Figure 2: Multiple septate hypae under direct microscopy of KOH
preparation
Discussion:
Tinea corporis bullosa is rare presenation of tinea and can be mistaken
for a variety of dermatoses such as bullous phemigoid, erythema
multiformie, bullous allergic contact dermatitis and linerar IgA bullous
dermatosis 5. The common causative agents for Tinea corposris bullosa
are Tinea rubrum, Microsporum Canis, Trichophyton schoenleinii. 5-7.
Misdiagonosis and treatment delays are common. But in our case, pruritic
nature of lesion, contact history with cattles, annular shape of lesion
with scaling and central clearing raised the early suspicion for tinea
corporis bullosa. But exclusion of other common causes of blistering
skin condition is must. The mechanism of bulla formation is inflammatory
response due to dermatophyte leading to hypersensitivity reactions
provoked by presence of dermatophyte antigen, which might be implicated
in bulla formation accompained by dermal infiltrate 7. Treatment is
similar to treatment of tinea corporis and lesion usually resolves
within 1-2 months. Recurrance is common.
Conclusion:
Bulla formation in tinea corporis is rare but should be considered in
patient after excluding other blistering dermatologic conditions. It is
important to be aware about unusal presentation and should be considered
in acute infections without past history and family history of
blistering skin infections.
Acknowledgment: Author wants to thank all teaching staff of
Department of Dermatology and staffs of Department of Pathology,
Bakulahar Ratnanagar Hospital for their suggestions and constant support
to make this work successful.
Declaration of Conflicting Interests: The author(s) declared no
potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.
Funding: The author(s) received no financial support for the
research, authorship, and/or publication of this article.
Patient consent: Written informed consent was obtained from the
patient to publish this report in accordance with the journal’s patient
consent policy
Data Availability Statement: All the data underlying the
results are available as part of the article and no additional source of
data are required.
References:
1. Gupta, A. (2001), Uncommon localization or presentation of tinea
infection. Journal of the European Academy of Dermatology and
Venereology, 15:
7-8. https://doi.org/10.1046/j.1468-3083.2001.00195.x
2.Kokollari F, Daka A, Blyta Y, Ismajli F, Haxhijaha-Lulaj K. Tinea
Corporis, Caused by Microsporum Canis - a Case Report From Kosovo. Med
Arch. 2015 Oct;69(5):345-6. doi: 10.5455/medarh.2015.69.345-346. Epub
2015 Oct 4. PMID: 26622092; PMCID: PMC4639369.
3.Ebrahimi M, Zarrinfar H, Naseri A, Najafzadeh MJ, Fata A, Parian M,
Khorsand I, Novak Babič M. Epidemiology of dermatophytosis in
northeastern Iran; A subtropical region. Curr Med Mycol. 2019
Jun;5(2):16-21. doi: 10.18502/cmm.5.2.1156. PMID: 31321333; PMCID:
PMC6626711.
4.Leung AK, Lam JM, Leong KF, Hon KL. Tinea corporis: an updated review.
Drugs Context. 2020 Jul 20;9:2020-5-6. doi: 10.7573/dic.2020-5-6. PMID:
32742295; PMCID: PMC7375854.
5. Derek Lim SY, Lee JS, Chong WS. Targetoid bullous tinea corporis:
Unusual presentation of a dermatophyte infection. Indian J Dermatol
Venereol Leprol 2021;87:101-103.
6. Terragni L, Marelli MA, Oriani A, Cecca E. Tinea corporis
bullosa. Mycoses. 1993;36:135–
7. Sahu P, Dayal S, Mawlong PG, Punia P, Sen R. Tinea Corporis Bullosa
Secondary to Trichophyton Verrucosum: A Newer Etiological Agent with
Literature Review. Indian J Dermatol. 2020 Jan-Feb;65(1):76-78. doi:
10.4103/ijd.IJD_483_19. PMID: 32029951; PMCID: PMC6986116.