Expert Insights on Identifying Tinea Dermatophytoses at DERM 2025

At the DERM 2025 NP PA CME Conference held in Las Vegas from July 23 to 26, 2025, Dr. Adam Friedman, a prominent dermatology expert and chair of dermatology at The George Washington University School of Medicine, delivered an engaging lecture titled "Hang Ten, Not Tinea: An Image-Based Competition to Strengthen Your Management Balance." His presentation emphasized the importance of accurate diagnosis in dermatophytoses, a category of common skin infections caused by dermatophytes, which are often misdiagnosed due to their subtle presentations.

Dermatophytoses are frequently overlooked in clinical discussions despite their prevalence, according to Dr. Friedman, who noted that many practitioners may not find them compelling enough to warrant attention. "These infections are super common but are not commonly discussed because they just aren’t sexy," he explained in an interview with Dermatology Times. This perception may contribute to the underdiagnosis and subsequent undertreatment of these conditions, which can lead to complications such as antifungal resistance.

The conference featured an interactive component where attendees were challenged to identify various skin conditions solely based on images. Dr. Friedman revealed that even experienced dermatologists struggled to differentiate between dermatophyte infections and other inflammatory skin disorders through visual inspection alone. He stated, "Clinical inspection is not going to be enough. I know we pride ourselves as master diagnosticians, but we have proven time and again in the published literature that clinical inspection is not enough."

To address these challenges, Dr. Friedman advocated for the use of potassium hydroxide (KOH) preparations. This simple diagnostic technique allows clinicians to distinguish between dermatophyte infections and primary inflammatory conditions effectively. "Use my favorite tool of all time, your potassium hydroxide prep," he advised, acknowledging the limitations posed by Clinical Laboratory Improvement Amendments (CLIA) certification but asserting the method's utility in clinical practice.

The importance of accurate diagnosis was underscored by Dr. Friedman’s discussion on the implications of antifungal resistance. He warned that without proper identification of dermatophyte infections, clinicians risk inappropriate treatment that could contribute to the development of resistance. "We need to be able to make the right diagnosis, but also consider the potential for antifungal resistance if we don’t treat the right thing or if we’re not thoughtful about how we use our antifungals, of which we don’t have, unfortunately, a huge amount," he said.

This conference session drew attention to the necessity for enhanced diagnostic practices and ongoing education in dermatology, particularly regarding prevalent conditions like dermatophytoses that can have significant health implications if not correctly identified and treated. As the field continues to evolve, the insights shared at DERM 2025 serve as a reminder of the critical role of accurate diagnosis in ensuring effective patient care and combating the growing concern of antifungal resistance within dermatology.

The DERM conference is a significant event in the dermatological calendar, providing a platform for experts to discuss innovative practices, share research findings, and enhance the skills of healthcare professionals in the field. As dermatology continues to advance, the lessons learned from conferences like DERM 2025 will be pivotal in shaping future practices and improving patient outcomes in dermatological care.