A Case of Tinea Incognito Associated with Kerion Celsi and Tinea Barbae.

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We report the case of a 40-year-old man with tinea incognito associated with kerion celsi and tinea barbae. The patient had suffered from tinea pedis for about 10 years. In March of 1989, he developed erythematous itchy plaques on his cheek, which were treated with various topical ointments including corticosteroid at a dermatology clinic without any improvement. On May 23, 1989, he visited our hospital with the development of numerous erythematous plaques with pustules and three nodules on his face. Physical examination showed nodules and pustules with crusts in the perioral and forehead regions, as well as disseminated erythemas with pustules and scales on his entire face. A fungal infection was confirmed with direct examination of hairs, pustules and scales using KOH preparation. The isolated organisms from those lesions were identified as T. rubrum. The trichophytin reaction was positive. Laboratory studies were within normal ranges except for leukocytosis. Histopathological findings of nodules from the perioral region revealed marked inflammatory reaction with mainly neutrophils in the dermis and hair follicles. PAS stain showed a number of fungi in the horny layer and hair follicles. The patient was treated orally with a new antifungal agent, Itraconazole, for 41 days. The organisms could no longer be isolated after 30 days and the lesions disappeared within 40 days of this treatment.
日本医真菌学会の論文