A 7-year-old Caucasian female child, who was a resident of Itapema town on the northern coast of Santa Catarina State, Brazil, presented dark spots on the left palm about 1 month before the exam; they converged to a unique macule with speckled pattern, with a 1.5 × 2.0-cm diameter and geographic shape (Figure 1).
The mycological exam revealed septate, dematiaceous hyphae, and presence of yeast-like cells with spores. The fungi culture in Sabouraud's agar showed a moist, shiny, rough, and black colony. The fungi in the culture were identified as Hortaea werneckii (Figure 2).
The topical treatment with butenafine hydrochloride 1% for 4 weeks caused complete remission of lesions, with no recurrence during follow-up for 1 year.
Reports of Tinea nigra have been rare since the first publication by Cerqueira in 1916.1,2 This cosmopolitan dermatomycosis usually affects Caucasian patients, such as in the present report. We describe a form of rare geographic Tinea nigra with a speckled pattern.
The “salt and pepper” aspect should be taken into consideration when the mycosis is suspected.
Rossetto AL, Cruz RCB, Haddad V Jr, 2013. Double-blind study with the topical isoconazole and terbinafine for the treatment of one patient bilateral Tinea nigra plantaris and suggestions for new differential diagnoses. Rev Inst Med Sao Paulo 52: 125–128.