title: A case of tinea incognito.
abstract: Tinea incognito is a dermatophyte infection of the skin that presents atypically because it has previously been treated with imunnosuppresive medication. Herein we present a case of a middle-aged man who was initially clinically diagnosed to have plaque-type psoriasis on his arms. Over the course of two months of topical hydrocortisone and calciptriol treatment as well as phototherapy, the rash worsened. At the time of presentation to hospital the patient had a pruritic, widespread, sloughing, erythematous rash with areas of eschar. A punch biopsy skin confirmed dermatophyte fungal infection of the skin. Fungal culture was positive for Trichophyton Rubrum and the eruption resolved with systemic anti-fungal therapy. Patient specific risk factors for atypical presentation included poor hygiene and hepatatic disease.
authors.affiliation: Schulich School of Medicine, Department of Medicine, Western University, London, Ontario, Canada.
authors.forename: Dan
authors.initials: D
authors.lastname: Segal
authors.forename: Malcolm M
authors.initials: MM
authors.lastname: Wells
authors.forename: Amit
authors.initials: A
authors.lastname: Rahalkar
authors.forename: Mariamma
authors.initials: M
authors.lastname: Joseph
authors.forename: Marko
authors.initials: M
authors.lastname: Mrkobrada
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D002117:Calcitriol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003951:Diagnostic Errors; D005076:Exanthema / Q000175:diagnosis; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects / Q000627:therapeutic use*; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000175:diagnosis; D012867:Skin / Q000473:pathology; D014005:Tinea / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology / Q000532:radiotherapy; D014249:Trichophyton / Q000302:isolation & purification; D014467:Ultraviolet Therapy / Q000009:adverse effects
chemical_list: D000935:Antifungal Agents; D007166:Immunosuppressive Agents; C055085:calcipotriene; D015725:Fluconazole; D002117:Calcitriol; D006854:Hydrocortisone