ICD-10: B36.1

Tinea nigra is a superficial fungal infection characterized by dark, painless patches on the skin, primarily affecting the palms of the hands and the soles of the feet. This condition is caused by the fungus Hortaea werneckii, which is a dematiaceous (darkly pigmented) mold. Below is a detailed clinical description and relevant information regarding ICD-10 code B36.1.

Clinical Description of Tinea Nigra

Etiology

Tinea nigra is caused by Hortaea werneckii, which thrives in warm, humid environments. The fungus is typically found in soil and decaying vegetation, and human infection often occurs through direct contact with contaminated materials. The condition is not contagious and is more common in tropical and subtropical regions.

Symptoms

The primary symptom of tinea nigra is the appearance of one or more dark brown to black patches on the skin. These patches:
- Are usually asymptomatic, meaning they do not cause itching or discomfort.
- Can vary in size, often ranging from a few millimeters to several centimeters.
- Are most commonly located on the palms and soles but can also appear on other areas of the body.

Diagnosis

Diagnosis of tinea nigra is typically made through clinical examination. However, laboratory confirmation may be necessary in atypical cases. This can include:
- KOH Preparation: A skin scraping is treated with potassium hydroxide (KOH) to visualize the fungal elements under a microscope.
- Culture: Fungal cultures can be performed to identify Hortaea werneckii.

Treatment

Treatment for tinea nigra is generally straightforward and may include:
- Topical Antifungals: Creams or solutions containing antifungal agents such as clotrimazole or miconazole are commonly used.
- Oral Antifungals: In more severe or resistant cases, oral antifungal medications may be prescribed.

Prognosis

The prognosis for tinea nigra is excellent, with most cases responding well to topical treatment. Recurrence is rare, but individuals should be advised to avoid environments that may promote fungal growth.

ICD-10 Code B36.1

The ICD-10 code B36.1 specifically designates tinea nigra. This code falls under the category of "Other superficial mycoses," which includes various fungal infections that affect the skin but do not penetrate deeper tissues.

Related Codes

• B36.0: Tinea capitis (scalp)
• B36.2: Tinea corporis (body)
• B36.3: Tinea pedis (athlete's foot)

Importance of Accurate Coding

Accurate coding is essential for proper diagnosis, treatment, and billing purposes. Tinea nigra, while not a serious health threat, can cause cosmetic concerns for patients, making accurate identification and treatment important for patient satisfaction and care.

In summary, tinea nigra is a benign fungal infection that can be effectively treated with topical antifungals. The ICD-10 code B36.1 is crucial for healthcare providers to ensure proper documentation and management of this condition.

Tinea nigra, classified under ICD-10 code B36.1, is a superficial fungal infection primarily affecting the skin, particularly the palms of the hands and the soles of the feet. This condition is caused by the dematiaceous fungus Hortaea werneckii, which is known for its ability to thrive in keratinized tissues. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with tinea nigra is essential for accurate diagnosis and effective treatment.

Clinical Presentation

Signs and Symptoms

• Skin Lesions: The hallmark of tinea nigra is the appearance of dark brown to black macules or patches on the skin. These lesions are typically well-defined and can vary in size from a few millimeters to several centimeters in diameter[1].
• Location: Most commonly, lesions are found on the palms and soles, but they can also appear on other areas of the body, including the fingers and forearms[1][2].
• Asymptomatic Nature: Patients often report that the lesions are asymptomatic, meaning they do not usually cause itching, pain, or discomfort. This lack of symptoms can lead to delayed diagnosis[2][3].

Patient Characteristics

• Demographics: Tinea nigra can affect individuals of any age, but it is more frequently observed in young adults and adolescents. There is no significant gender predisposition noted in the literature[2][3].
• Geographic Distribution: The condition is more prevalent in tropical and subtropical regions, where the climate may favor the growth of the causative fungus. It is often associated with exposure to contaminated soil or vegetation[3][4].
• Risk Factors: Individuals with compromised immune systems or those who frequently engage in activities that expose their skin to moisture and warmth may be at higher risk for developing tinea nigra. Additionally, those who have a history of skin trauma or pre-existing skin conditions may also be more susceptible[4].

