J Korean Med Sci.  2013 Jan;28(1):145-151. 10.3346/jkms.2013.28.1.145.

Tinea Incognito in Korea and Its Risk Factors: Nine-Year Multicenter Survey

• Kim WJ
• Kim TW
• Mun JH
• Song M
• Kim HS
• Ko HC
• Kim BS
• Park CW
• Lee SJ
• Lee MH
• Lee KS
• Kye YC
• Suh KS
• Chung H
• Lee AY
• Kim KH
• Lee SK
• Park KC
• Lee JY
• Choi JH
• Lee ES
• Lee KH
• Choi EH
• Seo JK
• Choi GS
• Park HJ
• Yun SK
• Seo SJ
• Yoon TY
• Kim KH
• Yu HJ
• Ro YS
• Kim MB

• KMID: 2158014
• DOI: http://doi.org/10.3346/jkms.2013.28.1.145

Abstract

Tinea incognito (TI) is a dermatophytic infection which has lost its typical clinical appearance because of improper use of steroids or calcineurin inhibitors. The incidence of TI is increasing nowadays. We conducted retrospective review on 283 patients with TI from 25 dermatology training hospitals in Korea from 2002-2010 to investigate the demographical, clinical, and mycological characteristics of TI, and to determine the associated risk factors. More than half (59.3%) patients were previously treated by non-dermatologists or self-treated. The mean duration of TI was 15.0 +/- 25.3 months. The most common clinical manifestations were eczema-like lesion, psoriasis-like, and lupus erythematosus-like lesion. The trunk and face were frequently involved, and 91 patients (32.2%) also had coexisting fungal infections. Among 67 isolated strains, Trichophyton rubrum was the most frequently detected (73.1%). This is the largest study of TI reported to date and the first investigational report concerning TI in Korea. We suggest that doctors should consider TI when a patient has intractable eczema-like lesions accompanied by tinea pedis/unguium. Furthermore, there should be a policy change, which would make over-the-counter high-potency topical steroids less accessible in some countries, including Korea.

Keyword

Calcineurin Inhibitor; Dermatophytoses; Korea; Steroid; Tinea; Tinea Incognito

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Demography
Eczema/pathology
Face/pathology
Female
Humans
Lupus Erythematosus, Cutaneous/pathology
Male
Middle Aged
Psoriasis/pathology
Republic of Korea
Retrospective Studies
Risk Factors
Tinea/*diagnosis/microbiology
Trichophyton/isolation & purification
Young Adult

Figure

• 

  Fig. 1 Various features of tinea incognito (A-G). Vitiligo-like (A; pre-treatment, B; after 4 weeks of application of topical pimecrolimus, C; 6 weeks after topical antifungal treatment), contact dermatitis-like (D), nonspecific eczema-like (E), seborrheic dermatitis-like (F), and lupus erythematosus-like (G) lesions.

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