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Zacharopoulou A, Tsiogka A, Tsimpidakis A, Lamia A, Koumaki D, Gregoriou S. Tinea Incognito: Challenges in Diagnosis and Management. J Clin Med 2024; 13:3267. [PMID: 38892976 PMCID: PMC11172699 DOI: 10.3390/jcm13113267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 05/07/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
Tinea incognito is a dermatophyte infection with atypical features, due to the use of topical or systemic steroids or other immunosuppressive medications. Delayed diagnosis, spread of the infection to critical body surfaces, resistance to antifungal drugs, and increased costs due to prolonged hospitalization and multiple treatment regimens often complicate tinea incognito. It can affect individuals of all ages and genders, but it is more common in children. Atypical clinical appearance often necessitates differentiation from other diseases such as eczema, seborrheic dermatitis, lupus erythematosus, psoriasis, or other non-fungal skin conditions. The treatment of tinea incognito usually involves discontinuation of topical steroids or other immunosuppressive medications. Preventive measures and management of the underlying fungal infection are necessary and can be achieved with antifungal drugs. Patients should wear loose cotton clothes, use boiling water for laundry, and iron their clothing before wearing them. Additionally, they should avoid sharing bed linens, towels, clothes, and shoes. This review aims to raise awareness of tinea incognito among health practitioners, provide tips for detecting the disorder, include it in the differentials, and evaluate the available diagnostic procedures.
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Affiliation(s)
- Aikaterini Zacharopoulou
- Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 16121 Athens, Greece; (A.T.); (A.T.); (A.L.); (S.G.)
| | - Aikaterini Tsiogka
- Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 16121 Athens, Greece; (A.T.); (A.T.); (A.L.); (S.G.)
| | - Antonios Tsimpidakis
- Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 16121 Athens, Greece; (A.T.); (A.T.); (A.L.); (S.G.)
| | - Androniki Lamia
- Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 16121 Athens, Greece; (A.T.); (A.T.); (A.L.); (S.G.)
| | - Dimitra Koumaki
- Dermatology Department, University Hospital of Heraklion, 71110 Heraklion, Greece;
| | - Stamatios Gregoriou
- Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 16121 Athens, Greece; (A.T.); (A.T.); (A.L.); (S.G.)
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Kokandi AA. Tinea Incognito. Clin Cosmet Investig Dermatol 2024; 17:993-998. [PMID: 38737948 PMCID: PMC11086394 DOI: 10.2147/ccid.s465942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 04/29/2024] [Indexed: 05/14/2024]
Abstract
Tinea incognito (TI), or incognita, are superficial fungal dermatophyte infections that are changed in shape, most frequently because of topical, systemic steroids use and other immunosuppressants. There are different clinical presentations depending on host factors and the species of dermatophyte causing the disorder. Diagnosis can be challenging and might need combined methods. Once diagnosed the treatment is the usual antifungals, either topical or systemic or combined depending on the site, extent, and host factors.
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Affiliation(s)
- Amal Atallah Kokandi
- Department of Dermatology, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
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Kumar MB, Gulati N, Chander J, Singla N, Bhalla M, Nayyar C, Sharma S, Kaur M. Species Distribution and Antifungal Susceptibility Profile of Dermatophytes from a Tertiary Care Centre in North India. J Lab Physicians 2022; 14:449-455. [DOI: 10.1055/s-0042-1748826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Abstract
Objective Dermatophytoses, one of the most ancient diseases, is becoming a menace in recent times. This has made the knowledge of antifungal susceptibility a priority in today's times.
Material and Methods This is a prospective study conducted over 18 months including all dermatophytes isolated during the period. Dermatophytes were identified by routine phenotypic methods. Antifungal susceptibility testing was performed for griseofulvin, terbinafine, and itraconazole as per the Clinical Laboratory Standard Institute M38 A2, and minimum inhibitory concentrations (MICs) were read after 5 days.
Results Patient details and associated risk factors were recorded. Fixed dose combinations with steroids were associated with 79.3% (46 out of 58) of patients with dermatophytosis of skin. Among the 72 dermatophytes isolated during the study period, 58 (80.5%) were isolated from skin scrapings and 14 (19.4%) from nail samples. Tinea corporis with cruris was the most common presentation. The most common dermatophyte isolated from skin scrapings was Trichophyton mentagrophytes complex (70.6%, 41 out of 58), while from nail samples it was Trichophyton rubrum complex (78.57%, 11 out of 14). Based on the MIC50 and MIC90 results, itraconazole showed the lowest MICs, followed by terbinafine and then griseofulvin.
