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November 2002

Inflammatory Tinea Pedis/Manuum Masquerading as Bacterial Cellulitis

Author Affiliations

From the Departments of Medicine (Drs Sweeney and Wiss) and Pediatrics (Dr Wiss), Division of Dermatology, University of Massachusetts Medical School, Worcester; and the Department of Pediatrics, Washington University School of Medicine, St Louis Children's Hospital, St Louis, Mo (Dr Mallory).

Arch Pediatr Adolesc Med. 2002;156(11):1149-1152. doi:10.1001/archpedi.156.11.1149

Background  Tinea pedis and tinea manuum in children are more common than previously recognized. Clinical presentations of dermatophyte infections may vary in children and may be difficult to diagnose.

Objective  To show the necessity of potassium hydroxide preparations and/or fungal cultures in assessing suspicious cases of cellulitis in children who may have dermatophyte infections.

Patients  We describe 4 children with inflammatory tinea pedis or tinea manuum who were initially misdiagnosed as having bacterial cellulitis.

Intervention  A potassium hydroxide examination was performed on 3 patients. Fungal cultures were performed on 2 patients.

Results  Inflammatory/bullous dermatophyte infections were detected by potassium hydroxide examination in all 4 patients and all 4 children successfully responded to topical antifungal therapy.

Conclusions  These cases demonstrate that inflammatory tinnea pedis/manuum can masquerade as cellulitis in children. Early potassium hydroxide examination can allow appropriate antifungal treatment to be initiated before fungal culture results are finalized.