title: Case Report. Bullous tinea pedis in an elderly man.
abstract: We report a case of recurrent bullous tinea pedis that had been misdiagnosed for a long time and treated with oral steroids. Initially, direct microscopy of potassium hydroxide preparations was negative and culture did not reveal any fungal organism. In a biopsy taken simultaneously from the edge of a bulla and stained with periodic acid-Schiff, septate mycelia were clearly visible. Trichophyton mentagrophytes was later identified in repeated cultures. The infection resulted in two clinical variants of tinea: initially, the vesiculobullous type and later - after intake of steroids because of an unrelated disease - the dry squamous hyperkeratotic type. The change of the clinical pattern indicates the important role of the host's immune response in determining the clinical presentation of the disease.
authors.affiliation: Center of Dermatology and Andrology, Justus Liebig University, Giessen, Germany. Yehia.El-Seguini@derma.med.Uni-Giessen.de
authors.forename: Y
authors.initials: Y
authors.lastname: El-Segini
authors.forename: W-B
authors.initials: WB
authors.lastname: Schill
authors.forename: W
authors.initials: W
authors.lastname: Weyers
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D012872:Skin Diseases, Vesiculobullous / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D014008:Tinea Pedis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D014249:Trichophyton / Q000302:isolation & purification*
chemical_list: D000935:Antifungal Agents