Tinea incognito is a fungal skin infection that occurs when treated with steroid cream instead of antifungal cream. Symptoms include itching, redness, and increase in size. Diagnosis is difficult, but treatment includes topical antifungal ointment or oral antifungal medication.
Tinea incognito is a condition that occurs after a fungal skin infection has been treated incorrectly with a steroid cream. These creams, while appropriate for treating certain conditions such as eczema or psoriasis, can make fungal infections worse. Patients may experience symptoms such as itching, redness, or an increase in size of the initial lesion. Treatment of incognito tinea varies based on the symptoms experienced, but might include a topical antifungal ointment or an antifungal pill taken by mouth.
A number of different fungi, including those of the Epidermophyton, Trichophyton and Microsporum classes, can infect superficial regions of the body. Collectively, they are known as dermatophyte infections and can cause a variety of conditions including those commonly known as athlete’s foot, itchy skin, 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 called steroids.
Many times the incorrect treatment of dermatophyte 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 itching at the location of the fungal infection. The skin itself may become redder, may develop a purple color, or may lift above its natural contour. Occasionally, the condition can infect hair follicles, resulting in a painful condition known as folliculitis.
Diagnosing tinea incognito can be difficult. Patients typically were initially misdiagnosed with conditions such as psoriasis or eczema, instead of being given the correct diagnosis of having a superficial fungal infection. After a worsening of symptoms due to the application of a steroid cream, attentive doctors may recognize that an initial misdiagnosis may have occurred. Confirmation of the diagnosis of dermatophyte infection can be done by scraping a sample of the affected skin and examining it under a microscope.
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, may require treatment with antifungal drugs taken in pill form. This is especially true if the condition has progressed to folliculitis. Medications taken by mouth typically have more side effects and require more follow-up visits than antifungal medications applied directly to the skin.
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