When Fungal Infections Mimic Acne: Diagnostic Pitfalls and Practical Approaches.

Dermatophyte infections including tinea incognita and Majocchi granuloma as well as Malassezia folliculitis may manifest as follicular papules or pustules in acne-prone areas, leading to frequent misdiagnosis as acne vulgaris, particularly after topical corticosteroid use alters their clinical appearance. Early recognition of these entities is important to reduce morbidity and prevent inappropriate therapy, especially corticosteroids, which may exacerbate the infection and delay appropriate treatment. This review highlights dermatophyte infections as an underrecognized mimic of acne vulgaris, emphasizing key clinical distinguishing features, common diagnostic pitfalls, and a practical approach to evaluation.