Conclusion With the changing epidemiology of species distribution and antifungal resistance, there is a need for continuous surveillance of these parameters of dermatophytes.
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Affiliation(s)
- Mani Bhushan Kumar
- Department of Microbiology, Government Medical College Hospital, Chandigarh, India
| | - Neelam Gulati
- Department of Microbiology, Government Medical College Hospital, Chandigarh, India
| | - Jagdish Chander
- Department of Microbiology, Government Medical College Hospital, Chandigarh, India
| | - Nidhi Singla
- Department of Microbiology, Government Medical College Hospital, Chandigarh, India
| | - Mala Bhalla
- Department of Dermatology, Venereology and Leprosy, Government Medical College Hospital, Chandigarh, India
| | - Charu Nayyar
- Department of Microbiology, Medanta Hospital, Sriganganagar, Rajasthan, India
| | - Swati Sharma
- Department of Microbiology, Government Medical College Hospital, Chandigarh, India
| | - Manharpreet Kaur
- Department of Microbiology, Government Medical College Hospital, Chandigarh, India
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Zhang F, Feng Y, Wang S, Li D, Shi D. Case Report and Literature Review of Impetigo-Like Tinea Faciei. Infect Drug Resist 2022; 15:2513-2521. [PMID: 35586559 PMCID: PMC9109911 DOI: 10.2147/idr.s359500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 04/29/2022] [Indexed: 11/25/2022] Open
Abstract
Impetigo, commonly caused by bacteria, is characterized by lesions of pustules, bullae or golden yellow crusts; it is seldom caused by fungi. Here, we report one case of a 17-year-old female patient with a 1-month history of erythematous pustules on her left cheek. She was clinically diagnosed with “impetigo”, but did not respond to 1 week of treatment with topical mupirocin cream (antibacterial agent). We then saw that a fungal colony grew on the culture, which was identified as T. mentagrophytes based on the morphological and molecular characteristics. The patient was then diagnosed with tinea faciei and was topically treated with 0.2% ketoconazole cream twice per day for 7 days. Through a literature review, we found another 18 cases of impetigo-like tinea faciei with similar clinical manifestations and pathogenic characteristics. Among these, the most common causative agent was T. mentagrophytes complex, which frequently occurs in children and adolescents and exhibits no gender preferences. Systemic and topical antifungals such as terbinafine or itraconazole are effective for impetigo-like tinea faciei caused by T. mentagrophytes complex. However, prolonged course of impetigo in more than 50% cases highlights the importance of mycological examination when dealing with apparent antibiotic-resistant impetigo cases in clinical settings.
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Affiliation(s)
- Fangfang Zhang
- College of Clinical Medicine, Jining Medical University, Jining, 272000, People’s Republic of China
- Department of Dermatology, Jining Dermatosis Prevention and Treatment Hospital, Jining, 272000, People’s Republic of China
| | - Yahui Feng
- College of Clinical Medicine, Jining Medical University, Jining, 272000, People’s Republic of China
| | - Sisi Wang
- Laboratory of Medical Mycology, Jining No. 1 People’s Hospital, Jining, 272000, People’s Republic of China
| | - Dongmei Li
- Department of Microbiology & Immunology, Georgetown University Medical Center, Washington, DC, 20057, USA
| | - Dongmei Shi
- Laboratory of Medical Mycology, Jining No. 1 People’s Hospital, Jining, 272000, People’s Republic of China
- Department of Dermatology, Jining No. 1 People’s Hospital, Jining, 272000, People’s Republic of China
- Correspondence: Dongmei Shi, Laboratory of Medical Mycology, Jining No. 1 People’s Hospital, Jining, 272000, People’s Republic of China, Tel +86 537-6051008, Email
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Tinea Incognito with Intrafamilial Outbreak Caused by Microsporum canis. J Pediatr 2022; 244:242-243. [PMID: 34953818 DOI: 10.1016/j.jpeds.2021.12.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/13/2021] [Accepted: 12/17/2021] [Indexed: 11/20/2022]
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Tinea Incognito—A Great Physician Pitfall. J Fungi (Basel) 2022; 8:jof8030312. [PMID: 35330314 PMCID: PMC8951265 DOI: 10.3390/jof8030312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 02/04/2023] Open
Abstract
Tinea incognito is a dermatophyte infection exacerbated after inadequate administration of topical or systemic glucocorticoids. A 57-year-old man presented to the Department of Dermatology due to skin lesions persisting for one month. He reported having recently worked under hot conditions, in tight clothing, which caused sweating. Later, he noticed erythematous–exfoliative lesions in his groins and on the buttocks. He presented to the general practitioner who diagnosed him with eczema and prescribed clobetasole ointment. Since the skin lesions became more severe, he presented to the Department of Dermatology. On the physical examination, extensive erythematous–infiltrative lesions were observed in the area of medial, lateral, and posterior surface of both thighs and buttocks. Pustules were also present. Suspicion of tinea incognito was raised, and direct mycological examination and culture confirmed the presence of dermatophytes. The patient was prescribed topical terbinafine and oral itraconazole. Tinea incognito may be challenging to diagnose because the clinical presentation is relatively nonspecific and definitive culture or histopathological diagnosis such as by microscopic sample examination to identify fungal elements is not universally available. Every doctor has to keep in mind the fact that tinea may be a great mimicker of other dermatoses and to not prescribe medications without microscopic confirmation of tinea, and refer patients for dermatological consultation in case of doubt.
