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    Black macule with geographic shape and speckled pattern on the left palm of the Caucasian patient.

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    Presence of annelloconidia with pigmented filaments (Magnification: 400×).

  • 1.

    Rossetto AL, Cruz RCB, 2011. Tinea nigra in geographical forms of “heart” and “parrot beak.” An Bras Dermatol 86: 398390.

  • 2.

    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: 125128.

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Tinea nigra Presenting Speckled or “Salt and Pepper” Pattern

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  • Department of Dermatology, University of Vale do Itajaí (Univali), Itajaí, SC, Brazil; Department of Pharmaceuticals-Biochemistry, University of Vale do Itajaí (Univali), Itajaí, SC, Brazil; Department of Dermatology, Botucatu School of Medical, Universidade Estadual Paulista “Júlio de Mesquita Filho”–São Paulo, State University (FMBUNESP), Vital Brazil Hospital, Butantan Institute, São Paulo, SP, Brazil

A 7-year-old Caucasian female resident of the southern coast of Brazil presented dark spots on the left palm that converged to a unique macule with speckled pattern at about 1 month. The mycological exam and the fungi culture were typical of Hortaea werneckii, the agent of the superficial mycosis Tinea nigra. The patient received butenafine hydrochloride 1% for 30 days, resulting in a complete remission of the lesion. At a follow-up visit 12 months after treatment, there was no lesion recurrence. We describe a form of rare geographical Tinea nigra with a speckled pattern. The “salt and pepper” aspect should be taken into consideration when the mycosis was suspected.

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).

Figure 1.
Figure 1.

Black macule with geographic shape and speckled pattern on the left palm of the Caucasian patient.

Citation: The American Society of Tropical Medicine and Hygiene 90, 6; 10.4269/ajtmh.13-0394

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).

Figure 2.
Figure 2.

Presence of annelloconidia with pigmented filaments (Magnification: 400×).

Citation: The American Society of Tropical Medicine and Hygiene 90, 6; 10.4269/ajtmh.13-0394

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.

  • 1.

    Rossetto AL, Cruz RCB, 2011. Tinea nigra in geographical forms of “heart” and “parrot beak.” An Bras Dermatol 86: 398390.

  • 2.

    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: 125128.

    • Search Google Scholar
    • Export Citation

Author Notes

* Address correspondence to André Luiz Rossetto, Avenue Alvin Bauer, 655 Sala 203, Centro Médico Vida, 88330-643 Balneário Camboriú, SC, Brazil. E-mail: rossettovida@terra.com.br

Authors' addresses: André Luiz Rossetto, Department of Dermatology, University of Vale do Itajaí (Univali), Itajaí, SC, Brazil, E-mail: rossettovida@terra.com.br. Rosana Cé Bella Cruz, Department of Pharmaceuticals-Biochemistry, Universidade do Vale do Itajaí (Univali), Itajaí, Santa Catarina, Brazil, E-mail: rcbcruz@univali.br. Vidal Haddad Junior, Department of Dermatology, Universidade Estadual Paulista “Júlio de Mesquita Filho,” Botucatu, São Paulo, Brazil, E-mail: haddadjr@fmb.unesp.br.

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