tacrolimus and Tinea

Topics: Administration, Cutaneous; Administration, Oral; Adolescent; Anticestodal Agents; Humans; Immunosuppressive Agents; Male; Naphthalenes; Scleroderma, Localized; Skin Cream; Tacrolimus; Terbinafine; Tinea; Treatment Outcome

Tinea faciei has commonly been included within the spectrum of tinea corporis. We report two pediatrics cases of tinea faciei that have been evaluated in our unit. Both were exacerbated by topical application of pimecrolimus cream. It is important to note the exacerbation of dermatophyte infection by pimecrolimus in addition to the better known exacerbation by topical corticosteroids.

Topics: Administration, Topical; Child, Preschool; Cycloheptanes; Disease Progression; Female; Griseofulvin; Humans; Imidazoles; Immunosuppressive Agents; Male; Tacrolimus; Tinea

Tinea incognito was first described 50 years ago. It is a dermatophytic infection with a clinical presentation modified by previous treatment with topical or systemic corticosteroids, as well as by the topical application of immunomodulators such as pimecrolimus and tacrolimus. Tinea incognito usually resembles neurodermatitis, atopic dermatitis, rosacea, seborrheic dermatitis, lupus erythematosus, or contact dermatitis, and the diagnosis is frequently missed or delayed.

Topics: Administration, Cutaneous; Antifungal Agents; Dermatitis, Atopic; Dermatitis, Contact; Dermatitis, Seborrheic; Dermatologic Agents; Diagnosis, Differential; Humans; Immunosuppressive Agents; Lupus Erythematosus, Discoid; Neurodermatitis; Ointments; Rosacea; Tacrolimus; Tinea; Trichophyton

A 58-year-old, obese, male, army officer was presented with tinea incognito of the groin masking intertriginous psoriasis. According to his history, he had pruritic, symmetrical erythematous eruption of the groin of 2-month duration that he treated himself by using topical pimecrolimus 1%. This medication had been prescribed for his 8-year son's atopic dermatitis by the paediatrician. Direct examination with potassium hydroxide preparation showed fungal hyphae and Trichophyton rubrum was isolated in culture. This is the second case of topical pimecrolimus induced tinea incognito. We also review the cutaneous disorders that tinea incognito may mimic.

Topics: Diagnosis, Differential; Erythema; Groin; Humans; Immunosuppressive Agents; Male; Middle Aged; Psoriasis; Tacrolimus; Tinea; Trichophyton

Fluconazole-FK506 or fluconazole-cyclosporine drug combinations were tested in an ex vivo Trichophyton mentagrophytes human skin infection model. Conidia colonization was monitored by scanning electron microscopy over a 7-day treatment period. The fluconazole-FK506 combination demonstrated the most obvious advantage over single-drug therapy by clearing conidia and protecting skin from damage at low drug concentrations.

Topics: Antifungal Agents; Calcineurin; Colony Count, Microbial; Culture Media; Cyclosporine; Drug Synergism; Drug Therapy, Combination; Ergosterol; Fluconazole; Humans; Immunosuppressive Agents; Naphthalenes; Signal Transduction; Skin; Tacrolimus; Terbinafine; Tinea; Trichophyton

Tacrolimus and pimecrolimus represent a new class of topical nonsteroidal medications currently used in the treatment of a variety of inflammatory skin lesions. We report the case of a patient in whom topical tacrolimus therapy resulted in widespread lesions of tinea incognito. This case shows that partial treatment of dermatophytosis with griseofulvin may obscure the diagnosis. It also suggests that topical tacrolimus appears capable of inducing widespread dermatophytosis. The clinical appearance in this case was similar to tinea incognito induced by a topical corticosteroid.

Topics: Child; Humans; Immunosuppressive Agents; Male; Tacrolimus; Tinea