Clinical Notes : Dermatology

133. Tinea corporis

corporis.jpg
 

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 :

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

  • Favus

 

Tinea corporis

 

Tinea corporis (ringworm) is the name used for infection of the trunk, legs or arms with a dermatophyte fungus.

In different parts of the world, different species cause tinea corporis.

In New Zealand, Trichophyton rubrum (T. rubrum) is the most common cause.

Infection often comes from the feet (tinea pedis) or nails (tinea unguium) originally.

Microsporum canis (M. canis) from cats and dogs, and T. verrucosum, from farm cattle, are also common.

Tinea corporis

corporis 1.jpg
corporis 2.jpg
corporis 3.jpg
corporis 4.jpg
corporis 5.jpg
corporis 6.jpg
corporis 7.jpg
corporis 8.jpg
corporis 9.jpg
 

Clinical features of tinea corporis

Tinea corporis may be acute (sudden onset and rapid spread) or chronic (slow extension of a mild, barely inflamed, rash).

It usually affects exposed areas but may also spread from other infected sites.

Acute tinea corporis presents as itchy inflamed red patches and may be pustular.

The cause is often infection by an animal (zoophilic) fungus such as M canis.

 

Chronic tinea corporis tends to be most prominent in body folds (spreading from tinea cruris).

T. rubrum is the most common cause.

If widespread, the condition tends to be stubborn to treat and prone to recurrence. This is possibly due to a decreased natural skin resistance to fungi or because of reinfection from the environment.

 

The term ringworm refers to round or oval red scaly patches, often less red and scaly in the middle or healed in the middle. Sometimes one ring arises inside another older ring.

Kerion is an inflamed fungal abscess. It presents as a boggy mass studied with pustules, often with satellite spots. It is often confused with a large boil or carbuncle or a tumour such as a skin cancer.

 

Majocchi granuloma describes tinea corporis involving the hair follicles resulting in pustules and nodules.

 

Tinea imbricata is due to T. concentricum and occurs in the Pacific Islands and other tropical areas.

It results in brown scaly concentric rings.

 

Non-fungal conditions resembling tinea corporis include:

  • Impetigo

  • Seborrhoeic dermatitis

  • Psoriasis

  • Discoid eczema

  • Lichen simplex

  • Contact allergic dermatitis

  • Pityriasis rosea

 

Diagnosis of tinea corporis

The diagnosis of tinea corporis is confirmed by microscopy and culture of skin scrapings.

Occasionally, the diagnosis is made on skin biopsy because of characteristic histopathological features of tinea corporis and organisms may be found in the outside layers of the skin.

Treatment of tinea corporis

Tinea corporis is usually treated with topical antifungal agents, but if the treatment is unsuccessful, oral antifungal medicines may be considered, including terbinafine and itraconazole.

 
 
 

Tinea corporis

DermNetNZ  (CCPL)

Access

Ireland notes.png

The following oral meds are available in Ireland :

Terbinafine (Fungasil, Lamisil, Nailderm, Terbasil, Ternaf)

Fluconazole (Diflazole, Diflucan, Flucol, Fluconazole Actavis)

The following oral meds are N/A available in Ireland :

Itraconazole.

The following shampoos are available in Ireland :

Selenium sulfide (Selsun)

Ketoconazole (Ketozol, Nizoral)

The following shampoos are available in Ireland :

1% to 2% zinc pyrithione

Povidone-iodine

tinea-capitis map.png
read more - Copy.png
tinea.jpg
 

CPD Quiz and Certificate

This activity attracts 1,0 CPD point

Scroll down the box above to view its entire content

All users who successfully complete the quiz are e-mailed a copy of their personalised CPD certificate.