Tinea Nigra Differential Diagnoses

Updated: May 12, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
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DDx

Diagnostic Considerations

Consider the following:

  • Hyperpigmentation due to pinta

  • Chemical stains

  • Junctional nevi, postinflammatory pigmentation, melanoma, and melanosis of syphilis and pinta [23]

  • Superficial phaeohyphomycosis: Even in an immunocompetent individual, clinical and microscopic patterns may be similar to tinea nigra, but with the culture showing Aureobasidium melanogenum. [24]

  • Tattooing from dirt or other substances [25]

Lichen planus may rarely be evident as asymptomatic black patches on both palms, simulating tinea nigra. [26]

The recognition of tinea nigra is crucial to prevent any unnecessary diagnostic procedures for the evaluation of pigmented lesions. Tinea nigra may easily be confused with a junctional nevus or acral lentiginous melanoma, [27] which would require excisional biopsy. Furthermore, suspicion of a melanoma may cause unnecessary anxiety in a patient. A simple microscopic examination of the skin scrapings of the affected area readily aids the distinction between tinea nigra and other serious medical disorders that result in pigmentary changes.

Differential Diagnoses