Tinea nigra presenting speckled or "salt and pepper" pattern.

A 7-year-old Caucasian female resident of the southern coast of Brazil presented dark spots on the left palm that converged to a unique macule with speckled pattern at about 1 month. The mycological exam and the fungi culture were typical of Hortaea werneckii, the agent of the superficial mycosis Tinea nigra. The patient received butenafine hydrochloride 1% for 30 days, resulting in a complete remission of the lesion. At a follow-up visit 12 months after treatment, there was no lesion recurrence. We describe a form of rare geographical Tinea nigra with a speckled pattern. The "salt and pepper" aspect should be taken into consideration when the mycosis was suspected. © The American Society of Tropical Medicine and Hygiene.

A 7-year-old Caucasian female child, who was a resident of Itapema town on the northern coast of Santa Catarina State, Brazil, presented dark spots on the left palm about 1 month before the exam; they converged to a unique macule with speckled pattern, with a 1.5 × 2.0-cm diameter and geographic shape (Figure 1).

Figure 1.

Black macule with geographic shape and speckled pattern on the left palm of the Caucasian patient.

The mycological exam revealed septate, dematiaceous hyphae, and presence of yeast-like cells with spores. The fungi culture in Sabouraud's agar showed a moist, shiny, rough, and black colony. The fungi in the culture were identified as Hortaea werneckii (Figure 2).

Figure 2.

Presence of annelloconidia with pigmented filaments (Magnification: 400×).

The topical treatment with butenafine hydrochloride 1% for 4 weeks caused complete remission of lesions, with no recurrence during follow-up for 1 year.

Reports of Tinea nigra have been rare since the first publication by Cerqueira in 1916.1,2 This cosmopolitan dermatomycosis usually affects Caucasian patients, such as in the present report. We describe a form of rare geographic Tinea nigra with a speckled pattern.

The “salt and pepper” aspect should be taken into consideration when the mycosis is suspected.