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Tinea imbricata or Tokelau.

Alexandro Bonifaz1, Carla Archer-Dubon, Amado Saúl

  • 1Department of Dermatology, Hospital General de México, and Dermatology Service, Instituto Nacional de la Nutrición SS, México City, Mexico. bonyalx@servidor.unam.mx

International Journal of Dermatology
|July 3, 2004
PubMed
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Tinea imbricata (TI), a fungal skin infection, presents as scaly, concentric plaques. Diagnosis involves clinical signs and lab tests, with oral antifungals like griseofulvin and terbinafine showing best results for this chronic condition.

Area of Science:

  • Dermatology
  • Mycology
  • Infectious Diseases

Background:

  • Tinea imbricata (TI), also known as Tokelau, is a superficial fungal infection caused by the dermatophyte *Trichophyton concentricum*.
  • This anthropophilic fungus is endemic in tropical regions, particularly islands of the South Pacific, Southeast Asia, and the Americas, often affecting individuals in isolated communities.
  • The characteristic skin lesions are lamellar, concentric plaques of scale, giving the condition its name ('imbricata' meaning tiled).

Purpose of the Study:

  • To describe the etiology, epidemiology, clinical presentation, diagnosis, and treatment of Tinea imbricata.
  • To highlight TI as a disease model for studying environmental, genetic, immunologic, and therapeutic factors in superficial mycoses.
  • To review current therapeutic strategies and outcomes for this chronic and relapsing fungal infection.

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Main Methods:

  • Clinical diagnosis based on characteristic skin lesions.
  • Microscopic examination of skin scrapings to identify fungal elements.
  • Fungal culture for *Trichophyton concentricum* isolation and identification.
  • Review of predisposing factors including humidity, inheritance, and immunologic status.

Main Results:

  • Tinea imbricata is characterized by distinctive tiled, scaly skin plaques.
  • Diagnosis is primarily clinical, supported by mycological investigations.
  • The condition is chronic and prone to relapse, with oral griseofulvin and terbinafine showing efficacy.

Conclusions:

  • Tinea imbricata is a significant superficial mycosis in endemic tropical areas.
  • Effective management involves oral antifungal agents and topical keratolytic treatments.
  • Further research into genetic and immunologic factors may elucidate disease pathogenesis and improve treatment outcomes.