Overview
Tinea nigra is a superficial fungal infection typically caused by Phaeoannellomyces werneckii, characterized by brown to black macules on palmar or plantar skin, often mistaken for melanocytic lesions 23.Diagnosis
Clinical Presentation: Brown to black macules on palmar or plantar surfaces 23.
Potassium Hydroxide (KOH) Preparation: Reveals pigmented hyphae, confirming diagnosis 3.
Dermoscopy: Utilizes Stolz system for differentiation from melanocytic lesions; fastest and simplest diagnostic tool 2.
Biopsy: Rarely needed but can be definitive if other methods are inconclusive 2.Management
Topical Antifungals: Terbinafine or ciclopirox are commonly used; specific dosing not detailed in abstracts 3.
Systemic Antifungals: Considered in extensive or refractory cases, though specific agents and dosing are not specified 3.Special Populations
Pediatrics: No specific considerations mentioned in provided abstracts 1.
Elderly: No specific considerations mentioned in provided abstracts 1.
Comorbidities: No specific interactions or considerations noted in provided abstracts 1.Key Recommendations
Utilize dermoscopy as a rapid and non-invasive tool to differentiate tinea nigra from melanocytic lesions (Evidence: Moderate) 2.
Confirm diagnosis with potassium hydroxide (KOH) preparation to visualize fungal elements (Evidence: Moderate) 3.
Initiate treatment with topical antifungals such as terbinafine or ciclopirox for localized tinea nigra (Evidence: Expert opinion) 3.References
1 Ravizza T, Velísková J, Moshé SL. Testosterone regulates androgen and estrogen receptor immunoreactivity in rat substantia nigra pars reticulata. Neuroscience letters 2003. link01317-4)
2 Smith SB, Beals SL, Elston DM, Meffert JJ. Dermoscopy in the diagnosis of tinea nigra plantaris. Cutis 2001. link
3 Hall J, Perry VE. Tinea nigra palmaris: differentiation from malignant melanoma or junctional nevi. Cutis 1998. link