A presumed case of tinea blepharociliaris in a 10-year-old boy

We report the case of a 10-year-old boy with a unilateral periocular rash, initially misdiagnosed and treated unsuccessfully with multiple courses of topical steroids, oral antibiotics, and eye drops. The rash improved temporarily with tacrolimus ointment, but periocular lesions persisted and spread. Although skin scraping was unsuccessful, the patient was diagnosed clinically with tinea blepharociliaris and treated empirically with a 2-week course of oral antifungal, resulting in rapid clinical improvement. The case highlights key clinical signs to avoid diagnostic delays, unnecessary treatments, and patient distress and supports empiric antifungal therapy when diagnostic tests are inconclusive.