Clinical profile of Tinea pseudoimbricata: an observational study from a tertiary care institution in western Maharashtra, India

Abstract

Background: Topical steroid-modified tinea corporis and tinea cruris is on the rise due to the ease of availability of over-the-counter potent topical corticosteroid preparations and their inappropriate use, alters the true morphology of lesion. As there is paucity of literature about increasing prevalence and varied presentation of this condition, we aimed to study the clinical profile and dermoscopic features of Tinea pseudoimbricata due to topical steroid abuse. We present a case-series of 77 cases of a distinct morphological pattern with central erythematous, scaly, pruritic concentrically spreading plaques with raised and scaly borders known as Tinea pseudoimbricata. Methods: We evaluated 77 clinically diagnosed patients of Tinea pseudoimbricata with positive 10% potassium hydroxide examination and culture. Dermoscopy was performed in all patients. The demographic, clinical, and mycological features of each patient were recorded on a predesigned proforma. Results: There were 52 male and 25 female patients with a mean age of 28.66 and a mean disease duration of 7.6 months. There was a history of application of potent or super-potent topical steroid for varying durations. Culture isolates were Trichophyton rubrum species. Dermoscopic analysis showed features of steroid abuse. Conclusions: Injudicious and inappropriate use of topical steroid causes Tinea pseudoimbricata; a special subset of tinea incognito, which is very common now a days. This should alert the dermatologist about the steroid abuse and requires systemic anti-fungal treatment for prolong time.