Tinea nigra
ICD-10 B46.4 is a billable code used to indicate a diagnosis of tinea nigra.
Tinea nigra is a superficial fungal infection caused by the dematiaceous fungus Hortaea werneckii, which primarily affects the skin of the palms and soles. The condition is characterized by the appearance of dark brown to black patches on the skin, which may be mistaken for other skin conditions such as melanoma or other pigmented lesions. The infection is typically asymptomatic, although some patients may experience mild itching. Tinea nigra is more common in tropical and subtropical regions and is often associated with exposure to contaminated soil or vegetation. Diagnosis is usually made through clinical examination and confirmed by microscopic examination of skin scrapings, which reveal the characteristic fungal elements. Treatment involves topical antifungal agents such as azoles or allylamines, and in some cases, systemic antifungal therapy may be necessary for extensive or resistant cases. Immunocompromised patients may be at higher risk for more severe manifestations of the infection, necessitating careful monitoring and management.
Detailed clinical notes including lesion description, location, and any associated symptoms.
Diagnosis of tinea nigra in patients presenting with dark patches on palms or soles.
Ensure that laboratory results confirming the diagnosis are included in the documentation.
Comprehensive patient history, including immunocompromised status and previous fungal infections.
Management of tinea nigra in immunocompromised patients requiring systemic antifungal therapy.
Document any complications or co-infections that may arise due to the patient's immunocompromised state.
When a biopsy is performed to confirm the diagnosis of tinea nigra.
Document the reason for the biopsy and the findings.
Dermatologists should ensure that the biopsy site is clearly documented.
Common treatments include topical antifungal agents such as clotrimazole or ketoconazole. In more severe cases, systemic antifungals may be required.
