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Systematic Review of Tinea Nigra: A Clinical Approach

Summary

Tinea nigra is a rare fungal skin infection that causes dark spots, usually on the palms, and is most common in tropical regions. It primarily affects younger people and women. The infection is easily diagnosed using microscopic examination and treated successfully with topical antifungal creams like ketoconazole or Whitfield’s ointment, typically clearing within 4 weeks.

Background

Tinea nigra is a rare superficial fungal infection caused by the melanized fungus Hortaea werneckii, characterized by irregular dark patches typically on the palms. It is more prevalent in tropical and subtropical regions, particularly in the Americas, and accounts for 0.085% to 0.1% of reported mycoses in Latin American centers.

Objective

This systematic review aims to evaluate the epidemiology, demographic characteristics, lesion distribution, diagnostic approaches, causative agents, and treatment outcomes of tinea nigra through analysis of published literature from January 1990 to January 2025.

Results

Analysis revealed tinea nigra more prevalent in females (58 cases vs 44 males) with mean age 16.7 years. Palms were most affected (75 cases total). Hortaea werneckii was predominant (74 cases). Over 25 treatment modalities were used, with Whitfield’s ointment and ketoconazole 2% cream most common, achieving 100% resolution rate with average 4-week duration.

Conclusion

Tinea nigra is responsive to topical antifungal treatment with high resolution rates. Understanding its epidemiology, clinical presentation, and diagnostic approaches is crucial for optimal patient care, especially in non-endemic regions where travel history aids diagnosis.
  • Published in:Journal of Fungi (Basel),
  • Study Type:Systematic Review,
  • Source: PMID: 40278108, DOI: 10.3390/jof11040287
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