From Dermographism in Bracelets to Dermatophytosis in Circles: The First Case of Tinea Imbricata Diagnosed in Morocco.

Tinea imbricata is a chronic superficial dermatophytosis caused by the anthropophilic dermatophyte Trichophyton concentricum and is typically characterized by pruritic concentric annular scaly lesions. The disease is endemic to regions of Southeast Asia, the Pacific Islands, and Latin America and remains exceptionally rare in North Africa. We report the first documented case of tinea imbricata diagnosed in Morocco in a 38-year-old Pakistani man residing in Louisiana, USA, who developed characteristic skin lesions while staying in Morocco. The lesions appeared as intensely pruritic concentric plaques involving the inner thighs. Direct microscopic examination and fungal culture findings were highly suggestive of Trichophyton concentricum as the causative organism. Initial treatment with oral terbinafine combined with topical antifungal therapy resulted in only partial clinical improvement. Complete remission was achieved after switching to oral itraconazole associated with topical antifungal treatment. This case highlights the importance of considering imported tropical dermatophytoses even in non-endemic settings.