Tinea corporis in an African migrant

Excerpt

A 26-year-old Nigerian man presented with a 3-year history of itchy skin lesions with centrifugal growth. He applied various ointment on the skin with no improvement. He had lived in Italy for the previous 6 years. His past medical history was unremarkable. Physical examination reveals extensive brown circinate skin macules and patches in the right axilla (Fig. 1a) and shoulder blade (Fig. 2a), and in the posterior surface of both thighs and buttocks (Fig. 3a). The external part of the plaques in the abdomen, inguinal fold, pubis and genital regions had a raised erythematous scaling border with exfoliation (Fig. 4a). The clinical diagnosis of tinea corporis was confirmed by direct microscopy and fungal culture of skin scrapings, with identification of Trichophyton rubrum. HIV and hepatitis tests were negative and liver function tests were normal. Treatment began with terbinafine 250 mg daily with almost total disappearance of the lesions in 3 months (Figs. 1b, 2b, 3b, 4b). Two weeks after the lesions disappeared, terbinafine was replaced by fluconazole 200 mg weekly for an additional month (Figs. 1c, 2c, 3c, 4c). No adverse effects were recorded. No recurrence was evident in the following year.

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