Tinea faciei incognito due to Trichophyton rubrum as a result of autoinoculation from onychomycosis

Abstract

The localisation of a dermatophytosis on the face is rare. Differential diagnoses include a broad range of dermatological disorders, e. g. contact dermatitis, psoriasis vulgaris, seborrhoeic dermatitis, demodicosis, and polymorphic photo eruptions. Two patients suffering from tinea faciei incognito caused by Trichophyton rubrum are presented. Diagnosis was based on mycological diagnostics of skin scrapings using Calcofluor preparation and cultivation of the causative dermatophyte. Both patients were suffering from tinea pedis and tinea unguium caused by the same dermatophyte species. An infection caused by Trichophyton rubrum of the face always occurs following autoinoculation from a pre-existing tinea pedis and tinea unguium of feet and toenails, sometimes of the fingernails.

Mycology – an update. Part 1: Dermatomycoses: Causative agents, epidemiology and pathogenesis

“…rubrum infections are increasingly occurring at other sites on the body than previously reported . An example is tinea faciei due to T. rubrum after autoinoculation with tinea pedis et unguium of the lower extremities . Tinea capitis due to T. rubrum is unusual.…”

“…Neben der Tinea pedis und Tinea unguium muss zunehmend mit T.-rubrum-Infektionen an anderen, früher als ungewöhnlich angesehenen Körperlokalisationen gerechnet werden [6]. Das kann eine Tinea faciei durch T. rubrum infolge einer Autoinokulation von einer Tinea pedis et unguium der unteren Extremitäten sein [7]. Ungewöhnlich ist eine Tinea capitis durch T. rubrum.…”

Dermatophytes

“…In fact, up to 25% of all patients visiting a dermatology clinic may have occult tinea pedis, making the feet an important fungus reservoir from which dermatophytes can spread [13]. Tinea facei secondary to autoinoculation of T. rubrum from tinea pedis and onychomycosis is one example [14].…”

Mykologie – ein Update. Teil 1: Dermatomykosen: Erreger, Epidemiologie und Pathogenese

“…Das kann eine Tinea faciei durch T. rubrum infolge einer Autoinokulation von einer Tinea pedis et unguium der unteren Extremitäten sein [7]. Ungewöhnlich ist eine Tinea capitis durch T. rubrum.…”