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Tinea nigra (Pityriasis nigra)

Etiology: - Exophiala werneckii (Hortae werneckii) - Stenella araguata Epidemiology: - prevalence higher in tropics Clinical manifestations: 1) dark lesions giving a spattered appearance 2) lesions are most common on the palms of the hands - soles less frequently affected 3) generally unilateral * image Tinea nigra palmaris [2] Laboratory: - skin lesion scraping - direct microscopic examination on potassium hydroxide (10%) mount - brown branched septate hyphae - culture in Sabouraud agar - brownish black wet colonies after 1 month of inoculation at 21 C Special laboratory: - dermoscopy - nonmelanocytic pigmentation not respecting furrows & ridges - contrast with parallel ridge pattern seen in melanocytic lesions, in which pigmentation spares furrows Differential diagnosis: - melanocytic nevus - palmar lichen planus - Cydnidae pigmentation - melanosis of syphilis - postinflammatory hyperpigmentation Management: - topical azole antifungals & keratolytics (salicylic acid & urea) provide resolution within 2 months - vigorous washing & scraping may be helpful

Related

Exophiala werneckii; Cladosporium werneckii; Hortae werneckii stratum corneum (keratin {horny} layer)

General

Tinea

References

  1. Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995
  2. Saraswat N, Tripathy DM, Kumar S Images in Dermatology: Tinea Nigra Palmaris JAMA Dermatol. 2022;158(12):1439. Ot 26 PMID: 36287580 https://jamanetwork.com/journals/jamadermatology/fullarticle/2797841