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Vol 3, No 4 (2017)
Case report
Published online: 2018-03-01
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Diagnosis of dermatophytoses still problematic for general practitioners — 10 case studies and review of literature

Nicole Machnikowski12, Wioletta Barańska-Rybak3, Aleksandra Wilkowska3, Roman Nowicki3
Forum Dermatologicum 2017;3(4):157-165.
Affiliations
  1. Gdansk Medical University, Mari-Sklodowskiej- Curie, 80-210 Gdansk, Poland
  2. Ninwells Hospital & Medical School, Dundee, United Kingdom
  3. Department of Dermatology, Venerology and Allergology, University Clinical Centre in Gdańsk, Kliniczna St. 1A, 80-402 Gdańsk, Poland

open access

Vol 3, No 4 (2017)
CASE STUDY
Published online: 2018-03-01

Abstract

Dermatophytoses, also referred to as Tinea or Ringworm, is a fungal infection of the skin caused by Trichophyton, Microsporum and Epidermophyton dermatophytes. It presents clinically as an erythematous, scaly, pruritic rash with a well-defined border (1,4). Recognizing this clinical picture is still problematic and this issue needs to be addressed. Many factors can contribute to diagnostic errors such as: the fungal infection resembling lesions of another etiology (e.g. psoriasis, discoid eczema) or the lesions presenting atypically due to the prior use of topical steroids preparations (e.g. Tinea incognito). It is now well known that potent corticosteroids increase the number of fungal hyphae on the cutaneous surface due to a suppressed immune response, all whilst giving the impression that the patient’s lesions are improving (13,17.18.19). It is preventable by performing simple mycological tests in any skin lesions without one clear etiology. A cohort of 10 cases of cutaneous dermatophytic infections with varying initial misdiagnoses were analyzed on their cutaneous presentations, clinical course, and treatments in order to raise awareness and give guidance for general practitioners.

Abstract

Dermatophytoses, also referred to as Tinea or Ringworm, is a fungal infection of the skin caused by Trichophyton, Microsporum and Epidermophyton dermatophytes. It presents clinically as an erythematous, scaly, pruritic rash with a well-defined border (1,4). Recognizing this clinical picture is still problematic and this issue needs to be addressed. Many factors can contribute to diagnostic errors such as: the fungal infection resembling lesions of another etiology (e.g. psoriasis, discoid eczema) or the lesions presenting atypically due to the prior use of topical steroids preparations (e.g. Tinea incognito). It is now well known that potent corticosteroids increase the number of fungal hyphae on the cutaneous surface due to a suppressed immune response, all whilst giving the impression that the patient’s lesions are improving (13,17.18.19). It is preventable by performing simple mycological tests in any skin lesions without one clear etiology. A cohort of 10 cases of cutaneous dermatophytic infections with varying initial misdiagnoses were analyzed on their cutaneous presentations, clinical course, and treatments in order to raise awareness and give guidance for general practitioners.

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Keywords

tinea, dermatophyte, corticosteroids, antifungal treatment, tinea incognito

About this article
Title

Diagnosis of dermatophytoses still problematic for general practitioners — 10 case studies and review of literature

Journal

Forum Dermatologicum

Issue

Vol 3, No 4 (2017)

Article type

Case report

Pages

157-165

Published online

2018-03-01

Page views

712

Article views/downloads

2614

Bibliographic record

Forum Dermatologicum 2017;3(4):157-165.

Keywords

tinea
dermatophyte
corticosteroids
antifungal treatment
tinea incognito

Authors

Nicole Machnikowski
Wioletta Barańska-Rybak
Aleksandra Wilkowska
Roman Nowicki

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