When Steroids Backfire: Tinea Incognito Following Treatment for Presumed Psoriasis.
- 1Dermatology, Rocky Vista University College of Osteopathic Medicine, Ivins, USA.
- 2Dermatology, Kansas City University-Graduate Medical Education Consortium, Advanced Dermatology and Cosmetic Surgery-Orlando Program, Maitland, USA.
Abstract
Tinea incognito is an altered clinical presentation of a dermatophyte infection that develops following treatment with topical or systemic corticosteroids or other immunosuppressive agents. Suppression of inflammation temporarily improves the appearance of the eruption while masking the characteristic annular, scaly appearance of the infection, making diagnosis more challenging. If a fungal infection is suspected, a potassium hydroxide (KOH) preparation should be performed to evaluate for an underlying fungal etiology. A 43-year-old male presented to dermatology after treatment with clobetasol propionate 0.05% cream and roflumilast 0.3% cream for presumed psoriasis. His eruption initially improved but subsequently recurred and progressively worsened over three months. KOH preparation revealed fungal hyphae, leading to the diagnosis of tinea incognito. This case highlights the importance of maintaining a high index of suspicion for fungal infection in patients presenting with a scaly eruption and underscores the value of diagnostic tools, such as KOH preparation, prior to initiating corticosteroids or other immunosuppressive agents.
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BibTeX
@article{skalka2026when,
title = {{When Steroids Backfire: Tinea Incognito Following Treatment for Presumed Psoriasis.}},
author = {Nicole Skalka and Nathaniel Marroquin and Jay Nguyen and Panagiotis Mitropoulos and Patrick Dominguez},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116671},
url = {https://europepmc.org/article/MED/42910354},
note = {CC BY},
}
RIS
TY - JOUR
TI - When Steroids Backfire: Tinea Incognito Following Treatment for Presumed Psoriasis.
AU - Nicole Skalka
AU - Nathaniel Marroquin
AU - Jay Nguyen
AU - Panagiotis Mitropoulos
AU - Patrick Dominguez
PY - 2026
DA - 2026/09/21
JO - Cureus
DO - 10.7759/cureus.116671
UR - https://europepmc.org/article/MED/42910354
AB - Tinea incognito is an altered clinical presentation of a dermatophyte infection that develops following treatment with topical or systemic corticosteroids or other immunosuppressive agents. Suppression of inflammation temporarily improves the appearance of the eruption while masking the characteristic annular, scaly appearance of the infection, making diagnosis more challenging. If a fungal infection is suspected, a potassium hydroxide (KOH) preparation should be performed to evaluate for an underlying fungal etiology. A 43-year-old male presented to dermatology after treatment with clobetasol propionate 0.05% cream and roflumilast 0.3% cream for presumed psoriasis. His eruption initially improved but subsequently recurred and progressively worsened over three months. KOH preparation revealed fungal hyphae, leading to the diagnosis of tinea incognito. This case highlights the importance of maintaining a high index of suspicion for fungal infection in patients presenting with a scaly eruption and underscores the value of diagnostic tools, such as KOH preparation, prior to initiating corticosteroids or other immunosuppressive agents.
SN - 2168-8184
ER -