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Review
. 2023 Jun;9(2):52-63.
doi: 10.22034/cmm.2023.345069.1425.

Updates on Tinea Incognita: Literature review

Aliasghar Ghaderi  1 , Pegah Tamimi  1 , Alireza Firooz  1 , Maryam Fattahi  2 , Mona Ghazanfari  3 , Mahsa Fattahi  4   5
Affiliations
Review

Updates on Tinea Incognita: Literature review

Aliasghar Ghaderi et al. Curr Med Mycol. 2023 Jun.

Abstract

Background and purpose: Tinea incognita (TI), or the other equivalent tinea atypica, is a term used to declare the atypical presentation of dermatophyte infections caused by the administration of steroids or other immunosuppressive medications which modulate the local and systemic immune response. It can mimic other dermatoses; hence making diagnostic challenges for dermatologists. Tina incognita may be misdiagnosed as many dermatoses. Based on previous studies, corticosteroids may cause different clinical manifestations of dermatophytes that might be very different from those that are commonly described.

Materials and methods: This narrative review was conducted using PubMed and Scopus databases. Search terms included "Tinea incognita" and "Atypical dermatophytosis". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, reviews, and case reports. The search was restricted to articles written in the English language from 2006 to Feb 01, 2023. Moreover, duplicate articles and non-available full-text articles were excluded. The extracted data of the search results were retrieved in this study. The morphological patterns, prevalence, sight of infection, and causative agents were also described.

Results: Prevalence of different patterns of TI were recorded as 50% (431 out of 862 cases) for eczema-like lesions followed by psoriasis-like and 6.61% (57 out of 862) for parapsoriasis-like pattern. Moreover, each of the rosacea-like and pyoderma-like lesions equally accounted for 4.98 % of cases (43 out of 862). In addition, the prevalence of causative agents was reported as follows: Trichophyton rubrum accounted for 247 isolates (40%) as the most prevalent, followed by Trichophyton mentagrophytes (n=152, 24%) and Microsporum canis (n=119, 19%).

Conclusion: Tinea incognita is a great mimicker; hence, dermatologists should obtain a full medical history of the patients to make correct diagnoses. It is vital to encourage an exact identification of the etiological agent according to the internal transcribed spacer sequencing in some uncertain cases. This review highlights the importance of mycological tests and fast diagnosis of TI, especially in cases of atypical skin lesions, to choose appropriate treatment and avoid the spread of drug-resistant species.

Keywords: Dermatophytes species; Immunosuppressive medications; Tinea incognita; Topical corticosteroids.

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Conflict of interest statement

There is none to declare.

Figures

Figure 1
Figure 1
Causative agents of Tinea incognita in previous studies
Figure 2
Figure 2
Different patterns of tinea incognita from 2006 to 2023
See this image and copyright information in PMC

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