OpenHealth Q&A

Get answered by medical professionals

Do Oral Antifungals Necessitate Treatment for Tinea Incognito?

8/22/2025, 4:51:14 AMMale25-34

Age: 24, Gender: Female I can't believe how clueless I've been. While cleaning the floor, I suddenly felt an intense itch on my feet. When I looked down, I discovered numerous blisters had appeared seemingly out of nowhere, resembling dyshidrotic eczema. My first thought was, "Oh no, I must be allergic to the floor cleaner. This is entirely my fault. No big deal, I suppose." Having experienced dyshidrotic eczema flares frequently, I reverted to my usual method of managing it—starting a regimen of oral and topical steroids. After receiving my prescriptions, I picked up the medications and followed my standard protocol. I took the prednisone, applied the topical cream, and wore some high socks. However, as a few days passed, I noticed that my feet began to peel and, disturbingly, the skin had a yellowish hue. Glancing at my nails revealed the same yellow tint. With my prior education on onychomycosis, I realized the complications that lay ahead. I was unaware that vesicular athlete's foot existed. This was a valuable lesson, but it didn’t stop there. The situation escalated as it transformed into tinea incognito—likely exacerbated by the steroids. I have been utilizing the usual treatment methods, including soaking my feet like one would for athlete's foot or ringworm, along with topical applications, but progress has been slow. I find myself reluctant to start oral antifungals, which is understandable given the circumstances, yet I am concerned about delaying treatment if it’s the necessary course of action. Opinions on this matter vary widely, but it seems that many suggest that oral antifungals are essential for addressing tinea incognito. What are your thoughts? Thank you for your help! I apologize for the oversight on my part. :(

ArthritisMultiple SclerosisCrohn's Disease

Answers (1)

Cony

8/22/2025, 4:51:52 AM

OpenHealth AI

It sounds like you're dealing with a frustrating situation, and it's understandable to be concerned. Tinea incognito can indeed be tricky, especially as it can mimic other skin conditions and be exacerbated by topical steroids. Let's break down your situation and clarify the best approach.

Main Points

  • Tinea incognito is a fungal infection that often appears worse due to the use of topical steroids, making it harder to treat.
  • Oral antifungals can be crucial for effectively managing this condition, especially if topical treatments alone are not working.

Explanation

Tinea incognito occurs when a fungal infection (like athlete's foot) is masked by topical steroids, resulting in symptoms that can resemble other skin conditions. Treatment often requires more than just topical antifungal creams, especially if the infection has spread or persisted. Oral antifungals have been shown to penetrate the skin more effectively and eliminate the fungal infection from the body.

Given that you’ve noticed yellowing of your skin and nails and that your symptoms haven't improved significantly with topical treatments, it may be time to consider oral antifungals. They are often necessary because the topical treatment can sometimes fail to fully eradicate deeper infections.

Next Steps

  1. Consider Oral Antifungals: If you feel hesitant, try to evaluate your symptoms over the next few days. If there's no significant improvement, it's likely that oral antifungals will provide the necessary intervention.

  2. Continue with Soaking and Topical Treatment: Continue soaking your feet and applying antifungal topical creams to manage any discomfort and support treatment. Ensure that you're using a specified antifungal and not just an anti-itch cream.

  3. Monitor Your Symptoms: Keep an eye on your symptoms over the next few days. If the yellowing or peeling worsens, or if you develop new symptoms, this further indicates the need for a different approach.

  4. Practice Good Hygiene: Keep your feet dry and clean, and avoid using steroids until the infection is addressed. This can help prevent aggravation of the fungal infection.

  5. Educate Yourself: Familiarize yourself further with tinea incognito and its treatments. Understanding the condition can help you feel more in control of your health.

Give yourself grace for this learning curve; skin issues can be complex. By following these steps, you will be on a path to better management of your symptoms and may find relief soon. Let me know if you have further questions or need more information!

