Case from Dr Shahbaz Janjua
Tinea nigra is an uncommon superficial dermatomycosis usually caused by Hortaea werneckii. The infection appears as a hyperpigmented macule, which most commonly occurs on the palms but soles may also get involved. The pigmentary change in the skin results in a dark-colored macule due to the accumulation of a melaninlike substance in the fungus. Tinea nigra is believed to occur as a result of inoculation from a contamination source such as soil, sewage, wood, or compost subsequent to trauma in the affected area.
5 comments:
I have only seen one case of this condition which I have previously published in the Atlas. Is it more common in rural areas of Pakistan and is it a tropical condition?
Is there associated lichenification in t.Nigra as seen in this case ? I think in T. Nigra there is well defined brown to black piemented patch with out any thickening.
Dr. Nabar
usually there will not be lichenifcation in T.Nigra. Dr Janjua have you cultred?
Thank you Dr. Nabar and Dr. Jayaraaman for your comments on this case. I agree tinea nigra typically presents as non inflammatory and non scaly brown black colored macule with a predilection for the palmar surfaces. The lichenified pruritic brown black plaque looked more like a case of LSC but as we examined the KOH mounted skin scrapings, brown colored septate hyphae were seen. A culture was not performed. Pruritus may have caused the lichenification of the primary lesion in this case. The patient responded to topical antifungal agents.
Best regards,
Dr. Shahbaz A. Janjua
We see this commonly in "tropical" parts of the USA such as Texas. It is usually not lichenified. The most rapid therapy is with topical ciclopirox. See my paper: Rapid treatment of tinea nigra palmaris with ciclopirox olamine gel, 0.77%.
Skinmed. 2006 Jul-Aug;5(4):201-3.
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