Are cutaneous fungal infections commonly misdiagnosed?


Cutaneous fungal infections may be commonly misdiagnosed, according to a survey-based study published online in the Journal of the American Academy of Dermatology (Nov. 17, 2016).

This investigation was conducted by Dr. Adam Friedman and colleagues from George Washington University who surveyed dermatologists at the 2016 Orlando Dermatology Aesthetic & Clinical Conference. The survey asked dermatologists to anonymously review 13 clinical images and determine whether or not the image was consistent with a fungal cutaneous infection.

The majority of cases were only appropriately classified by 50% of participants, with only one of the cases correctly identified by 90% of the audience.

“It is crucial to push for proper and continued medical education on dermatophyte and other fungal skin infections to minimize misdiagnoses and ultimately curb disease impact,” said Dr. Friedman, associate professor, director of the residency program, and director of translational research in the Department of Dermatology at George Washington University in Washington, D.C.

The survey highlights the challenge of distinguishing between certain fungal skin infections and primary inflammatory conditions, and the ease with which one may miss the correct diagnosis.

“Secondary syphilis, annular psoriasis, and pityriasis rosea are among a few inflammatory skin diseases that mimic dermatophyte infections,” said Dr. Friedman, who was quoted in a press release. “However, knowledge and training of bedside diagnostic techniques like potassium hydroxide preps during residency and beyond can combat misdiagnosis.”

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