Tinea favosa: psoriasiform favus in bindi area of an adult

Favus is an uncommon chronic inflammatory dermatophyte infection of the scalp. Predominantly, a disease of childhood, uncommon reports of adult cases are described. For the most part, this infection is characterised by invasion of hair shaft clinically presenting as yellowish scaly plaques, alopecia and/or inflammatory lesions. We hereby present an immunocompetent adult presenting with a psoriasiform plaque over glabella, culturally referred to as 'bindi' area. No involvement of the scalp or other hair-borne areas was seen. As she did not agree to undergo a skin biopsy, a last resort of simple stains like potassium hydroxide was done confirming favus. Systemic itraconazole was initiated and complete clinical and mycological resolution was seen with no relapse. Such atypical presentations in adults can cause a diagnostic dilemma and simple stains still hold their ground in making a diagnosis in resource-poor settings.