Related Questions

Experiencing Occasional Hematuria: Seeking Guidance

Greetings, medical professionals. I appreciate your assistance with the following situation. **Patient Overview:** - **Age:** 47 - **Gender:** Male - **Height:** 6 feet - **Weight:** 202 pounds **Symptoms Overview:** Approximately three months ago, I began to observe small traces of blood in my urine. It's a minimal amount, usually just a couple of drops occurring at the end of urination. I do not suffer from any pain, fever, chills, or urinary difficulties. Initially, I suspected that this could be linked to kidney stones or exercise-induced hematuria, as I maintain a rigorous exercise routine spanning two hours daily, seven days a week. My workouts alternate between strength training 3-4 times a week and cardio exercises, including rowing, treadmill use, the elliptical, stair climbing, and jump rope. After several weeks, I also observed tiny tissue-like fragments in my urine, prompting me to consult a doctor, as I suspected a urinary tract infection. Although I have an enlarged prostate, my physician considered it a benign issue, attributing the swelling to the potential chain reaction of a UTI leading to bladder infection and subsequently causing prostate inflammation. **Diagnostic Tests and Outcomes:** I underwent a comprehensive metabolic panel, which included tests for glucose, BUN, creatinine, and various electrolytes. All results fell within normal ranges, with the exception of a low BUN/creatinine ratio (8). Additionally, I received a Creatine Kinase (CPK) test, which returned normal results. A complete blood count (CBC) with differential was conducted, showing all parameters, including WBC, RBC, and hemoglobin, to be normal. Urinalysis reflected negative findings for GLU, BLO, NIT, and LEU. However, it indicated a small amount of bilirubin, a ketone level of 15, a specific gravity of 1.025, a pH of 5.5, and a protein level at 30. Uric acid levels were 8.1, within normal limits, though an inflammatory marker was mildly elevated. A sedimentation rate (Westergren) displayed a slight elevation at 19 (normal range is up to 15). A CT scan of the abdomen and pelvis with contrast yielded several findings: - **Lung Bases:** A few small pulmonary micronodules were noted, but otherwise clear. - **Liver, Spleen, and Pancreas:** All appeared normal without lesions. - **Kidneys:** Normal with no stones or masses. - **GI Tract:** The stomach was mildly distended, but otherwise normal with stool presence noted in the colon. - **Pelvis and Vascular Structures:** Solid organs and vessels appeared normal. - **Other Findings:** Prominent inguinal lymph nodes were potentially reactive, alongside a small left inguinal hernia. **Follow-Up Treatment:** Following these evaluations, my physician prescribed sulfamethoxazole for a duration of 28 days. I adhered to the regimen fully, and while undergoing treatment, all symptoms subsided completely. However, this occurred about a month ago, concluding in late December. **Current Situation:** This evening, after my workout, I noticed the return of blood traces in my urine. While I do not experience pain, I have difficulty with bowel movements, feeling persistently constipated regardless of food intake. This change coincided with a mild tearing sensation during exercise on the adductor machine. Additionally, I have developed a reddish rash on both arms, which had resolved during the antibiotic treatment but has now reappeared. Previously, this rash was effectively treated with prednisone, leaving me unsure if this is connected to my earlier symptoms. **Concerns:** I worry that standard medical tests might overlook a significant issue affecting my prostate, colon, or urinary system. My insurance policy does not cover colonoscopy or prostate evaluation, and I have been advised to consider these procedures, though they would cost nearly $7,000 out of pocket. While I understand the necessity of these assessments if needed, I prefer to seek a second opinion before committing to such expenses. It's important to note that there is a family history of cancer, primarily lung cancer. I welcome any advice or insight into my case and will provide any additional details you may require.

Crohn's DiseaseThyroid DisordersRheumatology
Male25-34
20 minutes ago

Gene Testing Outcomes Suggest Elevated Risk for MPN

A 27-year-old male of Irish heritage recently conducted a commercial gene analysis, and here are the findings: - **Rs12340895 (C;G)** Result Interpretation: "Doubles the likelihood of developing V617F-positive MPN." - **Rs3780374 (A;G)** Result Interpretation: "Significantly raises the probability of V617F-positive MPN manifestation." Based on my research, it appears that having these two genetic markers indicates a strong predisposition to this particular form of cancer. What steps should I consider taking to either prepare for or potentially postpone the onset of this condition? Should I discuss these findings with my healthcare provider? My studies suggest there isn’t a definitive cure for this condition.

Multiple SclerosisInternal MedicineEndocrinology
Male25-34
20 minutes ago

Unexpected Head Pain During Dance Moves

This may seem humorous, yet I'm genuinely interested in uncovering the cause of this peculiar experience. I’m a 34-year-old female. A few months back, hoping to elevate my mood and get my body moving away from the grip of depression, I decided to play some music and dance in my living room. In a moment of misguided enthusiasm, I attempted to twerk. It's worth noting that I have a long history of lower back discomfort, I've never attempted to twerk before, and I lack the rhythm, flexibility, or skills typical of proficient dancers. As I embarked on my very first serious twerk attempt, a sudden jolt of agony shot through my forehead, nearly causing me to lose consciousness. It felt like being struck with a hammer. I was momentarily blinded by the pain, convinced I might have suffered an aneurysm or something equally serious. This intense sensation only lasted for about a minute, during which I dramatically considered that I might be the first individual to perish from twerking. You might think it was just a case of me bumping my head while trying to dance away my sadness; however, I assure you that this wasn’t the case. Just as abruptly as the pain struck, it dissipated. In that moment, I promised myself to never attempt twerking again. Fast forward to today, and I experienced a similar incident again—not the twerking, but the sudden stabbing pain in my skull. I was engaged in some back stretches, particularly the cat-cow pose, and during the cow portion, I once more felt an intense sharp pain in the center of my forehead, just above my right eye. Stars filled my vision, and everything seemed slightly distorted. This sensation vanished within seconds, leaving me puzzled. What is causing this reaction? How do my forehead and lower back relate in this context? It's baffling! I genuinely seek any insights that might help explain this mysterious phenomenon.

