Tinea Incognito
(Steroid-Modified Tinea)
A fungal infection in which clinical manifestations are modified by topical or systemic corticosteroids. When treated with topical corticosteroids, fungal infections appear to improve: inflammation subsides and scaling decreases. But attempts to discontinue the agent result in flare-ups. Prolonged use of corticosteroids can cause striae, atrophy, and telangiectasia to develop with the original dermatitis. Specimens prepared with KOH solution are floridly positive.
Treatment: A topical antifungal agent should be used. If a potent topical corticosteroid has been used, the number of applications may need to be gradually reduced to minimize the rebound flushing and fixed vasodilation seen in steroid-dependent skin.