PMC7470300_01
Description of lesions of Tinea in an immunocompetent Indian male. (a) Circinate scaly plaques with a well-defined erythematous scaly plaque of size 5x6 cm with papules in the border on the flexor aspect of the right forearm (arrowhead); (b) Erythematous irregular scaly plaques over the lower part of the lower leg of size 2x2 cm (arrowhead).
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F1
On dermatological examination, well-defined circinate, scaly plaques with erythematous papules of varying sizes were present over the flexor aspect of the right forearm and lower left leg, as shown in Fig. 1a, b. On further examination, similar lesions were seen in the lower abdomen, groin and the gluteal region (not shown in Fig. 1).
Direct microscopy and fungal culture of the skin scrapings. (a) Direct 20 % KOH preparation of the skin scrapings (40X) showing thin hyaline septate hyphae characteristic of dermatophytes (arrowhead). (b) Growth on SDA with chloramphenicol and cycloheximide showing powdery growth (arrowhead). (c) Growth on DTM with Dermato Supplement changing pH (arrowhead) of the media. (d) Subculture on PDA after 2 weeks showing powdery surface texture with buff or brownish colour and peripheral fringe of a white zone (arrowhead). (e) Reddish reverse on PDA (arrowhead).
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F2
On further incubation, the colonies turned pleomorphic with ragged edges, as shown in Fig. 2a-e.
Physiological and morphological features of the isolate. (a) Perforating organs on sterile pre-pubescent hair in vitro (arrowhead). (b) Powdery growth with brownish pigment on sterile polished rice grain inoculation (arrowhead). (c) Hydrolysis of Christensen's urea medium with 10 days of inoculation (arrowhead). (d, e) Lacto phenol cotton blue (LPCB) mount showing a moderate number of teardrop shaped microconidia (arrowheads), measuring 2-3x5-8 microm smooth walled and are borne laterally on the septate hyphae, arranged in solitary and small groups were seen. Numerous spindle-shaped macroconidia (arrowheads), thin-walled and echinulate surface (arrowheads) with 4-6 septa (arrowheads) and measuring 150x15 microm (arrowhead) and a few of them showing blunt tips (arrowhead).
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F3
Macroconidia were initially sparse but, older cultures showed an increased number of macroconidia, which are spindle-shaped, thin-walled with echinulations and blunt tips, as shown in Fig. 3a-e.
PMC7470300_02
Follow-up of tinea owing to N. gypsea after successful terbinafine regimen. Complete resolution of tinea caused by N. gypsea on the flexor aspect (a) of the right forearm, lower leg (b), and the lower abdomen (c) and other sites after terbinafine therapy without any residual scar or relapse at the follow-up of 1-year duration.
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F4
His itching and inflammatory lesions resolved without any residual scars or relapse after 1-year post-treatment, as shown in Fig. 4a-c.