Tinea pseudoimbricata

Tinea pseudoimbricata refers to usually two or rarely, three concentric circles within a lesion of dermatophytosis and is a clue to the application of preparations containing potent topical corticosteroids [Figure - 1]. “Rings within the ring” and “double-edged tinea” are apt descriptive terms to familiarize non-dermatologists with its morphology. It is essentially a form of tinea incognito that resembles tinea imbricata caused by Trichophyton concentricum, but the latter has many more concentric circles and is usually generalized. This lesion in our patient showed dermatophyte hyphae on a potassium hydroxide preparation and grew Trichophyton rubrum on culture. This appearance should alert the physician to the possible abuse of topical steroids. Other causes of immune suppression should also be ruled out.

Figure 1: Typical concentric circles of Tinea pseudoimbricata on the groin with “rings within the ring” and “double-edged tinea” appearance

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