Fungal skin infections, caused by yeasts or dermatophytes, may be commonly misdiagnosed, suggested a
survey published in the Journal of the American Academy of Dermatology
by George Washington University (GW) dermatologist Adam Friedman.
With colleagues from GW and Therapeutics Clinical Research in San
Diego, California, Friedman surveyed dermatologists at the 2016 Orlando
Dermatology Aesthetic & Clinical Conference. The survey asked
dermatologists to anonymously review 13 clinical images and determine
whether or not the image was consistent with a fungal skin infection.
‘It is challenging to distinguish between certain fungal skin infections and primary inflammatory conditions, often leading to misdiagnosis.’
The majority of cases were only appropriately classified by 50%
of participants, with only one of the cases correctly identified by 90% of the audience.
Dermatophyte infections, the most common kind of fungal infection in
the skin, hair, or nails, affect an estimated 25% of the world's
population and have accounted for 51 million outpatient visits over the
last 10 years in the United States. Misdiagnosis of dermatomycosis can result in
incorrect therapy selection, worsening of symptoms, and even additional
skin and soft tissue infections.
"It is crucial to push for proper and continued medical education on
dermatophyte and other fungal skin infections to minimize misdiagnoses
and ultimately curb disease impact," said Friedman, associate professor,
director of the residency program, and director of translational
research in the Department of Dermatology at the GW School of Medicine
and Health Sciences.
The survey highlights the challenge of distinguishing between
certain fungal skin infections and primary inflammatory conditions, and
the ease with which one may miss the correct diagnosis.
"Secondary syphilis, annular psoriasis, and pityriasis rosea are
among a few inflammatory skin diseases that mimic dermatophyte
infections," said Friedman. "However, knowledge and training of bedside
diagnostic techniques like potassium hydroxide preps during residency
and beyond can combat misdiagnosis."
"Cutaneous fungal infections are commonly misdiagnosed: a survey-based study" is published in the Journal of the American Academy of Dermatology