CHRONIC DERMATOPHYTIC INFECTION OF THE FACE AND HANDS: A CLINICAL REVIEW OF TINEA FACIEI AND TINEA MANUUM

Emini, Teuta and BEADINI, Irma and MEMETI, Mamudije and ZIBERI, Rufije and NAJDOVA, Anita (2026) CHRONIC DERMATOPHYTIC INFECTION OF THE FACE AND HANDS: A CLINICAL REVIEW OF TINEA FACIEI AND TINEA MANUUM. In: INTERNATIONAL CONFERENCE “FROM RESEARCH TO APPLICATION”, 20 May, 2026.

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Abstract

Background: Tinea faciei and tinea manuum are superficial dermatophyte infections affecting the glabrous skin of the face and the hands, respectively. Although they are well-recognized clinical entities, both are frequently misdiagnosed because their morphology may mimic eczema, lupus erythematosus, rosacea, contact dermatitis, and other inflammatory dermatoses. Persistence of lesions beyond several weeks of topical antifungal therapy in immunocompetent adults is increasingly reported and represents a relevant clinical challenge. Case Presentation: A 40-year-old immunocompetent male presented with a two-month history of erythematous, scaly lesions on the cheeks, forehead, and dorsal aspects of both hands. Initial empirical therapy with topical miconazole for three months produced no clinically significant improvement. Direct microscopy of skin scrapings with 20% potassium hydroxide (KOH) revealed septate fungal hyphae, confirming a diagnosis of concomitant tinea faciei and tinea manuum. Systemic therapy was initiated with oral fluconazole 150 mg once weekly for eight weeks, with concurrent skin care advice and hygienic measures. Marked clinical improvement was observed within four weeks, and complete resolution of the lesions was achieved at the end of the treatment course. No adverse effects were reported, and no recurrence was observed during follow-up. Discussion: Failure of topical antifungal therapy in adult dermatophytosis of the face and hands is multifactorial and may reflect inadequate drug penetration in hyperkeratotic lesions, poor adherence, large affected surface area, prior use of topical corticosteroids, and the emergence of less susceptible dermatophyte strains. In such circumstances, systemic azole therapy, particularly weekly fluconazole, has been shown to be both effective and well tolerated, providing a reasonable second-line option when first-line topical regimens fail. Conclusion: This case underlines the importance of mycological confirmation of facial and hand dermatoses that fail to respond to topical therapy, and the role of weekly oral fluconazole as an effective treatment option for chronic, topically-resistant tinea faciei and tinea manuum in immunocompetent adults.

Item Type:	Conference or Workshop Item (Paper)
Subjects:	R Medicine > RL Dermatology
Divisions:	Faculty of Medicine, Health and Life Sciences > School of Medicine
Depositing User:	Unnamed user with email zshi@unite.edu.mk
Date Deposited:	23 Sep 2026 09:18
Last Modified:	23 Sep 2026 09:18
URI:	http://eprints.unite.edu.mk/id/eprint/2464

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