Diagnosis

Diagnosis of tinea nigra is primarily clinical, based on the characteristic appearance of the lesions. However, laboratory confirmation can be achieved through:
- Microscopic Examination: Skin scrapings can be examined under a microscope to identify the presence of the fungus.
- Culture: Fungal cultures may be performed to confirm the diagnosis, although this is less commonly required due to the distinctive clinical presentation[1][2].

Conclusion

Tinea nigra, represented by ICD-10 code B36.1, is a fungal infection characterized by dark, asymptomatic skin lesions primarily located on the palms and soles. Understanding its clinical presentation, including the signs, symptoms, and patient demographics, is crucial for healthcare providers to ensure timely and accurate diagnosis. Given its benign nature, treatment is often not necessary unless for cosmetic reasons, but antifungal therapies can be employed if desired by the patient[3][4].

For further management, it is essential to educate patients about the condition, its benign nature, and preventive measures to avoid recurrence, especially in endemic areas.

Tinea nigra, classified under ICD-10 code B36.1, is a superficial fungal infection characterized by dark, painless patches on the skin, primarily affecting the palms of the hands and soles of the feet. This condition is caused by the fungus Hortaea werneckii (formerly known as Phaeoannellomyces werneckii), which thrives in warm, humid environments.

Alternative Names for Tinea Nigra

1. Tinea Versicolor: Although distinct, tinea versicolor is often confused with tinea nigra due to similar skin manifestations. However, tinea versicolor is caused by a different fungus, Malassezia spp., and typically presents with lighter patches on the skin.

2. Phaeohyphomycosis: This term refers to a group of fungal infections caused by dematiaceous (darkly pigmented) fungi, which includes tinea nigra as one of its manifestations.

3. Tinea Palmaris: This name emphasizes the common location of the infection on the palms of the hands.

4. Tinea Pedis: While primarily associated with athlete's foot, this term can sometimes be used in broader discussions of fungal infections affecting the feet, including tinea nigra.

Related Terms

• Superficial Mycoses: This broader category includes various fungal infections that affect the outer layers of the skin, hair, and nails, of which tinea nigra is a specific example.

• Dermatophyte Infections: Although tinea nigra is not caused by dermatophytes, it is often discussed in the context of other fungal skin infections.

• Fungal Skin Infections: This general term encompasses all types of fungal infections affecting the skin, including tinea nigra.

Conclusion

Understanding the alternative names and related terms for tinea nigra can help in recognizing and differentiating this condition from other similar skin infections. While tinea nigra is specifically associated with the fungus Hortaea werneckii, awareness of its alternative names and related terms is essential for accurate diagnosis and treatment. If you have further questions or need more detailed information, feel free to ask!

Tinea nigra, classified under ICD-10 code B36.1, is a superficial fungal infection characterized by dark, non-scaly patches on the skin, primarily affecting the palms of the hands and soles of the feet. The diagnosis of tinea nigra involves several criteria, which can be categorized into clinical presentation, laboratory findings, and patient history.

Clinical Presentation

1. Skin Lesions: The most prominent feature of tinea nigra is the presence of well-defined, brown to black macules or patches on the skin. These lesions are typically asymptomatic, meaning they do not cause itching or discomfort, which can help differentiate them from other skin conditions[1].

2. Location: Tinea nigra predominantly occurs on the palms and soles, although it can occasionally appear on other areas of the body. The lesions are often mistaken for other dermatological conditions, such as melanoma or other forms of dermatitis, due to their appearance[1][2].

Laboratory Findings

1. Microscopic Examination: A definitive diagnosis can be made through the microscopic examination of skin scrapings. The presence of the causative organism, Hortaea werneckii (formerly known as Phaeoannellomyces werneckii), can be confirmed by identifying the characteristic hyphae and yeast forms in the sample[2].

2. Culture: Fungal cultures can also be performed, although they may take longer to yield results. The growth of Hortaea werneckii in culture supports the diagnosis of tinea nigra[1][3].

