Tinea nigra: Report of three pediatrics cases

Abstract

Introduction: Tinea nigra is a superficial mycosis caused by Hortaea werneckii. Its clinical characteristic is the appearance of a blackish brown macula of rapid growth, caused by the pigment produced by the fungus itself. The presence of a dark, fast growing, acral pigmentary lesion causes concern among patients and their treating physician about the possibility of a malignant pigmentary lesion.

Objective: To present a series of three clinical cases in pediatric patients with this pathology and to show the tools that help to make a differential diagnosis.

Clinical Cases: Three patients between three and five years of age, which present a macular pigmented lesion on palms or soles, whose parents reported a rapid growth over a short period of time. Two of the patients reported previous trips to the Caribbean. Clinical and dermatoscopy suspicion of tinea nigra lead to a direct mycological examination, which confirmed the diagnosis. In all three cases, treatment with topical antifungals led to complete healing of the lesions.

Conclusions: Although tinea nigra is rare in a dry climate, increasing travel of patients to tropical countries will increase the number of cases. Dermatoscopy and direct mycological examination are the tools that allow performing a correct diagnosis and avoiding unnecessary biopsies and/or surgeries.