Tinea incognito is a condition that occurs after a fungal infection of the skin has been incorrectly treated with a steroid cream. These creams, while appropriate for treating certain conditions such as eczema or psoriasis, can worsen fungal infections. Patients could experience symptoms such as itchiness, redness, or an increase in the size of the initial lesion. Treatment of tinea incognito varies according to the symptoms experienced, but could include a topical antifungal ointment or an antifungal pill taken by mouth.
A number of different fungi, including those in the classes Epidermophyton, Trichophyton, and Microsporum, can infect the superficial regions of the body. As a collective, they are known as the dermatophytic infections, and can cause a variety of conditions including those commonly known as athlete’s foot, jock itch, cradle cap, and ringworm. Sometimes these fungal infections are misdiagnosed, and instead of being treated with an antifungal cream or spray, they are treated with skin creams that include anti-inflammatory substances referred to as steroids.
Many times the incorrect treatment of the dermatophytic infections with steroid creams does not cause any symptoms. In some cases, however, it causes the condition known as tinea incognito. Patients report symptoms such as pain or itchiness at the location of the fungal infection. The skin itself can become redder, can develop a purple color, or could become raised above the natural contour. Occasionally, the condition can infect hair follicles, causing a painful condition known as folliculitis.
Making the diagnosis of tinea incognito can be difficult. Patients typically were initially misdiagnosed with having conditions such as psoriasis or eczema, instead of receiving the correct diagnosis of having a superficial fungal infection. After a worsening of their symptoms due to application of a steroid cream occurs, alert doctors could recognize that an initial misdiagnosis might have occurred. Confirming the diagnosis of having a dermatophytic infection can be done by scraping off a sample of the affected skin and examining it under the microscope.
The treatment of tinea incognito depends on the symptoms experienced. Some patients with minor symptoms respond well to antifungal creams applied to the skin. More complicated cases, however, could require treatment with antifungal medications that are taken in pill form. This is especially true if the condition has progressed to folliculitis. The medications taken by mouth typically have more side effects and require more follow-up visits as compared to the antifungal medications applied directly to the skin.