Clinical Notes : Dermatology

135. Tinea faciei

 

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

What is tinea faciei ?

Tinea faciei is the name used for infection of the face with a dermatophyte fungus.

It does not include infection of the beard and moustache area, which is called tinea barbae.

 

Tinea faciei is uncommon and often misdiagnosed at first.

Tinea faciei can be due to an anthropophilic (human) fungus such as Trichophyton rubrum (T rubrum).

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

Zoophilic (animal) fungi such as Microsporum canis (M canis), from cats and dogs, and T verrucosum, from farm cattle, are also common.

 

Tinea faciei

kerion

Clinical features of tinea faciei

 

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

There are round or oval red scaly patches, often less red and scaly in the middle or healed in the middle.

It is frequently aggravated by sun exposure. It may also present as a kerion (fungal abscess).

 

Tinea faciei is often misdiagnosed as a non-fungal condition such as:

  • Atopic dermatitis

  • Seborrhoeic dermatitis

  • Psoriasis

  • Rosacea

  • Actinic keratoses

  • Contact allergic dermatitis

  • Perioral dermatitis

  • Cutaneous lupus erythematosus

  • Polymorphous light eruption

 

Misdiagnosis is particularly common in those treated with topical steroids or oral steroids (tinea incognita).

 

 

Diagnosis of tinea faciei

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

 

 

Treatment of tinea faciei

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

 
 
 
 

Tinea faciei

DermNetNZ  (CCPL)

Access

The following topical meds are available in Ireland :

Clotrimazole (Canesten)

Miconazole (Daktarin)

Terbinafine (Fungasil, Lamisil, Lenafine)

Amolorfine (Curanail, Loceryl)

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.

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