Tinea Barbae

Clinical Notes : Dermatology

131. Tinea barbae

Tinea infections

What is tinea barbae ?

Tinea infections

"Tinea" refers to a skin infection with a dermatophyte (ringworm) fungus.

Depending on which part of the body is affected, it is given a specific name :

Tinea barbae (beard)
Tinea capitis (head)
Tinea corporis (body)
Tinea cruris (groin)
Tinea faciei (face)
Tinea manuum (hand)
Tinea pedis (foot)
Tinea unguium (nail)

Sometimes, the name gives a different meaning :

Tinea versicolor is more accurately called pityriasis versicolor. This is a common yeast infection on the trunk.
Tinea incognita (often spelled incognito) refers to a tinea infection in which the clinical appearance has changed because of inappropriate treatment.
Tinea nigra is a mould infection (not a dermatophyte). It affects the palms or soles, which appear brown (on white skin) or black (on dark skin).

Clinical variants include :

Tinea imbricata
Majocchi granuloma
Kerion

What is tinea barbae?

Tinea barbae is the name used for infection of the beard and moustache areas of the face with a dermatophyte fungus.

It is less common than tinea capitis and generally affects only adult men.

The cause of tinea barbae is most often a zoophilic (animal) fungus:

T. verrucosum (originating from cattle)
T. mentagrophytes var. equinum (originating from horses)

Tinea barbae is usually due to infection of coarse facial hair with an ectothrix pattern (spores on the outside).

In ectothrix infections, the fungal filaments (hyphae) and spores (arthroconidia) cover the outside of the hair.

Clinical features of tinea barbae

Tinea barbae most often affects farmers and is due to direct contact with an infected animal.

It is rarely passed from one person to another.

Tinea barbae is usually very inflamed with red lumpy areas, pustules and crusting around the hairs (kerion).

The hairs can be pulled out easily.

Surprisingly, it is not excessively itchy or painful.

Tinea barbae can result in an id reaction, especially just after starting antifungal treatment.

Diagnosis of tinea barbae

The diagnosis of tinea barbae is confirmed by microscopy and culture of skin scrapings and hair pulled out by the roots.

Treatment of tinea barbae

Topical antifungal agents may be adequate for mild cases of tinea barbae, but it is usually treated with oral antifungal medicines, including terbinafine and itraconazole.