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Tinea facei
Etiology:
- Trichophyton benhamiae
Epidemiology:
- transmission person to person, animal to person
- case report of transmission from Guinea pig
Clinical manifestations:
- itchy, erythematous facial lesions not resposive to topical glucocorticoids
- annular plaque with sharply demarcated edges & associated scale & crust
- no regional lymph node involvement
* image [1]
Laboratory:
- skin scraping
- direct microscopy results after preparation with KOH shows fungal hyphae
- cultures on Sabouraud dextrose agar & lactophenol cotton blue stain
- septate hyaline hyphae
- spherical microconidia
- arranged likes grapes
- or inserting laterally & terminally at the hyphae
- DNA sequencing of the internal transcribed spacer region of the ribosomal DNA for confirmation of Trichophyton benhamiae [1]
Complications:
- residual hypopigmentation with fine telangiectasias
Management:
- clotrimazole 1% or terbinatine topical [2]
- terbinafine 125 mg PO daily + ketoconazole 2% shampoo for 6 weeks for larger areas of infection [2]
- fluconazole, itraconazole, & griseofulvin may also be used
- infected animals must be treated to avoid reinfection &/or spread to other persons
General
Tinea
References
- Iznardo H, Garcia-Melendo C, Berengua C
Tinea Facei From Trichophyton benhamiae From a Pet Guinea Pig.
JAMA Dermatol. Published online August 11, 2021.
PMID: 34379104
https://jamanetwork.com/journals/jamadermatology/fullarticle/2782890
- NEJM Knowledge+ Dermatology