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Nadelman D. Tinea incognita with secondary bacterial infection. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2022. [DOI: 10.4103/jdds.jdds_22_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Jhaj R, Asati DP, Chaudhary D, Sadasivam B. Topical steroid containing combinations: Burden of adverse effects and why the recent regulatory action may not be enough. Indian J Pharmacol 2021; 53:371-376. [PMID: 34854405 PMCID: PMC8641741 DOI: 10.4103/ijp.ijp_728_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES AND METHODS In September 2018, the government of India banned 328 fixed dose combinations (FDCs), 24 of which are combinations containing topical steroids. To assess what impact can be expected from this regulatory action, we analyzed reports of adverse drug events due to topical corticosteroids at a hospital-based pharmacovigilance center between January 2017 and August 2018. RESULTS Among 34 different steroid-containing FDCs responsible for 485 reports of ADEs with topical steroids, only three preparations, accounting for 50.10% of ADEs, come under the umbrella of the recent ban. Clobetasone propionate (68.87%) and betamethasone (28.45%) were the corticosteroids most frequently associated with adverse events. Most of the steroid preparations (87.84%) had been bought without a prescription for the treatment of dermatophytoses (76.70%). Males (77.73%) were predominantly affected, and nearly half (47.43%) of the patients were between 21 and 30 years of age. Skin atrophy (50.10%), striae (25.54%), and hypopigmentation (19.79%) were the major ADEs. CONCLUSION Nearly half of the cutaneous adverse effects were due to topical steroid combinations which are still widely available over the counter.
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Affiliation(s)
- Ratinder Jhaj
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Dinesh Prasad Asati
- Department of Dermatology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Deepa Chaudhary
- Regional Training Center for Pharmacovigilance, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Balakrishnan Sadasivam
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Diep D, Calame A, Cohen PR. Tinea Corporis Masquerading as a Diffuse Gyrate Erythema: Case Report and a Review of Annular Lesions Mimicking a Dermatophyte Skin Infection. Cureus 2020; 12:e8935. [PMID: 32760635 PMCID: PMC7392473 DOI: 10.7759/cureus.8935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Tinea is a superficial fungal infection of the skin. Gyrate erythemas are reactive conditions that present as annular red lesions. A 61-year-old woman was diagnosed with tinea corporis whose skin lesions morphologically mimicked a gyrate erythema. She presented with diffuse annular plaques affecting the left side of her chest and abdomen that did not respond to a combination antifungal-corticosteroid cream for six-month duration. The appearance and clinical differential diagnosis included a gyrate erythema. Initial evaluation of the skin biopsy from the lesion's edge demonstrated a spongiotic dermatitis, and staining for fungal organisms was negative. However, deeper sections and a different fungal stain revealed hyphae in the stratum corneum and established a diagnosis of tinea corporis. The PubMed database was used to review the following terms: tinea corporis, gyrate erythema, and tinea incognito. Relevant papers and references cited in those papers that were generated by the search were used. Tinea corporis, especially if previously treated with topical corticosteroids, can masquerade as other dermatoses including a gyrate erythema. Correlation of clinical presentation and pathology findings is essential, especially if the biopsy results do not confirm the suspected clinical diagnosis. Consideration to perform deeper sections or additional special stains or both should also be entertained when the initial pathology observations do not support the presumptive diagnosis based on clinical morphology and history.
