Department of Dermatology, Royal Brisbane and Women's Hospital, Brisbane, Australia.
Australas J Dermatol. 2011 Aug;52(3):191-4. doi: 10.1111/j.1440-0960.2011.00790.x. Epub 2011 Jun 23.
BACKGROUND/OBJECTIVES: Tinea nigra is a relatively uncommon dematiaceous fungal infection of the palms and soles, which clinically may mimic a melanocytic lesion. We sought to ascertain how frequently misdiagnosis of this infection occurred and whether the use of dermoscopy helped in its diagnosis.
Fifty consecutive cases of tinea nigra diagnosed at a dermatopathology laboratory were examined with regard to the clinical diagnosis, use of dermoscopy and the mode of management.
Of the 50 cases, 21 (42.0%) were treated by shave or surgical excision. The clinical diagnosis of tinea nigra was made in five cases (10.0%) and suggested along with other diagnoses in a further two cases (4.0%). The dermatologists (n = 9) gave the correct diagnosis in four patients (44.4%), the general practitioners (n = 38) gave the correct diagnosis in one patient (2.6%) and the three surgeons involved did not give the correct diagnosis. When dermoscopy was used, in seven of 13 (53.8%) cases tinea nigra was suggested as a probable diagnosis but when dermoscopy was not used (n = 37) tinea nigra was not clinically diagnosed (P < 0.001).
The diagnosis of tinea nigra is significantly improved by dermoscopy, the disease should be considered as a cause of palmar or plantar pigmentation.
背景/目的：黑癣是一种相对罕见的暗色真菌引起的手掌和足底感染，临床上可能类似于黑素细胞病变。我们旨在确定这种感染的误诊频率，以及使用皮肤镜检查是否有助于其诊断。
在皮肤科病理实验室连续诊断了 50 例黑癣病例，检查了临床诊断、皮肤镜检查的使用情况和治疗方式。
50 例中，21 例（42.0%）采用刮除或手术切除治疗。5 例（10.0%）临床诊断为黑癣，另有 2 例（4.0%）同时伴有其他诊断。9 名皮肤科医生中有 4 名（44.4%）正确诊断，38 名全科医生中有 1 名（2.6%）正确诊断，3 名外科医生均未正确诊断。在使用皮肤镜检查的 13 例中，有 7 例（53.8%）提示可能为黑癣诊断，但在未使用皮肤镜检查的 37 例中，临床上并未诊断为黑癣（P<0.001）。
皮肤镜检查显著提高了黑癣的诊断水平，应将该病视为掌跖色素沉着的原因之一。
