Tinea Nigra Differential Diagnoses

Updated: Apr 09, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
  • Print

Diagnostic Considerations

Consider the following:

  • Hyperpigmentation due to pinta

  • Chemical stains

  • Junctional nevi, postinflammatory pigmentation, melanoma, and melanosis of syphilis and pinta [25]

  • Superficial phaeohyphomycosis: Even in an immunocompetent individual, clinical and microscopic patterns may be similar to tinea nigra, but with the culture showing Aureobasidium melanogenum. [26]

  • Tattooing from dirt or other substances [27]

Lichen planus may rarely be evident as asymptomatic black patches on both palms, simulating tinea nigra. [28]

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, [29] 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