America’s First case of Tinea

Pseudoimbricata
By:
Dewi Liny Victoria
09.06.0026

Pembimbing :
dr. Wiwin Mulyaningsih, Sp.KK, M.kes.
dr. Angelica Vanini w. Taufik, Sp.KK
 Lisa Mask-Bull M. D.1, Ravi Patel Msiii2,
Michelle B. Tarbox M. D.3

1Residentof Dermatology, Texas Tech University Health Sciences Center, Department of

Dermatology, Lubbock, USA
2Medical student at Texas Tech University Health Sciences Center School of Medicine,

Odessa, USA
3Assistant professor of Dermatology, Texas Tech University Health Sciences Center,

Department of Dermatology, Lubbock, USA

 Abstract
• Tinea Imbricata  variant of Tinea Corporis
by. Trichophyton Concentricum  “ Scaly
Concentric Rings”.
• Tinea Pseudoimbricata usually
systematically immunosuppressed
• The first Tinea Pseudoimbricata in North
America. a man in West texas with
T.Pseudoimbricata secondary to Tricho.
tonsurans
 Key Word

Tinea
Pseudoimbricata
Tinea imbricata

Trichophyton Trichophyton
Concentricum Tonsurans
 Introduction
• Tinea Imbricata  annular concentric scaly
plaques  endemic in south pacific island +
Southeast Asia.
• There is other species has the classic clinical
persentation Tinea Pseudo imbricata or
Tinea Indecisiva  only 5 cases
• In this case  by Tricho. Tonsurans.
 Patient Presentation

• A 21-year-old Male
• From Dallas
• 12-month history  a persistent scaly
eruption on his lateral neck
• A Sudanese, born in US
 History ,,

12 month L’abidjanaise cream 2x in 3 month +

history Clobetasol Propionate 0,05%

NO history of
NO history of Evaluation in
HIV, hepatitis,
travel dermatology
or TB
 • Trichophyton tonsuran
KOH+ Fungal
Culture

• Erythema + scale
Oral Resolved
Terbinafine • hyperpigmentation
 Discussion
• Tinea Pseudoimbricata  commonly caused by
Tricho.Rubrum & tricho. Mentagrophytes.

In this Case  caused by Tricho. Tonsurans

There are only 5 cases happened by Tricho.tonsurans

All of the cases  OUTSIDE US + history of
Immunosuppression usage
 Conclusion
• Important to have an alternate diagnosis
when tinea imbricata like presentation is
encountered outside of endemic area.
• Aware of high potency topical corticosteroid.
Trichophyton Concentricum

• Kingdom: Fungi
• Division : Ascomycota
• Class : Eurotiomycetes
• Order: Onygenales
• Family:
Arthrodermataceae
• Genus: Trichophyton
 Trichophyton Tonsurans
• Kingdom: fungi
• Division: Ascomycota
• Class: Eurotiomycetes
• Order: onygenales
• Family;
Arthrodermataceae
• Genus: trichophyton
• Species: T. tonsurans
 References
• [1] Satter, E.K., 2009, Tinea Imbricata, Cutis, 83(4), 188-91.
• [2] Bonifaz, A., Vazquez-gonzalez, D., 2011, Tinea imbricata in the Americas, Curr Opin Infect Dis,
24(2), 106-11
• [3] Verma, S., Hay, R.J., 2015, Topical steroid-induced tinea pseudoimbricata: a striking form of
tinea incognito, Int J Dermatol, 54(5), e192-3.
• [4] Ouchi, T., Nagao, K., Hata, Y., Otuka, T., Inazumi, T., 2005, Trichophyton tonsurans infection
manifesting as multiple concentric annular erythemas, J Dermatol, 32(7), 565-8.
• [5] Batta, K., Ramlogan, D., Smith A.G., Garrido, M.C., Moss, C., 2002, ‘Tinea indecisica’ may mimic
the concentric rings of tinea imbricata, Br J Dermatol, 147(2), 384
• .[6] Lim, S.P., Smith A.G., 2003, “Tinea pseudoimbricata”: tinea corporis in a renal transplant
recipient mimicking the concentric rings of tinea imbricata, Clin Exp Dermatol, 28(3), 332-3.
• [7] Hoque, S.R., Holden, C.A., 2007, Trichophyton tonsurans infection mimicking tinea imbricata,
Clin Exp Dermatol, 32(3), 345-6.
• [8] Rao, A.G., Datta, N., 2013, Tinea corporis due to Trichophyton mentagophytes and Trichophyton
tonsurans mimicking tinea imbricata, Indian J Dermatol Venereol Leprol, 79(4), 554.
• [9] Foster, K.W., Ghannoum, M.A., Elewski, B.E., 2004, Epidemiologic surveillance of cutaneous
fungal infection in the United States from 1999 to 2002, J Am Acad Dermatol, 50(5), 748-52.[
• 10] Tucker, P.L.Y., 2013, Epidemiologic trends in pediatric tinea capititis: a population-based study
from Kaiser Permanente Northern California, J Am Acad Dermatol, 69(6), 916-21.
Thank You