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Tinea nigra

Created 2003. Updated by Adjunct A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. July 2020.


Tinea nigra — codes and concepts
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What is tinea nigra?

Tinea nigra is a mould infection of the skin of the palm or sole presenting as persistent brown or black patches.

Who gets tinea nigra?

Tinea nigra is most common in tropical regions and often infects those with a tendency to excessive sweating (hyperhidrosis).

What is the cause of tinea nigra?

Tinea nigra is due to infection with a brown mould, Hortaea werneckii. This mould usually inhabits soil.

The organism's previous names include:

  • Exophiala phaeoannellomyces
  • Phaeoannellomyces werneckii
  • Exophiala werneckii
  • Cladosporium werneckii.

What are the clinical features of tinea nigra?

Tinea nigra presents as unilateral or asymmetrical brown or black patches on the palms or soles. They are slightly scaly and do not itch or sting. The patches slowly enlarge. Dermoscopy can help distinguish tinea nigra from other brown-black skin lesions.

Tinea nigra

How is tinea nigra diagnosed?

Tinea nigra may be suspected clinically but should be confirmed by mycology. Scrapings that have been taken from the edge of the scaly lesion show a mycelium. The hyphae can be clear in colour, yellow or brown, and are septate.

Culture grows black colonies of Hortaea werneckii within a week.

The diagnosis may also be made on skin biopsy because of the characteristic histopathological features of tinea nigra.

Mycology of Hortaea werneckii

What is the differential diagnosis of tinea nigra?

What is the treatment of tinea nigra?

Tinea nigra usually clears with a topical antifungal applied for 2–4 weeks.

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Bibliography

  • Eksomtramage T, Aiempanakit K. Tinea nigra mimicking acral melanocytic nevi. IDCases. 2019;18:e00654. doi:10.1016/j.idcr.2019.e00654 Journal 
  • Giordano L MC, De la Fuente L A, Lorca J MB, Kramer H D. Tinea nigra: report of three pediatrics cases. Rev Chil Pediatr. 2018;89(4):506-10. doi:10.4067/S0370-41062018005000404 Journal
  • Ibraheim MK, McNally MA, Tschen J. Interdigital tinea nigra. Cureus. 2020;12(4):e7579. doi:10.7759/cureus.7579 PubMed Central
  • Noguchi H, Hiruma M, Inoue Y, Miyata K, Tanaka M, Ihn H. Tinea nigra showing a parallel ridge pattern on dermoscopy. J Dermatol. 2015;42(5):518-20. doi:10.1111/1346-8138.12830 PubMed

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