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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Skin Disorders Dermatophytoses

Dermatophytoses

Dermatophytoses are fungal infections of keratin in the skin and nails, frequently affects hair also. Human infections are caused by Epidermophyton, Microsporum, and Trichophyton spp. Transmission is person-to-person, animal-to-person, and rarely, soil-to-person. The organism may persist indefinitely. Most people do not develop clinical infection; HIV and diabetes are common risk factors.

Signs and symptoms

Asymptomatic or mildly itching lesions with a scaling, slightly raised border remit and recur intermittently.

Occasionally, inflammation is more severe and manifests as sudden vesicular or bullous disease (usually of the foot) or as an inflamed boggy lesion of the scalp (kerion)

 

  • Tinea capitis (scalp ringworm) is a dermatophyte infection of the scalp
  • Tinea capitis mainly affects children, is contagious, and can be epidemic
  • Tinea capitis causes the gradual appearance of round patches of dry scale, alopecia, or both
  • Tinea capitis less commonly manifests as diffuse scaling, like dandruff, or in a diffuse pustular pattern

 

Dermatophyte infection occasionally leads to formation of a kerion, which is a large, boggy, inflammatory scalp mass caused by a severe inflammatory reaction to the dermatophyte.

A kerion may have pustules and crusting and can be mistaken for an abscess. A kerion may result in scarring hair loss

 

  • Tinea corporis (body ringworm) is a dermatophyte infection of the face, trunk, and extremities
  • Tinea corporis causes pink-to-red annular patches and plaques with raised scaly borders that expand peripherally and tend to clear centrally
  • A variant form appears as nummular scaling patches studded with small papules or pustules

 

Tinea barbae (barber's itch) is a dermatophyte infection of the beard area. Tinea barbae presents as superficial annular lesions, but deeper infection similar to folliculitis may occur

 

  • Tinea cruris (jock itch) is a dermatophyte infection of the groin
  • The primary risk factors are associated with a moist environment (ie, warm weather, wet and restrictive clothing, obesity causing constant apposition of skin folds)
  • Men are affected more than women because of apposition of the scrotum and thigh

 

Tinea pedis (athlete's foot) is a dermatophyte infection of the feet. Tinea pedis is the most common dermatophytosis because moisture from foot sweating facilitates fungal growth

Diagnosis

  • Clinical appearance
  • KOH wet mount
  • Sometimes Wood's light examination

Treatment

  • Treatment of mild-to-moderate lesions is an imidazoles likeTerbinafine, Ketacanazole, Itracanazole. Flucanazole, Micanazole
  • Antihistaminic like Cetrizine, CPM are used to reduce itching
  • Caladryl/ Calak lotion can be applied topically
  • For severely inflamed lesion Corticosteroid topical applicants can be used. These reduces inflammation and also prevent scarring.

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