Tinea faciei in Adult
A severe antifungal-resistant tinea has emerged in South Asia from the rapid spread of a novel dermatophyte species: Trichophyton indotineae. Terbinafine-resistant T indotineae infections have been reported in Asia, Europe, Canada, and the United States, including one case in New York City with no history of recent international travel.
Transmission among humans is either by direct contact with those infected (animals or humans) or through fomites. Infection may also frequently arise from self-inoculation from the feet (tinea pedis), scalp (tinea capitis), or nails (tinea unguium). Tropical or humid climates are associated with more frequent and severe cases. More cases are also noted after holidays, as children may spend their holidays in rural areas where animal exposure occurs. The most common manifestation is that of one or more pruritic, erythematous, annular, scaling plaques, most often on the cheeks. Occasionally, pustules and crusting may be seen at the active edge. Untreated lesions tend to demonstrate centripetal growth over time and may become several centimeters in diameter.
In the immunocompromised patient, pruritus may be absent. There is an increased risk of all dermatophyte infections (tinea faciei, tinea pedis, tinea cruris, and tinea corporis as well as Majocchi granuloma) in immunocompromised individuals.
Related topics: Tinea capitis, Tinea barbae, Tinea manus, Tinea versicolor, Tinea imbricata
B35.8 – Other dermatophytoses
240696004 – Tinea faciei
Differential Diagnosis & Pitfalls
- There are reports of tinea faciei mimicking discoid lupus erythematosus (DLE); in one study, more than 50% of tinea faciei cases looked like DLE.
- Corticosteroid-modified tinea faciei can mimic rosacea and is often misdiagnosed as such.
- Seborrheic dermatitis
- Atopic dermatitis
- Contact dermatitis
- Polymorphous light eruption
- Granuloma annulare
- Acne vulgaris
- Perioral dermatitis
- Pityriasis alba
- Nummular dermatitis
- Secondary syphilis
- Majocchi granuloma
- Drug-induced photosensitive reaction
- Actinic keratosis