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Tinea incognito

Author: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. 2003.

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.

Compared with an untreated tinea corporis, tinea incognito:

There may also be secondary changes caused by long term use of a topical steroid such as:

Any organism causing tinea corporis may cause tinea incognito, but Trichophyton rubrum is the most common in New Zealand.

Diagnosis of tinea incognito

The diagnosis of tinea is made by taking skin scrapings for microscopy and culture.

If a skin biopsy is performed, the pathology of tinea incognito reveals the organisms.

Treatment of tinea incognito

Tinea is usually treated with topical antifungal agents, but if the treatment is unsuccessful, oral antifungal medicines may be considered, including terbinafine and itraconazole.

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