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Indian Pediatr 2019;56: 433

Tinea Faciei Incognito


Aounallah Amina and Mokni Sana

From the Department of Dermatology, Farhat Hached Hospital, Tunisia.
Email: [email protected]

 


An 11-year-old boy without any medical history was seen by a general practitioner for inflammatory lesions of the left eyelid, and treated as eczema with topical corticosteroids (betamethasone) for last one month. Dermatological examination revealed a squamous and erythematous lesions strewn with papules and pustules, localized to the left upper and lower eyelids, with an extension to the periorbital region and forehead (Fig. 1). Mycological examination revealed hyphae, with Microsporum canis species identified on culture on Sabouraud’s medium. We diagnosed Tinea faciei incognito was due to Microsporum canis, and triggered by the local application of corticosteroids. The organism was most likely transmitted to the patient from his cat. The patient was advised twice daily applications of ketoconazole cream for 3 weeks, with which the lesion resolved completely, and mycological examination was negative.

Fig. 1 Pustular erythematous lesion of the upper and lower left eyelids in Tinea facia incognito.

Tinea faciei incognito is often difficult to diagnose because of the modification of the usual aspect of the dermatophytosis by the topical corticosteroids. The differential diagnoses for lesion at this site include contact dermatitis (very itchy, and its elementary lesion is a vesicle) and blepharitis due to Demodex mites (rosacea-like dermatitis, folliculitis, and blepharitis). The presence of satellite pustules and microscopic examination facilitates the diagnosis of Tinea faciei.

 

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