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Affiliation(s)
- Darlene Diep
- Medicine, Burrell College of Osteopathic Medicine, Las Cruces, USA
| | - Antoanella Calame
- Dermatology/Dermatopathology, Compass Dermatopathology, San Diego, USA.,Dermatology, Scripps Memorial Hospital, La Jolla, USA
| | - Philip R Cohen
- Dermatology, San Diego Family Dermatology, National City, USA
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Cohen PR, Erickson C, Calame A. Malassezia (Pityrosporum) Folliculitis Incognito: Malessezia-associated Folliculitis Masked by Topical Corticosteroid Therapy. Cureus 2020; 12:e6531. [PMID: 32038889 PMCID: PMC6993079 DOI: 10.7759/cureus.6531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Malassezia (Pityrosporum) folliculitis usually appears as pruritic monomorphous papules and pustules on the upper back, chest, extensor arms and face. Acne vulgaris, bacterial folliculitis, eosinophilic folliculitis and systemic corticosteroid-induced acne can clinically mimic the fungal-caused acneiform condition. The designation incognito is used to describe tinea or scabies when the characteristic presentation is masqueraded by the application of topical corticosteroid treatment. Application of corticosteroid cream altered the morphology of the skin lesions in a man with Malassezia folliculitis. His cutaneous findings-localized areas of post-inflammatory hyperpigmentation with flattened or completely resolved follicular papules-raised the possibility of partially treated follicular eczema or follicular contact dermatitis. Pathognomonic findings from biopsies of the skin lesions established the diagnosis of Malassezia folliculitis; the condition completely resolved after treatment with topical antifungal shampoo and cream. Similar to tinea incognito and scabies incognito, folliculitis caused by Malassezia yeast in which the cutaneous morphology has been concealed by management with topical corticosteroids should be referred to as Malassezia (Pityrosporum) folliculitis incognito.
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Affiliation(s)
- Philip R Cohen
- Dermatology, San Diego Family Dermatology, San Diego, USA
| | | | - Antoanella Calame
- Dermatology/Dermatopathology, Compass Dermatopathology, Inc., San Diego, USA
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Sardana K, Khurana A, Singh A. Scientific rationale of antifungal drug combination, including oral itraconazole and terbinafine, in recalcitrant dermatophytoses. J DERMATOL TREAT 2019; 31:43-45. [PMID: 31580151 DOI: 10.1080/09546634.2019.1675857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Kabir Sardana
- Department of Dermatology, PGIMER & Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Ananta Khurana
- Department of Dermatology, PGIMER & Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Ajeet Singh
- Department of Dermatology, PGIMER & Dr Ram Manohar Lohia Hospital, New Delhi, India
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Abstract
Fungal infections in humans resulting from human or animal contact are relatively uncommon, but they include a significant proportion of dermatophyte infections. Some of the most commonly encountered diseases of the integument are dermatomycoses. Human or animal contact may be the source of all types of tinea infections, occasional candidal infections, and some other types of superficial or deep fungal infections. This narrative review focuses on the epidemiology, clinical features, diagnosis and treatment of anthropophilic dermatophyte infections primarily found in North America. Other human-acquired and zoonotic fungal infections also are discussed in brief.
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Affiliation(s)
- Dennis J Baumgardner
- Aurora University of Wisconsin Medical Group, Aurora Health Care, Milwaukee, WI; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI; Center for Urban Population Health, Milwaukee, WI
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Chang P, Moreno-Coutiño G. Review on Tinea Incognita. CURRENT FUNGAL INFECTION REPORTS 2016. [DOI: 10.1007/s12281-016-0262-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tinea incognito in an old patient with bullous pemphigoid receiving topical high potency steroids. J Mycol Med 2015; 25:245-6. [PMID: 26278826 DOI: 10.1016/j.mycmed.2015.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 07/12/2015] [Accepted: 07/13/2015] [Indexed: 11/19/2022]
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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. Tinea incognito in Korea and its risk factors: nine-year multicenter survey. J Korean Med Sci 2013; 28:145-51. [PMID: 23341725 PMCID: PMC3546093 DOI: 10.3346/jkms.2013.28.1.145] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 10/31/2012] [Indexed: 11/20/2022] Open
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.
