Dados do Trabalho

Título

A ten-year systematic review and case report on Tinea incognita: what do we know?

Introdução

Tinea incognita consists of the emergence/worsening of dermatophytosis after oral or topical corticosteroids. Distinct clinical presentations may occur, depending on host-related factors and/or dermatophyte species. Since corticosteroids abuse is becoming common, clinical information on this condition is relevant. 

Objetivo (s)

To perform a ten-year systematic review on Tinea incognita, as well as to present a case report.

Material e Métodos

A systematic search was conducted following the PRISMA statement. Articles were searched in Pubmed and SciELO. The research question was structured in PICO format. The following MESH terms were used with boolean operators: (“Tinea” AND “Dermatophytosis” AND “Corticoids”). Selection criteria (duplicate articles, exclusion by title and abstract, and full reading) and eligibility (risk of bias through the Joanna Briggs Institute checklists) were analyzed. 

Resultados e Conclusão

Among the fifty-three retrieved publications, nineteen met the eligibility criteria. Exclusion was related to the absence of dermatophytoses and/or mention of corticosteroid use. The Asian continent was the place with the highest prevalence and India was the country presenting the highest number of cases, driven by an outbreak in the mid-2010s. Only three studies were conducted in Brazil. Trichophyton rubrum and Trichophyton mentagrophytes were the most frequently isolated agents and the groin followed by the genitals the commonest body sites. Common misdiagnoses were: erythema, dermatitis and psoriasis. Overall, adjusted treatment after appropriate diagnosis provided a good therapeutic response. Case Report: the patient, male, 25 years-old, student, resident in Niterói, Rio de Janeiro, Brazil, reported a scaly and pruritic lesion on the left thigh, diagnosed as centrifugal annular erythema. Topical glucocorticoid was prescribed with regression observed in 10 days followed by worsening of inflammation, pruritus, and increase in lesion size on the 20th day. Mycological diagnosis was requested with isolation of Nannizzia gypsea. Oral terbinafine for fourteen days and topical fenticonazole for forty days promoted remission. Recently, the indiscriminate use of topical corticosteroids has emerged as a worrying epidemic in countries of hot and humid climate. Direct examination and mycological culture are recommended to promote specific treatment as well as prophylaxis against reinfection.  

Palavras Chave

Dermatophytosis; Corticosteroid; Dermatomycosis