A Case of Tinea Faciei Caused by Nannizzia gypsea

Abstract

We report a case of tinea faciei caused by Nannizzia gypsea around the philtrum of an 82-year-old woman. She noticed erythema on the philtrum 1 month before her first visit to our hospital. The lesion was previously treated by topical corticosteroid but did not improve. Clinical examination revealed scaly annular erythema surrounded by pustules around the philtrum and both nostrils. Based on examination under a microscope, DNA sequencing, and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), she was diagnosed with tinea faciei caused by Nannizzia gypsea. The lesion gradually disappeared after taking oral terbinafine at 125 mg/day for 1 month. Nannizzia gypsea, previously known as Microsporum gypseum, is a geophilic dermatophyte that is distributed globally. Nannizzia gypsea can cause tinea corporis, tinea capitis,kerion celsi, and tinea barbae, but rarely tinea faciei. Lesions caused by Nannizzia gypsea are often accompanied by severe inflammation mimicking other inflammatory dermatitis. Dermatologists should take this feature into consideration to avoid misdiagnosis and incorrect application of topical corticosteroids. Skin Research, 20 : 225-229, 2021