[1] The macules occasionally extend to the fingers, toes, and nails, and may be reported on the chest, neck, or genital area.

[4]: 311  Tinea nigra infections can present with multiple macules that can be mottled or velvety in appearance, and may be oval or irregular in shape.

[3] Differential diagnosis includes Addison's disease, syphilis, pinta, yaws, melanoma, lentigines, lichen planus of the palms, and junctional melanocytes nevus.

The ability of H. werneckii to tolerate high salt concentrations and acidic conditions allows it to flourish inside the stratum corneum.

H. wernickii tends remain localized in one spot or region, and produces darkly-colored, brown macules on the skin due to the production of a melanin-like substance.

[5] Diagnosis of tinea nigra is made based on microscopic examination of stratum corneum skin scrapings obtained by using a scalpel.

H. werneckii can generally be distinguished due to its two-celled yeast form and the presence of septate hyphae with thick, darkly pigmented walls.

Other treatment methods include the use of epidermal tape stripping, undecylenic acid, and other topical agents such as ciclopirox.