Tinea nigra presenting speckled or "salt and pepper" pattern.

Area of Science:

• Dermatology
• Mycology
• Infectious Diseases

Background:

• Tinea nigra is a superficial fungal infection characterized by superficial, pigmented macules.
• It is caused by the fungus Hortaea werneckii.
• This case highlights a rare geographical presentation with a distinct speckled pattern.

Observation:

• A 7-year-old female from coastal Brazil presented with a distinctive speckled pattern of dark spots on her left palm.
• The lesions evolved into a single macule with a "salt and pepper" appearance.
• Mycological examination and fungal culture confirmed the presence of Hortaea werneckii.

Findings:

• The patient was treated with butenafine hydrochloride 1% topical cream for 30 days.
• Complete clinical remission of the Tinea nigra lesion was achieved.
• No recurrence of the infection was noted during a 12-month follow-up period.

Implications:

• This case highlights a rare geographical presentation of Tinea nigra with a speckled pattern.
• The "salt and pepper" appearance should be considered in the differential diagnosis of palmar macules.
• Effective treatment with topical butenafine hydrochloride was demonstrated for this specific presentation.