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A Case of Tinea Incognito Mimicking Folliculitis in Atopic Dermatitis Patient

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초록

A 27-year-old male with underlying history of atopic dermatitis presented with skin lesion on the trunk and upper extremity, occurring a month ago. Scattered erythematous multiple tiny maculopapules and patches were noticed. The lesion was first diagnosed as aggravated atopic dermatitis with folliculitis based on the clinical manifestation, but had failed to improve with antibiotics and medications for atopic dermatitis. KOH examinations were performed on his upper arm's lesion, and with detection of hyphae and isolation of Trichophyton rubrum by fungus culture, he was successfully treated with oral itraconazole 200 mg/day and topical flutrimazole. Tinea incognito refers to dermatophyte infections with atypical clinical presentation caused by previous treatment with steroid. Nowadays, the cases of tinea incognito have been increasing due to the increased usage of steroid and other immunosuppressants. Therefore, it is essential to include fungal infection in the differential diagnosis when cutaneous lesions are noticed in patients taking steroid and other immunosuppressants. Herein, we present a tinea incognito that clinically mimicked folliculitis in atopic dermatitis patient.

Abstract

A 27-year-old male with underlying history of atopic dermatitis presented with skin lesion on the trunk and upper extremity, occurring a month ago. Scattered erythematous multiple tiny maculopapules and patches were noticed. The lesion was first diagnosed as aggravated atopic dermatitis with folliculitis based on the clinical manifestation, but had failed to improve with antibiotics and medications for atopic dermatitis. KOH examinations were performed on his upper arm's lesion, and with detection of hyphae and isolation of Trichophyton rubrum by fungus culture, he was successfully treated with oral itraconazole 200 mg/day and topical flutrimazole. Tinea incognito refers to dermatophyte infections with atypical clinical presentation caused by previous treatment with steroid. Nowadays, the cases of tinea incognito have been increasing due to the increased usage of steroid and other immunosuppressants. Therefore, it is essential to include fungal infection in the differential diagnosis when cutaneous lesions are noticed in patients taking steroid and other immunosuppressants. Herein, we present a tinea incognito that clinically mimicked folliculitis in atopic dermatitis patient.

참고문헌 (10)

  1. 김수영, "아토피 피부염 환자에서 발생한 Trichophyton rubrum에 의한 잠행백선 1예", 대한의진균학회지, 19(3), pp.59~63 (2014), 대한의진균학회[DOI]
  2. 김원정, "Tinea Incognito in Korea and Its Risk Factors: Nine-Year Multicenter Survey", Journal of Korean Medical Science, 28(1), pp.145~151 (2013), 대한의학회
  3. Ive Fa, "Tinea incognito", Br Med J, 3, pp.149~152 (1968)
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  5. Romano C, "Tinea incognito in Italy: a 15-year survey", Mycoses, 49, pp.383~387 (2006)
  6. Ansar A, "Clinico-epidemiological and mycological aspects of tinea incognito in Iran: A 16-year study", Med Mycol J, 52, pp.25~32 (2011)
  7. Aghamirian MR, "Dermatophytoses in outpatients attending the Dermatology Center of Avicenna Hospital in Qazvin, Iran", Mycoses, 51, pp.155~160 (2008)
  8. Aghamirian MR, "Dermatophytes as a cause of epizoonoses in dairy cattle and humans in Iran: epidemiological and clinical aspects", Mycoses, 54, pp.e52~e56 (2011)
  9. 유광호, "아토피피부염 환자에서의 표재성 진균증", 대한피부과학회지, 47(1), pp.1~5 (2009), 대한피부과학회
  10. Szepietowski JC, "Trichophyton rubrum autoinoculation from infected nails is not such a rare phenomenon", Mycoses, 51, pp.345~346 (2008)

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