Steroid-Exacerbated Tinea Corporis

A pruritic lesion on the arm of a 26-year-old woman had grown to 22 cm while she was “treating” the eruption with a topical corticosteroid. Joe Monroe, PA-C, of Tulsa, Okla, suspected corticosteroid-exacerbated tinea corporis despite obfuscation of the annular border, which was caused by the lesion's unusually large size.

Tinea corporis was confirmed by a potassium hydroxide evaluation; the patient was advised to discontinue the topical corticosteroid immediately. In addition, a 7-day course of oral terbinafine, 250 mg bid, and application of antifungal cream as needed were prescribed. The dermatophytosis cleared after 1 month.

This patient was an elementary school teacher. It was thought that she acquired the infection from a child in her class.