Tinea Corporis Masquerading as a Diffuse Gyrate Erythema: Case Report and a Review of Annular Lesions Mimicking a Dermatophyte Skin Infection

Abstract

Tinea is a superficial fungal infection of the skin. Gyrate erythemas are reactive conditions that present as annular red lesions. A 61-year-old woman was diagnosed with tinea corporis whose skin lesions morphologically mimicked a gyrate erythema. She presented with diffuse annular plaques affecting the left side of her chest and abdomen that did not respond to a combination antifungal-corticosteroid cream for six-month duration. The appearance and clinical differential diagnosis included a gyrate erythema. Initial evaluation of the skin biopsy from the lesion's edge demonstrated a spongiotic dermatitis, and staining for fungal organisms was negative. However, deeper sections and a different fungal stain revealed hyphae in the stratum corneum and established a diagnosis of tinea corporis. The PubMed database was used to review the following terms: tinea corporis, gyrate erythema, and tinea incognito. Relevant papers and references cited in those papers that were generated by the search were used. Tinea corporis, especially if previously treated with topical corticosteroids, can masquerade as other dermatoses including a gyrate erythema. Correlation of clinical presentation and pathology findings is essential, especially if the biopsy results do not confirm the suspected clinical diagnosis. Consideration to perform deeper sections or additional special stains or both should also be entertained when the initial pathology observations do not support the presumptive diagnosis based on clinical morphology and history.

Pruritic Erythematous Macules in a Patient with Systemic Sarcoidosis: A Quiz

“…In the current case, EGR was suspected due to the patient’s risk factors for gastro-oesophageal cancer ( 3 , 7 ). EGR is, however, characterized by rapidly migrating lesions, and the patient had no anaemia, weight loss, or cancerous lesions on total-body tomography ( 7 ).…”

“…Because of its unusual appearance, tinea incognita is difficult to diagnose and should be suspected in cases of aspecific, erythematous, pruritic patches, in which the typical ringworm appearance of tinea is minimal ( 3 ).…”

Tinea Incognito

“…The frequent use of combination creams of antifungal with potent topical steroids (such as clotrimazole/betamethasone) to treat undiagnosed dermatitis can lead to TI. 8,9 Iraq studies found that the topical steroid abuse by a patient or doctor can provide strong possible explanations for the epidemic of resistant dermatophytosis. 10 Some other factors may play a role in chronicity of superficial fungal infections and lead to the development of TI.…”

Annular elastolytic giant cell granuloma: an unusual presentation in non-sun-exposed areas

“…The differential diagnosis includes other granulomatous and annular diseases such as tinea corporis, leprosy, tuberculosis, sarcoidosis, granuloma annulare and necrobiosis lipoidica. 6 The histopathological analysis is crucial for a correct diagnosis. Mycotic and mycobacterial cultures may also be necessary to exclude infectious diseases.…”