Indecisiva: Case Report and Review of the Literature

Background: Tinea indecisiva is characterized by concentric scaly rings simulating tinea imbricata but caused by dermatophytes other than Trichophyton concentricum. Objective: Tinea indecisiva has been rarely reported. We report a unique case and review of the previously reported cases, pathogenesis, and management. Methods: An adult Indian man developed extensive tinea cruris and tinea corporis with concentric rings of scaly lesions over the groin, buttocks, and thighs following the use of oral corticosteroids and antifungal-steroid cream for 3 months. Mycologic and immunologic studies were performed for diagnosis. Results: Diagnosis of tinea indecisiva was confirmed on the appearance of ‘‘ring-within-a-ring’ ’ lesions clinically and isolation of Trichophyton mentagrophytes var. interdigitale as the etiologic agent on mycologic testing. Intradermal testing with Trichophyton extract showed fluctuating hypersensitivity responses. Four-week treatment with daily oral terbinafine resulted in complete resolution. Conclusion: Tinea indecisiva should be considered in a patient with tinea imbricata–like lesions with local immunosuppression caused by a non-concentricum dermatophyte. Contexte: Tinea indecisiva se caractérise par des anneaux squameux, concentriques, simulant tinea imbricata, mais l’affection est causée par d’autres dermatophytes que Trichophyton concentricum