3. KOH Preparation: A potassium hydroxide (KOH) preparation of the skin scraping can help visualize fungal elements, aiding in the diagnosis. This method is quick and can provide preliminary results before culture confirmation[2].

Patient History

1. Exposure History: A thorough patient history is essential, including any recent travel to tropical or subtropical regions where tinea nigra is more prevalent. Understanding the patient's exposure to environments conducive to fungal infections can provide context for the diagnosis[3].

2. Medical History: The presence of any underlying conditions that may predispose the patient to fungal infections, such as immunosuppression or diabetes, should also be considered during the diagnostic process[1].

Differential Diagnosis

It is crucial to differentiate tinea nigra from other skin conditions, such as:

• Melanoma: Due to the dark pigmentation of the lesions, a biopsy may be necessary to rule out malignancy.
• Pityriasis Versicolor: This condition can also cause discolored patches on the skin but typically presents with scaling and is caused by a different fungus[2].

Conclusion

The diagnosis of tinea nigra (ICD-10 code B36.1) relies on a combination of clinical observation, laboratory testing, and patient history. Accurate diagnosis is essential to ensure appropriate treatment and to rule out more serious conditions. If you suspect tinea nigra, consulting a healthcare professional for a thorough evaluation is recommended.

Tinea nigra, classified under ICD-10 code B36.1, is a superficial fungal infection caused primarily by the dematiaceous fungus Hortaea werneckii. This condition is characterized by dark, painless patches on the skin, typically found on the palms of the hands or the soles of the feet. Understanding the standard treatment approaches for tinea nigra is essential for effective management and resolution of the infection.

Diagnosis of Tinea Nigra

Before initiating treatment, a proper diagnosis is crucial. Tinea nigra can often be mistaken for other skin conditions, such as melanoma or other forms of dermatitis. Diagnosis typically involves:

• Clinical Examination: A healthcare provider will assess the appearance of the skin lesions.
• Microscopic Examination: Skin scrapings may be taken and examined under a microscope to identify the presence of Hortaea werneckii.
• Culture Tests: Fungal cultures can confirm the diagnosis, although they are not always necessary due to the characteristic appearance of the lesions[3][4].

Standard Treatment Approaches

1. Topical Antifungal Agents

The first line of treatment for tinea nigra usually involves topical antifungal medications. Commonly prescribed agents include:

• Selenium Sulfide: This is often used in a lotion or shampoo form, applied to the affected area.
• Ketoconazole Cream: An antifungal cream that can be applied directly to the lesions.
• Clotrimazole or Miconazole: These are also effective topical antifungals that can help clear the infection[3][5].

2. Oral Antifungal Medications

In cases where topical treatments are ineffective or if the infection is extensive, oral antifungal medications may be considered. Options include:

• Itraconazole: This is an oral antifungal that can be effective for more severe cases.
• Fluconazole: Another oral option that may be used depending on the patient's specific circumstances and response to treatment[4][5].

3. Supportive Care

In addition to antifungal treatments, supportive care can help manage symptoms and prevent recurrence:

• Hygiene Practices: Keeping the affected area clean and dry is essential, as moisture can exacerbate fungal infections.
• Avoiding Irritants: Patients should avoid harsh soaps or chemicals that may irritate the skin.
• Monitoring: Regular follow-up with a healthcare provider to monitor the effectiveness of treatment and make adjustments as necessary[3][4].

Prognosis and Follow-Up

Tinea nigra generally has a good prognosis with appropriate treatment. Most patients respond well to topical antifungals, and complete resolution of the lesions is expected. However, follow-up is important to ensure that the infection has cleared and to prevent recurrence, especially in individuals with risk factors such as immunosuppression or those living in warm, humid environments[5][6].

Conclusion

In summary, the standard treatment for tinea nigra (ICD-10 code B36.1) primarily involves topical antifungal agents, with oral medications reserved for more severe cases. Proper diagnosis and management are key to effectively treating this fungal infection, and maintaining good hygiene practices can help prevent future occurrences. If symptoms persist or worsen, it is advisable to consult a healthcare professional for further evaluation and treatment adjustments.