Tinea incognito

 Tinea incognito is a localized skin infection caused by a fungus. Due to the use of corticosteroids, the shape and severity of the lesion are different from the usual skin manifestations by dermatophytes.

A 39-year-old female with history of erythematous, scaly skin lesions on her hands, buttock, inguinal and both legs for 7 months referred to clinician, who prescribed Calamine-D and hydrocortisone without any treatment and clobetazole was recomended. She self-continued clobetazole. This case highlight the importance of mycological test in case of atypical skin lesions to choose an appropriate treatment and avoiding to spread of drug resistance species.

Regarding to history of patient, the mycological test (Direct Microscopy and culture) was made. In direct microscopy and culture mycelia of dermatophyte species was seen.

In our case steroid discontinued and she was treated with oral terbinafine 250 mg once a day for 4 weeks in combination with topical clotrimazole cream.

the prescription of topical/oral corticosteroids should still be limited and take a caution until confirmation of diagnosis, particularly since the use of steroids during COVID 19.