Tinea infection - ringworm - capitis, corporis - symptoms and treatment

Tinea infection - ringworm - capitis, corporis - symptoms and treatment

Tinea is a common fungal INFECTION of the SKIN, involving the layers (including the hair and nails) that are cornified (composed of dead keratinocytes). Several species of fungi, known collectively as dermatophytes, cause tinea infection (also called dermatophytosis). People commonly refer to some forms of tinea as ringworm because the lesions have the appearance of worms ringed beneath the surface of the skin. Though descriptive this is a misnomer as tinea has nothing to do with worms. There are numerous designations of tinea based on where it appears on the body, though the same group of dermatophytes can cause any of tinea’s presentations.

Tinea InfectionCommon NameBody Region Affected
tinea barbae ringworm beard area of the face
tinea capitis ringworm scalp
tinea cruris jock itch genitals
tinea corporis ringworm central trunk, arms, and legs
tinea pedis athlete’s foot bottom of the foot and between the toes

Tinea is fairly contagious and spreads from person to person as well as through contact with surfaces, such as shower floors or soil, that can harbor the fungi. Dermatophytes can exist outside the body for a considerable length of time and thrive in environments that are warm and moist.

Symptoms of Tinea and Diagnostic Path

The symptoms of tinea vary somewhat according to the part of the body affected, though generally include

  • itching (PRURITUS), which may be intense, or PAIN
  • redness (erythema)
  • lesions that may appear as papules, vesicles, or plaques
  • cracking or scaling of the lesions
  • irregular HAIR loss (ALOPECIA) when the site of the infection is the scalp

The diagnostic path is generally straightforward. The doctor may take small scrapings of affected tissue to examine under a microscope. Such examination reveals the dermatophytes or evidence of their presence, which is conclusive for diagnosis. Inability to identify evidence of dermatophytes points to other causes for the symptoms.

Tinea Treatment Options and Outlook

Topical ANTIFUNGAL MEDICATIONS often effectively treat all forms of tinea except those involving the hair or NAILS. Prescription antifungal medications produce the most reliable results; over-thecounter products may require multiple applications. Because many people who acquire tinea continue the activities that resulted in exposure, reinfection is common. Pervasive or resistant tinea may require oral antifungal medications to attack the infection systemically. Oral antifungal therapy is necessary to eradicate tinea that involves the hair or the nails. Treatment may require up to eight weeks for some infections, particularly those involving the nails and the feet (tinea pedis).

COMMON ANTIFUNGAL MEDICATIONS FOR TREATING TINEA
econazole (topical) fluconazole (oral)
griseofulvin (oral) itraconazole (oral)
ketoconazole (topical and oral) miconazole (topical)
naftifine (topical) oxiconazole (topical)
sertaconazole (topical) terbinafine (topical and oral)

Risk Factors and Preventive Measures

Common environmental settings in which dermatophytes thrive include communal showers, spas, and swimming pools. Wearing water socks or sandals when walking on wet surfaces helps protect the feet from contact with the fungi. Tinea can be an opportunistic infection in people who are IMMUNOCOMPROMISED, such as those taking IMMUNOSUPPRESSIVE THERAPY following ORGAN TRANSPLANTATION or who have HIV/AIDS.

See also ALOPECIA AREATA; CANDIDIASIS; DERMATITIS; ERYSIPELAS; FUNGUS; IMPETIGO; KERATINOCYTE; LESION; ONYCHOMYCOSIS; PAPULE; PSEUDOFOLLICULITIS BARBAE; PSORIASIS; TINEA VERSICOLOR; VESICLE.

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The Integumentary System

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