of his siblings.
Skin examination showed multiple well defined scaly patches and plaques on the right side of his face.

Differential diagnosis included psoriasis, atopic eczema, contact dermatitis, and subacute
lupus erythematosus. KOH microscopic examination and fungal culture revealed dermatophytes fungi.

Topical application of steroids may modify the presentation of the dermatophyte infection.
TI on the face may mimic lupus erythematosus, rosacea, and contact dermatitis.

TI is a rare skin disease that presents as atypical dermatophytosis. The typical dermatophyte
infection presents as annular
lesions with active scaly borders and central clearing. It is a
diagnostic challenge for dermatologist because it may mimic a
variety of different dermatosis. A high index of suspension is
required for dermatosis that are unresponsive to topical immunosuppressants.

TI should be confirmed by KOH microscopic
examination and fungal culture to isolate dermatophytes. It is
better to be treated by treated oral antifungals.

Dermatol Open J. 2017; 2(1): 7-9. doi: 10.17140/DRMTOJ-2-120

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