Ichthyosis associated with widespread tinea corporis: report of three\ncases
A 73-year-old male patient was diagnosed with ichthyosis linearis circumflexa in\n1999. Disseminated arciform and round patches had been seen since his first\ndermatology visit. Previous empiric treatment to rule out coincident fungal infection\nincluded ketoconazole, topical terbinafine, ketoconazole or ciclopirox olamine. This\ntherapy had no impact.\nDuring one of his regular visits in July 2011, he presented ill-defined erythematous\nscaly papules and plaques on the trunk and upper limbs (). Onycholysis, distal leukonychia, subungual\nhyperkeratosis and onychorrexis on the toenails were also evident. A mycological\nexamination demonstrated septate hyaline hyphae, and a positive culture for\nT. rubrum. Skin biopsy presented several hyphae within the\nstratum corneum, suggesting the diagnosis of dermatophytosis (). A subungual sample also demonstrated T. rubrum.\nPatient was treated with terbinafine 250 mg qd for 120 days, with significant\nimprovement of skin scaling and nail dystrophy ( and ).\nAfter this treatment, features of ichthyosis linearis circumflexa\nwere no longer observed. Lamellar desquamation, skin thinning and a discrete\nectropiun suggested lamellar ichthyosis as a primary diagnosis.