Tokelau (Dermatophytose imbriquée): une infection dermatophytique “magnifique” (Pour les professionnels)
Synonyms Tinea Imbricata, Tokelau, Concentric tinea, Indian tinea, Chinese tinea, Scaly tinea, Elegant tinea, Lace tinea, Chimbéré, Gogo. Grillé, Cacapash, Shishiyotl, Roña. Introduction E. Wilson a prominent British dermatologist of the 19th century used to say that two kinds of skin were interesting: beautiful skin or a beautiful skin disease. Tokelau (Tinea Imbricata) is compatible…
Tokelau (Dermatophytose imbriquée): distribution géographique (Pour les professionnels)
Geographical Distribution Tokelau refers to 3 atolls lying midway between Hawaii (Hawai) and New Zealand around 300Km to the North of Samoa. The population is around 1500 for a 12 sq. Km. surface. The isolation combined with the high humidity and density might explain in part the propensity of having this fungal infection. The condition…
Tokelau (Dermatophytose Imbriquée): présentation clinique (Pour les professionnels)
Clinical Presentation The disease presents with rapid development of polymorphic and polycyclic patches. Little erythema is present but itching tends to be intense. The disease starts with brownish maculo-papules with a central detachment progressing towards the periphery. The free border is turned towards the centre and a brownish edge leads the active edge. It can…
Tokelau (Dermatophytose imbriquée): Diagnostic et diagnostic différentiel (Pour les professionels)
Diagnosis and Differential Diagnosis
- Diagnosis is clinical and can be confirmed by scale scrapings and fungal culture.
- In acute presentation in can be confused with secondary syphilis, granuloma annulare and erythema annulare centrifugum.
- In chronic presentation it can look like ichtyosis and erythema gyratum repens.
Tokelau (Dermatophytose imbriquée): Causes (étiologie)
Causes
- The condition is caused by a strictly anthropophilic dermatophyte called tinea concentricum.
- Transmission is incompletely understood. Close contact is important but not enough and genetic (mode of inheritance mainly autosomal recessive (“pure race”) with a few autosomal dominant cases), environmental (poor hygiene, iron deficiency, malnutrition) and immunological factors play an important role.
Tokelau (Dermatophytose imbriquée): Traitement (Pour les professionnels)
Treatment
- Combination of an oral antifungal (griseofulvin, terbinafine. Itrconazole and fluconazole are ineffective) with a topical keratolytic.
- Recurrence rates are very high.
Tokelau (Dermatophytose imbriquée): Bibliographie (Pour les professionels)
A case of tinea imbricata (Hanumarn ringworm) treated with fulcin. Chermsirivathana S, Boonsri P. Aust J Dermatol. 1961 Jun;6:63-6. Endemic tinea imbricata–a study on Goodenough Island, Papua New Guinea. Hay RJ, Reid S, Talwat E, Macnamara K. Trans R Soc Trop Med Hyg. 1984;78(2):246-51. Revista de la Sociedad Venezolanade Microbiología: www.scielo.org.ve Tinea imbricata or Tokelau.…