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Case Report. Bullous tinea pedis in an elderly man
Y El-Segini1, W-B Schill, W Weyers
1Center of Dermatology and Andrology, Justus Liebig University, Giessen, Germany. Yehia.El-Seguini@derma.med.Uni-Giessen.de
Mycoses
|November 8, 2002
Summary
Recurrent bullous tinea pedis was misdiagnosed and treated with steroids. Biopsy revealed fungal infection, highlighting the immune response
Area of Science:
- Dermatology
- Mycology
- Infectious Diseases
Background:
- Recurrent bullous tinea pedis often presents diagnostic challenges.
- Initial diagnostic methods like KOH microscopy and fungal culture can be negative.
- Misdiagnosis can lead to inappropriate treatments, such as oral steroids.
Observation:
- A case of recurrent bullous tinea pedis initially showed negative microscopy and culture.
- A biopsy stained with periodic acid-Schiff revealed septate mycelia.
- The patient was treated with oral steroids for an unrelated condition.
Findings:
- Trichophyton mentagrophytes was eventually identified in repeated cultures.
- The fungal infection presented with two distinct clinical variants: vesiculobullous and dry squamous hyperkeratotic.
- Steroid treatment altered the clinical presentation of the tinea pedis.
Implications:
- Accurate and timely diagnosis of tinea pedis is crucial.
- The host's immune response significantly influences the clinical manifestation of fungal infections.
- Understanding the interplay between host immunity and fungal pathogens can guide treatment strategies.