A man in his 20s presented with a 2-year history of slowly increasing, asymptomatic dark spots on his left palm. On examination, there were multiple coalescing brownish black macules with irregular borders over the left palm and palmar aspect of the digits, with black pigmentary accentuation over the creases. They were devoid of any scaling or signs of inflammation (Figure). A direct microscopic examination (DME) on potassium hydroxide (10%) mount revealed brown branched septate hyphae. A culture in Sabouraud agar revealed brownish black wet colonies after 1 month of inoculation at 21 °C. A diagnosis of tinea nigra palmaris was made, and he was treated with topical azoles and keratolytics with excellent response and resolution within 2 months of therapy.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Sushil Kumar, MD, Department of Dermatology, Military Hospital, Prayagraj, Uttar Pradesh 211002, India (firstname.lastname@example.org).
Published Online: October 26, 2022. doi:10.1001/jamadermatol.2022.4442
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient for granting permission to publish this information.
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