To Study Clinical and Dermoscopic Picture of Steroid Modified Tinea Infection in a Tertiary Care Teaching Hospital

Background: Topical corticosteroid misuse can obscure and alter classical dermatophytosis, producing steroid-modified tinea (tinea incognito) that complicates diagnosis. Dermoscopy may reveal characteristic bedside patterns that facilitate recognition in routine care. Material and Methods: An observational, descriptive, cross-sectional study was undertaken in a tertiary-care dermatology service. Consecutive patients with clinical diagnosis of steroid- modified tinea who provided consent for dermoscopy were enrolled. A structured proforma captured demographics, comorbidities, lesion size/morphology, prior tinea history, discoloration, infection duration, steroid misuse duration, and clinical type. Dermoscopy recorded diffuse erythema, marginal scales, brown/black globules, black dots, and other follicular/vascular signs. IBM SPSS v23 was used for descriptive statistics (frequency, percentage; mean ± SD). Results: A total of 220 patients were included (male 134, 60.9%; female 86, 39.1%); mean age 33.45 ± 13.24 years. Most were 15–29 years (45.5%) and 30–44 years (32.7%). Clinical morphology was dominated by ill-defined erythematous-to-hyperpigmented plaques with fine white scales (73.6%), with the same morphology with striae in 26.4%. Dermoscopy commonly showed diffuse erythema + brown globules + marginal scales (73.6%), and the same with black dots (26.4%). Past tinea history was frequent (67.3%); hypopigmentation occurred in 8.6%. Predominant types were tinea cruris (46.4%) and tinea corporis (38.2%). Infection and steroid- misuse durations most often clustered at 6–12 months (34.6%). Conclusion: In routine practice, steroid-modified tinea presents with consistent clinical (ill- defined plaques with fine scales) and dermoscopic patterns (diffuse erythema, brown globules, marginal scales ± black dots). Integrating dermoscopy with systematic history of steroid exposure can speed recognition and guide management and patient counseling.

Keywords: Steroid-modified tinea; Tinea incognito; Dermoscopy; Dermatophytosis; Topical steroid misuse.