Concluded Case

Tinea Cruris - now Tinea incognito

20 years male with recurrent tinea cruris . On taking history- he has been using lot of topical creams containing steroids and antifungals. Now presents with tonea cruris with atypical lesions- NOW Tinea incognito

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Concluded answer

Extensive Tinea corporis- thanks to quacks - repeated prescriptions of steroids converted it into Tinea incognito. Now patient requires an oral combination of prolonged antifungals Tab Itraconazole 200 mg O.D for 1 month and tab Fluconazole 400 mg weekly for 1 month with topical luliconazole cream application

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Obviously it is Tinea incognito/cruris First to keep part dry, Secondly blood sugar to be done, Tab fluconazole 150mg biweekly Tab foristal1bd Antifungal powder/ lulliconazole locally No corticosteroid

Thanks Nihar Ranjan mohanty ,Dr A Dutta ,Dr Taimoor dr Taimoor, Dr. Kute Ankush, Dr. Ashok leel Dr. Dinesh Gupta
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Loos like Extensive Tinea infection. Rx. Maintain personal proper hygiene. Wear loose cotton garments, Avoid:-Inner garments,,and scrubbing also. Orally Antifungal like Zocon 150 mg OD Tab.Terbinafine 250 mg OD Fluconazole/Ketoconazole Powder. Ketoconazole for bath.

Tinea infection Zocon 150mg Baclate

Tinea incognito” .. It is a term used to describe a tinea infection modified by topical steroids. It is caused by prolonged use of topical steroids, sometimes prescribed as a result of incorrect diagnosis. Topical steroids suppress the local immune response and allow the fungus to grow easily... Topical corticosteroid use is the culprit for the difference.. The new appearance of tinea incognito is quite different from other fungal infections. Instead of a localized lesion, it becomes much more extensive and loses its original circular shape, which is one of the most important clinical clues to diagnose fungal infection.  Discontinue the topical corticosteroids. oral medications like terbinafine and fluconazole, may be necessary.

As per mentioned in details patient was on steroids. Stopping steroids consumption or stopping local application of steroid will help better as steroids aggravate fungle infections. Tab.Fluconazole 150 mg per week for 4 -12 weeks Tab.Levocetrizine twice a day. Antifungle powder application Ketoconazole soap to wash lesion. 1st avoid tight clothing 2nd wash lesion with Ketoconazole soap, then make it completely dry , (don't rub the lesion) 3rd sprinkle antifungal powder The lesions should always try to keep dry, just by applying soft cloth & then powder.

Sir please suggest antifungal powder brand and instruction of application for better result
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Use ludura cream locally Give tab. Griseofulvin or fluconazole for 8 to 12 wks... Tab. Levocetirizine+montelukast.....sos tab. Atarax Review every 15 days... Require proper patient counselling for long duration course and its commitment

Yes sir tenia cruri Terbinafine oint twice daily Amrolfine oint twice daily Orally tab flucanazole 200mg 1od Tab fexofenadine180mg 1od Adv to change inner wears

Thanx dr Ashok Leel
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Tinea infection with recurrence Give Voricanazole od Amrolfine cream topical Antihistamine

Thanks@Soumya Hazra
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Tinea cruris Friction dermatitis Keto 400 mg od4 to6 week Oint halox ibernet bd

Stop topical steriods Adv antifungal itraconazole, ludura oint locally, antihistamines

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