Fungal skin infections commonly misdiagnosed

With colleagues from GW and Therapeutics Clinical Research in San Diego, California, Friedman 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 skin infection. The majority of cases were only appropriately classified by 50 percent of participants, with only one of the cases correctly identified by 90 percent of the audience.

Dermatophyte infections, the most common kind of fungal infection in the skin, hair, or nails, affect an estimated 25 percent of the world's population and have accounted for 51 million outpatient visits over the last 10 years in the U.S. Misdiagnosis of dermatomycosis can result in incorrect therapy selection, worsening of symptoms, and even additional skin and soft tissue infections.

"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 Friedman, associate professor, director of the residency program, and director of translational research in the Department of Dermatology at the GW School of Medicine and Health Sciences.

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 Friedman. "However, knowledge and training of bedside diagnostic techniques like potassium hydroxide preps during residency and beyond can combat misdiagnosis."

"Cutaneous fungal infections are commonly misdiagnosed: a survey-based study" is published in the Journal of the American Academy of Dermatology.