An Annular Facial Erythema in a 2-Year-Old Girl

Abstract

Tinea faciei is a relatively uncommon superficial dermatophytosis that occurs on the glabrous skin of the face. The causative agent varies according to the geographic region and the potential environment reservoirs. Two age peaks are observed in tinea vesfaciei. One peak involves children, often due to direct contact with pets. The other peak occurs in those aged 20–40 years. Typical lesions of tinea faciei are single or multiple annular scaling patches with central clearing. Compared with other forms of tinea, tinea faciei has a high potential for misdiagnosis, possibly due to the complex anatomy of the face. Direct fungal microscopic examination along with fungal culture of the lesions remains the gold standard for establishing the diagnosis of tinea faciei. Histopathological examination can also be performed, but special stains are usually needed to detect fungal elements. Topical antifungals are the first-line treatment for most cases of tinea faciei. The most common used antifungal drugs are azoles and allylamines. Systemic antifungal treatment is needed for those with co-existence of vellum hairs infection, very atypical forms or multiple affected cutaneous areas. Here we reported a case of tinea faciei caused by Microsporum canis in a 2-year-old girl. She had close contact with her pet cat which had an annular patch of alopecia, mild scaling on the trunk. Direct fungal microscopic examination of the lesion revealed numerous fungal hyphae. Fungal culture grew Microsporum canis. She was treated with topical terbinafine hydrochloride cream for 4 weeks with complete remission of the lesion.KeywordsTinea faciei Microsporum canis TerbinafineDermatophytosis