A Case of Tinea Faciei due to <i>Trichophyton indotineae</i> with Steroid Rosacea Related to Topical Over-The-Counter Drugs Purchased Outside of Japan

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  • Fukada Norihito
    Department of Dermatology, Teikyo University Chiba Medical Center
  • Kobayashi Hisashi
    Department of Plastic and Reconstructive Surgery, Teikyo University Chiba Medical Center
  • Nakazono Manabu
    Department of Dermatology, Teikyo University Chiba Medical Center
  • Ohyachi Keita
    Department of Dermatology, Teikyo University Chiba Medical Center
  • Takeda Akinori
    Department of Dermatology, Teikyo University Chiba Medical Center
  • Yaguchi Takashi
    Mycology Research Center, Chiba University
  • Okada Miyuki
    Division of Clinical Laboratory, Teikyo University Chiba Medical Center
  • Sato Tomotaka
    Department of Dermatology, Teikyo University Chiba Medical Center

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  • A Case of Tinea Faciei due to Trichophyton indotineae with Steroid Rosacea Related to Topical Over-The-Counter Drugs Purchased Outside of Japan

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Abstract

A Filipino woman in her forties had facial erythema that was being self-treated with over-the-counter (OTC) drugs purchased outside of Japan. The drugs included clobetasol propionate, antibiotic, and antifungal components. Her facial erythema symptoms were worse during summertime. KOH direct examination of annular erythema was positive for fungal hyphae and negative for Demodex folliculorum. Fungal culture revealed Trichophyton indotineae based on internal transcribed spacer sequence analysis. Minimal inhibitory concentration for terbinafine was 0.06 µg/mL. We made a diagnosis of tinea faciei with steroid rosacea. We treated the patient with oral itraconazole. Physicians should be aware of increasing T. indotineae infections and increasing self-medication using topical OTC steroids combined with antifungals and antibiotics not only in India but also among foreign people living in other countries such as Japan.

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