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Tinea Pseudoimbricata as a Unique Manifestation of Steroid Abuse: A Clinico-Mycological and Dermoscopic Study from a Tertiary Care Hospital.
Indian Dermatol Online J 2019 Jul-Aug; 10(4):422-425ID

Abstract

Background

Tinea pseudoimbricata, characterized by concentric scaly rings simulating Tinea imbricata is caused by dermatophytes other than Trichophyton concentricum. It is reported to occur in patients with steroid abuse and in immunocompromised individuals.

Aim

To study the clinico-mycological profile and dermoscopic features of T. pseudoimbricata in immunocompetent patients.

Methods

We have evaluated 14 consecutive, clinically diagnosed patients of T. pseudoimbricata with positive 10% potassium hydroxide (KOH) examination and culture, seen over a period of 6 months. Dermoscopy was performed in all patients. The demographic, clinical, and mycological features of each patient were recorded on a predesigned proforma.

Results

There were seven male and seven female patients with a mean age of 27.6 years and a mean disease duration of 3.8 months. All patients gave a history of application of potent or super-potent topical steroid with or without oral/injectable steroid for varying duration. Culture isolates were Trichophyton mentagrophytes complex and Trichophyton rubrum in 11 and 3 patients, respectively. Dermoscopic analysis showed features of steroid abuse in majority of the patients.

Limitation

A small sample size was the limitation of our study.

Conclusion

T. pseudoimbricata is a special subset of Tinea incognito caused by injudicious and inappropriate use of topical steroid. The typical appearance should alert the dermatologists regarding the possible abuse of steroids. Most common species isolated on culture was T. mentagrophytes complex.

Authors+Show Affiliations

Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital (University of Delhi), Dilshad Garden, Delhi, India.Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital (University of Delhi), Dilshad Garden, Delhi, India.Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital (University of Delhi), Dilshad Garden, Delhi, India.Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital (University of Delhi), Dilshad Garden, Delhi, India.Department of Microbiology, University College of Medical Sciences and GTB Hospital (University of Delhi), Dilshad Garden, Delhi, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31334062

Citation

Singal, Archana, et al. "Tinea Pseudoimbricata as a Unique Manifestation of Steroid Abuse: a Clinico-Mycological and Dermoscopic Study From a Tertiary Care Hospital." Indian Dermatology Online Journal, vol. 10, no. 4, 2019, pp. 422-425.
Singal A, Jakhar D, Kaur I, et al. Tinea Pseudoimbricata as a Unique Manifestation of Steroid Abuse: A Clinico-Mycological and Dermoscopic Study from a Tertiary Care Hospital. Indian Dermatol Online J. 2019;10(4):422-425.
Singal, A., Jakhar, D., Kaur, I., Pandhi, D., & Das, S. (2019). Tinea Pseudoimbricata as a Unique Manifestation of Steroid Abuse: A Clinico-Mycological and Dermoscopic Study from a Tertiary Care Hospital. Indian Dermatology Online Journal, 10(4), pp. 422-425. doi:10.4103/idoj.IDOJ_385_18.
Singal A, et al. Tinea Pseudoimbricata as a Unique Manifestation of Steroid Abuse: a Clinico-Mycological and Dermoscopic Study From a Tertiary Care Hospital. Indian Dermatol Online J. 2019;10(4):422-425. PubMed PMID: 31334062.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tinea Pseudoimbricata as a Unique Manifestation of Steroid Abuse: A Clinico-Mycological and Dermoscopic Study from a Tertiary Care Hospital. AU - Singal,Archana, AU - Jakhar,Deepak, AU - Kaur,Ishmeet, AU - Pandhi,Deepika, AU - Das,Shukla, PY - 2019/7/24/entrez PY - 2019/7/25/pubmed PY - 2019/7/25/medline KW - Dermoscopy KW - Tinea indecisiva KW - Tinea pseudoimbricata KW - steroid abuse SP - 422 EP - 425 JF - Indian dermatology online journal JO - Indian Dermatol Online J VL - 10 IS - 4 N2 - Background: Tinea pseudoimbricata, characterized by concentric scaly rings simulating Tinea imbricata is caused by dermatophytes other than Trichophyton concentricum. It is reported to occur in patients with steroid abuse and in immunocompromised individuals. Aim: To study the clinico-mycological profile and dermoscopic features of T. pseudoimbricata in immunocompetent patients. Methods: We have evaluated 14 consecutive, clinically diagnosed patients of T. pseudoimbricata with positive 10% potassium hydroxide (KOH) examination and culture, seen over a period of 6 months. Dermoscopy was performed in all patients. The demographic, clinical, and mycological features of each patient were recorded on a predesigned proforma. Results: There were seven male and seven female patients with a mean age of 27.6 years and a mean disease duration of 3.8 months. All patients gave a history of application of potent or super-potent topical steroid with or without oral/injectable steroid for varying duration. Culture isolates were Trichophyton mentagrophytes complex and Trichophyton rubrum in 11 and 3 patients, respectively. Dermoscopic analysis showed features of steroid abuse in majority of the patients. Limitation: A small sample size was the limitation of our study. Conclusion: T. pseudoimbricata is a special subset of Tinea incognito caused by injudicious and inappropriate use of topical steroid. The typical appearance should alert the dermatologists regarding the possible abuse of steroids. Most common species isolated on culture was T. mentagrophytes complex. SN - 2229-5178 UR - https://www.unboundmedicine.com/medline/citation/31334062/Tinea_Pseudoimbricata_as_a_Unique_Manifestation_of_Steroid_Abuse:_A_Clinico-Mycological_and_Dermoscopic_Study_from_a_Tertiary_Care_Hospital L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31334062/ DB - PRIME DP - Unbound Medicine ER -