Objective To analyze the clinical manifestations,etiology and dermoscopic features of patients with tinea incognito,to improve the understanding of tinea incognito,and to provide reference for clinical diagnosis.Methods The clinical data,pathogenic bacterial spectrum,direct microscopic and dermoscopic features of 591 patients with tinea incognito diagnosed by mycological examination in the Outpatient Department of Wuhan No.1 Hospital from January 2013 to December 2023 were reviewed.In addition,the pathogenic site and clinical manifestations of 241 patients with complete data and the dermoscopic signs of 101 patients undergoing imaging examination were analyzed.Results Among 591 patients with tinea incognito,254 were males and 337 were females,aged 5 days to 85 years.Faciocervical region was the most commonly involved(51.04％),and eczema-like skin was the most common clinical manifestation(48.96％).Trichophyton rubrum was the main pathogen of tinea incognito(58.71％).The infection of children was mainly zoophilic(80.38％),and the infection of adult was mainly anthrophilic(80.37％).Direct microscopic examination of fungi showed that anthrophilic was mainly composed of coarse separated hyphae.In addition to hyphae,zoophilic was often associated with endothix or ectothrix infection in vellus hair.The most common dermatoscopic sign was scale(60.40％).In terms of age,the proportion of patients with scales in adults was significantly higher than that in children,and the proportion of follicular pustules in children was significantly higher than that in adults,suggesting significant differences(P＜0.05).In terms of the isolated fungal species,tinea incognito caused by anthrophilic infection was mainly manifested in arborizing vessels and corkscrew vellus hairs,whereas zoophilic infection was mainly manifested in dotted or glomerular vessels and zigzag vellus hairs,showing significant differences(P＜0.05).Conclusion The clinical manifestations of tinea incognito are varied and prone to misdiagnosis.Fungal microscopy and dermoscopy can help to identify the source of pathogens and reduce missed diagnosis and misdiagnosis.
维普
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