Finding fungus - an asymmetric scaly rash is fungus until proved otherwise!
There are not many cures in dermatology! But the onus is on us to find those that are!
Dermatophyte fungal infections can be one of those. Although we are now entering the era of oral antifungal drug resistance, the vast majority of dermatophyte infections are still curable with current medications.
Dermatophyte infections are usually asymmetric and are usually scaly and may have an accentuated edge.
On the palms, tinea is usually unilateral.
Tinea is occasionally sufficiently inflammatory to produce blistering.
The proof of the pudding however is in taking scrapings for mycology. Otherwise, it is educated guess work. It is relatively inexpensive and either PCR or culture will identify the causative fungus which will indicate whether the infection has been acquired from another human or from an animal.
The zoophilic fungi are usually very species-specific, so it is possible to tell exactly the source of the infection; so important in eradicating a potential outbreak. So take specimens - it's money well spent.
Remember that appearances of tinea can be modified by the use of topical steroids. They make the infection spread and allows the fungus to delve into hair follicles producing pustules.
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