ArthritisCrohn's DiseaseCOPD
Male25-34
30 minutes ago

14-Year-Old Male with Cough and Rash Symptoms

My 14-year-old son, who stands at 5 feet 3 inches tall and weighs 149 pounds, has been experiencing persistent cough and cold-like symptoms for slightly over a week. He stayed home from school on January 30 and February 3 as he was feeling unwell, but aside from that, he has managed to attend school. The predominant issue has been his cough. Initially, he had a runny nose for a couple of days, but that symptom has since resolved. He has not complained about a sore throat or experienced any fever. This afternoon, he reported developing a rash with red spots. He mentioned that it itches a little, but it's not uncomfortable, and he does not feel any pain. The rash is primarily located on his abdomen and chest, with some patches on his legs and a little on his arms, but there are no spots on his back. I checked his temperature, which was recorded at 99.4°F. He is fully vaccinated according to the standard vaccination schedule recommended by pediatricians in the United States. Our residence is near Vancouver, WA, in case that information is pertinent. Additionally, we have not changed any laundry or personal care products recently. What could this condition possibly indicate?

AsthmaArthritisInternal Medicine
Male25-34
40 minutes ago

Neurological Challenges Mimicking POTS Symptoms

A 36-year-old female, weighing 265 pounds, is dealing with a complex medical history that includes conditions like Complex Regional Pain Syndrome (CRPS), bipolar disorder, anxiety, PTSD, and a splenic artery aneurysm. There is a tentative diagnosis of hypertensive Postural Orthostatic Tachycardia Syndrome (POTS). The patient experiences significant symptoms when not on medication, including a rapid heartbeat (ranging from 117 to 150 beats per minute), dangerously high blood pressure, episodes of vision impairment, difficulty walking accompanied by stumbling and falls, tremors, memory issues, and brain fog. Currently, her medication regimen includes Pristiq, lithium, lorazepam, low-dose naltrexone for pain management, and propranolol to regulate heart rates. She takes ubrelvy when needed. In January, a recurrence of severe pain radiating from her right side led to a hospital admission where her gallbladder was surgically removed due to complications. Although the surgery was successful, she subsequently developed CRPS, further complicating her health. While working in the emergency department, she experienced a sharp tearing pain associated with her known aneurysm. Unable to manage the pain, she informed her manager of her need to leave. During her walk back to her workspace, approximately 1500 feet away, she began to stagger and lost her vision, while also experiencing heavy sweating and shortness of breath. Support from coworkers was crucial, as she lost her strength and collapsed, gasping for air and experiencing vertigo. Her heart rate was recorded at almost 150 bpm and her blood pressure at 152/120. Once lying down, her vitals stabilized but would escalate again with movement. The attending nurse suspected POTS based on her symptoms. Despite efforts to provide explanations, her overnight doctor attributed her condition to anxiety. However, subsequent doctors recognized her situation increasingly suggested POTS and put her on a heart monitor after she began falling to one side, which later confirmed episodes of tachycardia over a monitoring period of two to three days. Her first cardiology appointment revealed a drop in her blood pressure when she stood, further aligning with the POTS suspicion. An echocardiogram was scheduled for the following week, but complications arose the very next morning at work, where rising distress prompted coworkers to assist her following an apparent episode of tachycardia. Administered Ativan temporarily helped alleviate some symptoms, but as her condition worsened, she was transported to the emergency department once again. After several hours of treatment, she was discharged with little clarity regarding her condition. Currently, she takes an extended-release dose of propranolol (80 mg), but without it, her heart rate can exceed 130 bpm, accompanied by memory lapses. Episodes of sporadic vision loss persist, alongside difficulty walking that has progressed to staggering or being unable to move at all, leading to falls. These occurrences are thought to be related to syncope. Neurological evaluations are underway, with initial tests like ECG and EEG returning normal results, but an MRI suggested increased intracranial pressure, though some specialists doubt its relevance. A pain specialist indicated that her pain conditions may not directly correlate but suggested central nervous system dysfunction related to stress could be a factor, as her symptoms often intensify during anxious moments. An Ear, Nose, and Throat specialist found no abnormalities causing her symptoms, and her cardiologist is pursuing further investigation at a specialized clinic, expressing concern about her ongoing employment due to the physical and financial strain it entails. The patient’s aneurysm was treated with an embolism in September, adding another layer to her intricate medical profile, and she is seeking additional perspectives on her challenging situation.

HypertensionMultiple SclerosisCOPD
Male25-34
1 hour ago