Tinea imbricata B35.50

William Dampier, 1789 (Island of Mindanao/Philippines)

Special form of Tinea corporis superficialis with typical cocard-like flocks. "Imbricata" is derived from the Latin term "imbrex" = overlapping roof tiles.

Trichophyton concentricum (anthropophilic fungus that typically spares hair and nails).

Occurs mainly in tropical regions, especially in Africa, South America or Asia (especially Vietnam). Tinea imbricata is endemic to the Philippines and Indonesia.

A genetically predisposed increased sensitivity to T. concentricum (hereditary defect of cell-mediated immunity) is suspected.

Infection often occurs in childhood. So far there are no reports of cases before the age of two.

Located mainly on the trunk. Palmae and Plantae remain mostly free.

Brownish, peripherally migrating, very loose, hardly adherent, scaly, itchy, anular skin changes. Little or no erythema. Older lesions show signs of lichenification and usually itch less than fresh lesions.

Fungus detection: native preparation of potassium hydroxide solution, periodic acid staining (PAS) of the ship in the histological preparation, cultural identification of the pathogen (white-yellowish colonies with a powdery border wall and brown underside).

Terbinafine 1 time/day 250 mg for 4 weeks is effective and safe in the therapy of T. imbricata. The therapeutic success lasts at least 8 weeks. Griseofulvin is therefore an effective and inexpensive therapy. Itraconazole 200 mg/day p.o. for 1 week can be seen as an alternative.

Spontaneous remissions are rare.

1. Budimulja U (1994) A double-blind, randomized, startified controlled study of the treatment of tinea imbricata with oral terbinafine or itraconazole. Br J Dermatol 130: 29-31
2. Halde C et al (1965) Tinea imbricata treated with griseofulvin. Am J Trop Med Hyg 14: 1062-1065
3. Wingfield AB et al (2004) Treatment of tinea imbricata: a randomized clincal trial using griseofulvin, terbinafine, itraconazole and fluconazole. Br J Derm 150: 119-126