Tinea Incognito on the Face and Neck / 대한의진균학회지

Tinea incognito is a dermatophytosis modified by previous treatments such as prolonged use of corticosteroids. Because the lesions often atypical appearing without classic features of ringworm, the diagnosis can be delayed or missed especially when tinea incognito is on the face and neck. A 75-year-old male patient who had been treated with topical steroids at the local dermatologic clinic for 10 years for the eczematous lesion on the scalp and face and recently the lesions spread throughout his neck and back. Physical examination showed ill-defined erythematous scaly patches on the face, neck and back and reddish crusted papules on the scalp. Potassium hydroxide (KOH) preparation on the left face and right neck showed hyphae and fungus cultures were positive for colonies of Trichophyton rubrum (T. ruburum). The result of DNA sequencing from the colony was identical to that of T. rubrum. The lesions were treated by oral terbinafine and topical isoconazole.

Pattern Alopecia during Hormonal Anticancer Therapy in Patients with Breast Cancer

We report five cases of pattern alopecia in female patients who are undergoing hormonal anticancer therapy for the prevention of recurrence of breast cancer after surgery. Three patients demonstrated male pattern alopecia with receding frontal hairlines, and two patients demonstrated female pattern alopecia without receding hairlines. The detailed clinical history showed that the pattern alopecia of the patients developed after the full recovery of global hair loss of the entire scalp due to previous cytotoxic chemotherapy. All of the adjuvant hormonal anticancer drugs that were used in the patients are antiestrogenic agents, either aromatase inhibitors or selective estrogen receptor modulators. Considering androgen effect on the hair follicles of the fronto-parietal scalp, the androgen-estrogen imbalance caused by the drugs was thought to be the reason for the onset of pattern alopecia in the patients. In general, alopecia that develops during cytotoxic chemotherapy is well known to both physicians and patients; however, the diagnosis of pattern alopecia during hormonal anticancer therapy in breast cancer patients seems to be overlooked.