Diagnosis of dermatophytoses still problematic for general practitioners — 10 case studies and review of literature
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.
Keywords: tineadermatophytecorticosteroidsantifungal treatmenttinea incognito
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