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Common features of periocular tinea.

S Alison Finger Basak¹, David R Berk, Gregg T Lueder

¹Department of Internal Medicine, Division of Dermatology, Washington University School of Medicine, and St Louis Children's Hospital, St Louis, MO 63110, USA.

Archives of Ophthalmology (Chicago, Ill. : 1960)

|March 16, 2011

Summary

Periocular tinea, a fungal infection around the eye, is often misdiagnosed and treated with steroids. Eyelash loss is a key symptom, and prompt antifungal treatment leads to recovery.

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Area of Science:

Dermatology
Ophthalmology
Mycology

Background:

Superficial fungal infections of the face, particularly periocular tinea, are frequently misdiagnosed due to varied presentations.
Early and accurate diagnosis is crucial for effective treatment and preventing complications.

Observation:

A retrospective review identified 10 cases of periocular tinea in a pediatric dermatology clinic.
Commonly observed features included prolonged misdiagnosis, normal ophthalmologic findings, and prior corticosteroid use.
All patients experienced eyelash loss, a characteristic sign of this infection.

Findings:

Potassium hydroxide preparation and/or fungal culture confirmed fungal elements in 7 out of 10 cases.
Only 2 cases exhibited central clearing, a classic sign of tinea corporis.
All patients showed improvement with topical and oral antifungal therapy, including eyelash regrowth.

Implications:

Periocular tinea should be included in the differential diagnosis for persistent periocular inflammation, especially when unresponsive to common treatments.
Eyelash loss is a significant indicator of periocular fungal infection, mirroring hair loss in tinea capitis.
Timely diagnosis and appropriate antifungal therapy are essential for successful management and resolution of periocular tinea.