title: Common features of periocular tinea.
abstract: OBJECTIVE
  To present the common features of periocular tinea to aid physicians in future diagnosis and therapy of this condition, because superficial fungal infections on the face are often misdiagnosed owing to the diverse morphologies that they manifest. This is especially true of dermatophytoses involving the periocular region.
  
  
  METHODS
  A retrospective review was performed of patients with a diagnosis of periocular tinea who were seen between January 2003 and September 2009 in the pediatric dermatology clinic at St. Louis Children's Hospital.
  
  
  RESULTS
  Ten cases of periocular tinea were identified (6 male patients and 4 female patients). Common features included prolonged misdiagnosis (all 10 cases), a normal ophthalmologic examination (all 10 cases), and inappropriate corticosteroid application (7 cases). Loss of the eyelashes occurred in all 10 patients. No cases had evidence of other tinea infections on examination. Only 2 cases had the central clearing classically associated with tinea corporis. Seven patients had a potassium hydroxide preparation and/or culture positive for fungal elements. Lesions improved with topical and oral antifungal treatment in all cases, and patients were able to regrow their eyelashes.
  
  
  CONCLUSIONS
  Periocular tinea should be considered in the differential diagnosis for periocular inflammation, especially in those patients refractory to therapy for more common conditions. Loss of the eyelashes is characteristic of these fungal infections, similar to the hair loss that occurs in kerions associated with tinea capitis.
authors.affiliation: Department of Internal Medicine, Division of Dermatology, Washington University School of Medicine, and St Louis Children's Hospital, St Louis, MO 63110, USA.
authors.forename: S Alison Finger
authors.initials: SA
authors.lastname: Basak
authors.forename: David R
authors.initials: DR
authors.lastname: Berk
authors.forename: Gregg T
authors.initials: GT
authors.lastname: Lueder
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Bayliss
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D019557:Dermatitis, Perioral / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D003937:Diagnosis, Differential; D004464:Econazole / Q000627:therapeutic use; D004485:Eczema / Q000175:diagnosis; D015821:Eye Infections, Fungal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005140:Eyelashes / Q000382:microbiology / Q000473:pathology*; D005141:Eyelid Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005148:Facial Dermatoses / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006118:Griseofulvin / Q000627:therapeutic use; D006801:Humans; D007169:Impetigo / Q000175:diagnosis; D008297:Male; D009824:Ointments; D012189:Retrospective Studies; D014005:Tinea / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D009824:Ointments; D006118:Griseofulvin; D004464:Econazole