Thursday, April 30, 2009
Tinea incognito. DermNet NZ
Tinea incognito. DermNet NZ
Tinea incognito is the name given to tinea when the clinical appearance has been altered by inappropriate treatment, usually a topical steroid cream. Tinea is an infection with a dermatophyte fungus.
The result is that the original infection slowly extends. Often the patient and/or their doctor believe they have a dermatitis, hence the use of a topical steroid cream. The steroid cream dampens down inflammation so the condition feels less irritable. But when the cream is stopped for a few days the itch gets worse, so the steroid cream is promptly used again. The more steroid applied, the more extensive the fungal infection becomes.
Tinea incognito is the name given to tinea when the clinical appearance has been altered by inappropriate treatment, usually a topical steroid cream. Tinea is an infection with a dermatophyte fungus.
The result is that the original infection slowly extends. Often the patient and/or their doctor believe they have a dermatitis, hence the use of a topical steroid cream. The steroid cream dampens down inflammation so the condition feels less irritable. But when the cream is stopped for a few days the itch gets worse, so the steroid cream is promptly used again. The more steroid applied, the more extensive the fungal infection becomes.
Tinea Incognito
Tinea Incognito
Tinea corporis is a superficial fungal infection involving the body and face, with the exclusion of the beard area in men. The episodes may last for weeks to months and occurs in all age groups. It is more common in tropical or subtropical climates. Tinea incognito occurs if a topical glucocorticoid has been applied and the clinical appearance of the initial tinea lesion is altered, becoming less scaly, more extensive, pustular, pruritic, and painful (Berger, 2007; Committee on Infectious Diseases, American Academy of Pediatrics, 2006; Uphold & Graham, 2003; Wolff, Johnson, & Suurmond, 2005).
Tinea corporis is a superficial fungal infection involving the body and face, with the exclusion of the beard area in men. The episodes may last for weeks to months and occurs in all age groups. It is more common in tropical or subtropical climates. Tinea incognito occurs if a topical glucocorticoid has been applied and the clinical appearance of the initial tinea lesion is altered, becoming less scaly, more extensive, pustular, pruritic, and painful (Berger, 2007; Committee on Infectious Diseases, American Academy of Pediatrics, 2006; Uphold & Graham, 2003; Wolff, Johnson, & Suurmond, 2005).
Dermatophytosis (Tinea)
Dermatophytosis (Tinea)
Differential diagnosis
Other annular rashes are often confused with tinea infections. Eczema and psoriasis are commonly confused with tinea. Pityriasis versicolor occurs all over the trunk while candida occurs as a flexural rash at extremes of age or in the immunocompromised, diabetic or patients on antibiotics.Treatment with topical steroids often causes confusion making tinea less scaly and more erythematous. Steroid use also makes the 'active' edge and the inactive centre less distinct (tinea incognito). Clinically the diagnosis can be difficult, but if it is a possibility take scrapings for mycology. Other fungal infections look nothing like tinea. Other conditions to consider include:
Contact dermatitis
Seborrhoeic dermatitis
Intertrigo
Erythrasma
Mycosis fungoides
Alopecia areata
Differential diagnosis
Other annular rashes are often confused with tinea infections. Eczema and psoriasis are commonly confused with tinea. Pityriasis versicolor occurs all over the trunk while candida occurs as a flexural rash at extremes of age or in the immunocompromised, diabetic or patients on antibiotics.Treatment with topical steroids often causes confusion making tinea less scaly and more erythematous. Steroid use also makes the 'active' edge and the inactive centre less distinct (tinea incognito). Clinically the diagnosis can be difficult, but if it is a possibility take scrapings for mycology. Other fungal infections look nothing like tinea. Other conditions to consider include:
Contact dermatitis
Seborrhoeic dermatitis
Intertrigo
Erythrasma
Mycosis fungoides
Alopecia areata
Wednesday, April 29, 2009
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