Tietze syndrome - a case report of 20 year old male patient with steroid induced tinea incognito

Tietze syndrome is a self-limiting, rare and benign condition that might be mistaken with potentially fatal chest diseases and misdiagnosed mostly as costochondritis.  This disease is most often diagnosed in young individuals under the age of 40, with painful, localized inflammation.Tinea incognito is a ringworm infection that has been altered by corticosteroids and other immunosuppressive medications. Corticosteroids are administered for pre-existing illness or are used incorrectly for the treatment of tinea. We report a case of 20years old male patient admitted in emergency department with complaints of chest pain and SOB with normal ECG while neutrophils, ESR, CRP have found to be abnormal. Patient has been using steroids and itraconazole for maculopapular rashes in lower limb since 1year. Other diagnostic methods such as CT, MRI should be performed to avoid misdiagnosis.  He was prescribed with NSAIDS, antifungals, antihistamines and other supportive measures which helped him to relieve from pain. Proper diagnostic criteria and early diagnosis remain challenging tasks, resulting in undue treatment costs for patients. Before confirming a diagnosis, other underlying diseases should be ruled out.