Two Cases of Tinea Incognito Misdiagnosed as Eczema

Suh, Dong Woo; Lew, Bark Lynn; Sim, Woo Young

Abstract

Tinea incognito is a dermatophytosis of atypical clinical manifestation due to improper use of topical or systemic corticosteroids. We report two cases of tinea incognito misdiagnosed as eczema by non-dermatologist physicians. First, the lesions were manifested by pruritic, scaly localized erythematous macules and patches on the left ankle in a 61-year-old woman. She had been treated with topical steroids for 1 month without improvement. KOH smear revealed multiple fungal hyphae and histopathologic examination revealed the presence of fungal hyphae in the stratum corneum. Second, the lesions were manifested by localized scaly erythematous patches with pruritus on the face in a 76-year-old woman. She had been also treated with topical steroids for 2 months. KOH mount was positive for hyphae. All two patients were treated with 250 mg of terbinafine daily for 2 weeks and topical flutrimazole application. The lesions improved one month after treatment and no recurrence was observed.