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Affiliation(s)
- Won-Jeong Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Tae-Wook Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Je-Ho Mun
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Margaret Song
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hoon-Soo Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Byung-Soo Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Chun Wook Park
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Seok-Jong Lee
- Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Mu Hyoung Lee
- Department of Dermatology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Kyu Suk Lee
- Department of Dermatology, Keimyung University School of Medicine, Daegu, Korea
| | - Young Chul Kye
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Kee Suck Suh
- Department of Dermatology, Kosin University College of Medicine, Busan, Korea
| | - Hyun Chung
- Department of Dermatology, The Catholic University of Daegu College of Medicine, Daegu, Korea
| | - Ai Young Lee
- Department of Dermatology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - Ki Ho Kim
- Department of Dermatology, Dong-A University College of Medicine, Busan, Korea
| | - Sook Kyung Lee
- Department of Dermatology, Maryknoll Medical Center, Busan, Korea
| | - Kyoung Chan Park
- Department of Dermatology, Seoul National University Bundang Hostpital, Seongnam, Korea
| | - Jun Young Lee
- Department of Dermatology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jee Ho Choi
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun-So Lee
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
| | - Kwang Hoon Lee
- Department of Dermatology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eung Ho Choi
- Department of Dermatology, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jong Keun Seo
- Department of Dermatology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Gwang Seong Choi
- Department of Dermatology, Inha University College of Medicine, Incheon, Korea
| | - Hai Jin Park
- Department of Dermatology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Seok Kweon Yun
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea
| | - Seong Jun Seo
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Tae Young Yoon
- Department of Dermatology, Chungbuk National University School of Medicine, Cheongju, Korea
| | - Kwang Ho Kim
- Department of Dermatology, Hallym University College of Medicine, Anyang, Korea
| | - Hee Joon Yu
- Department of Dermatology, Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Young Suck Ro
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Moon-Bum Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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Uva L, Miguel D, Pinheiro C, Antunes J, Cruz D, Ferreira J, Filipe P. Mechanisms of action of topical corticosteroids in psoriasis. Int J Endocrinol 2012; 2012:561018. [PMID: 23213332 PMCID: PMC3508578 DOI: 10.1155/2012/561018] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 10/14/2012] [Accepted: 10/20/2012] [Indexed: 11/17/2022] Open
Abstract
Psoriasis is a lifelong, chronic, and immune-mediated systemic disease, which affects approximately 1-3% of the Caucasian population. The different presentations of psoriasis require different approaches to treatment and appropriate prescriptions according to disease severity. The use of topical therapy remains a key component of the management of almost all psoriasis patients, and while mild disease is commonly treated only with topical agents, the use of topical therapy as adjuvant therapy in moderate-to-severe disease may also be helpful. This paper focuses on the cutaneous mechanisms of action of corticosteroids and on the currently available topical treatments, taking into account adverse effects, bioavailability, new combination treatments, and strategies to improve the safety of corticosteroids. It is established that the treatment choice should be tailored to match the individual patient's needs and his/her expectations, prescribing to each patient the most suitable vehicle.
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Affiliation(s)
- Luís Uva
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
- *Luís Uva:
| | - Diana Miguel
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| | - Catarina Pinheiro
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| | - Joana Antunes
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| | - Diogo Cruz
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| | - João Ferreira
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| | - Paulo Filipe
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
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Morales-Cardona CA, Bermúdez-Bula LF. [Disseminated tinea incognita mimicking pustular psoriasis]. Rev Iberoam Micol 2011; 29:47-8. [PMID: 21816230 DOI: 10.1016/j.riam.2011.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 06/17/2011] [Accepted: 06/29/2011] [Indexed: 11/26/2022] Open
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19
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Agustí-Mejias A, Messeguer Badia F, Agustí Mejias P, Febrer I, Alegre-de Miquel V. [Tinea corporis in a patient with black skin; the importance of the direct examination]. An Pediatr (Barc) 2011; 75:290-2. [PMID: 21752741 DOI: 10.1016/j.anpedi.2011.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2010] [Revised: 05/01/2011] [Accepted: 05/08/2011] [Indexed: 11/29/2022] Open
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20
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[Tinea of the buttocks]. Presse Med 2011; 40:1209-10. [PMID: 21511429 DOI: 10.1016/j.lpm.2011.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 03/08/2011] [Indexed: 11/21/2022] Open
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21
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Polilli E, Fazii P, Ursini T, Fantini F, Di Masi F, Tontodonati M, Sozio F, Parruti G. Tinea incognito Caused by Microsporum gypseum in a Patient with Advanced HIV Infection: A Case Report. Case Rep Dermatol 2011; 3:55-9. [PMID: 21487462 PMCID: PMC3073754 DOI: 10.1159/000326055] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The prevalence and the clinical relevance of dermatophytoses in HIV-infected patients are poorly documented, particularly for those caused by tinea incognito. Here, we report a case of widespread facial tinea incognito occurring in an Italian patient with advanced HIV infection, showing both skin and brain lesions. Second-line treatment with liposomal amphotericin B and cotrimoxazole, administered after a microbiological characterization of the skin scrapings, led to complete clearance of all lesions.
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Affiliation(s)
- Ennio Polilli
- Unit of Clinical Pathology, Pescara General Hospital, Pescara, Modena, Italy
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