What are the main causes of ringworm. How is tinea corporis diagnosed. What are the most effective treatments for fungal skin infections. Can ringworm be prevented. How long does it take for ringworm to clear up with proper treatment.

The Fundamentals of Ringworm: Causes and Transmission

Ringworm, medically known as tinea or dermatophytosis, is a common fungal infection that affects the skin, hair, and nails. Despite its name, it’s not caused by worms but by dermatophyte molds. These fungi thrive in warm, moist environments and can spread through various means.

How does ringworm spread? The infection can be transmitted through:

• Direct skin contact with infected individuals or animals
• Sharing personal items such as towels, clothing, or bedding
• Contact with contaminated surfaces in moist areas like shower stalls, locker rooms, or pool areas
• Self-spread from one part of the body to another

Understanding these transmission routes is crucial for prevention and control of ringworm infections. Are certain individuals more susceptible to ringworm? While anyone can contract ringworm, factors such as compromised immune systems, frequent exposure to moist environments, or close contact with infected individuals or animals may increase the risk.

Identifying Ringworm: Clinical Presentation and Diagnostic Challenges

Recognizing ringworm can be challenging, as its appearance can mimic other skin conditions. The classic ringworm lesion presents as an erythematous, raised, scaly ring with central clearing. However, the severity and appearance can vary significantly.

What are the key characteristics of ringworm lesions?

• Circular or ring-shaped patches with raised, scaly borders
• Redness and inflammation around the affected area
• Possible itching or discomfort
• In severe cases, potential bacterial superinfection leading to exudative lesions

Why is visual diagnosis alone insufficient? While the physical appearance can be indicative, ringworm may be easily confused with other skin conditions such as eczema, psoriasis, or other fungal infections. This similarity underscores the importance of confirmatory diagnostic tests before initiating treatment.

Advanced Diagnostic Techniques for Accurate Ringworm Identification

Given the potential for misdiagnosis, healthcare professionals employ various diagnostic methods to confirm suspected ringworm infections. These techniques range from simple, rapid tests to more complex laboratory analyses.

Potassium Hydroxide (KOH) Preparation

This quick and straightforward test involves examining skin scrapings or nail clippings under a microscope after treatment with potassium hydroxide. While it provides rapid results, its accuracy heavily depends on the clinician’s experience and technique.

Fungal Culture

More specific than KOH preparation, fungal culture involves growing the causative organism in a laboratory setting. Though highly accurate, results may take several weeks to obtain.

Histopathologic Examination with Periodic Acid-Schiff (PAS) Stain

Particularly useful for diagnosing onychomycosis (fungal nail infections), this method involves examining nail clippings stained with PAS under a microscope.

Polymerase Chain Reaction (PCR)

PCR is a rapidly emerging diagnostic tool for ringworm, offering quick and accurate results by detecting the DNA of dermatophytes.

Ultraviolet Light (Wood’s Lamp)

While limited in its application, a Wood’s lamp can be useful for diagnosing specific types of ringworm caused by Microsporum canis and Microsporum audouinii, which fluoresce blue-green under UV light.

How do these diagnostic methods compare in terms of speed and accuracy? PCR and KOH preparation offer the fastest results, while fungal culture provides the highest specificity but takes longer. The choice of diagnostic method often depends on the suspected type of infection, available resources, and the need for rapid results.

Targeted Treatment Approaches for Different Types of Ringworm

Treatment strategies for ringworm vary depending on the location and extent of the infection. Understanding these differences is crucial for effective management.

Tinea Pedis (Athlete’s Foot)

Over-the-counter topical antifungal products are usually sufficient for mild cases. For chronic or extensive infections, systemic antifungals like terbinafine, itraconazole, or fluconazole may be necessary. Adjunctive therapies such as foot powders can help prevent skin maceration.

Tinea Capitis (Scalp Ringworm)

This type requires systemic antifungal medication, as topical treatments are ineffective. Griseofulvin is often considered the first-line treatment, with terbinafine as an FDA-approved alternative for patients four years and older. Selenium sulfide shampoos can serve as adjunctive therapy.

Tinea Corporis (Body Ringworm) and Tinea Cruris (Jock Itch)

These infections typically respond well to topical antifungal products. For extensive or recurrent cases, systemic therapy may be required. Patients with tinea cruris should be advised on proper hygiene and wearing breathable cotton underwear.

How long does ringworm treatment typically last? The duration of treatment can vary from a few weeks for topical treatments to several months for systemic therapy, depending on the severity and location of the infection.

Navigating Treatment Challenges: Addressing Failure and Resistance

While most ringworm infections improve with antifungal treatment, treatment failure can occur. Understanding the reasons behind these failures is crucial for effective management.

Common Causes of Treatment Failure

• Incorrect diagnosis leading to inappropriate treatment
• Inadequate treatment duration or improper application of medications
• Patient non-compliance with prescribed regimens
• Reinfection from untreated sources (e.g., family members, pets)

What role does antifungal resistance play in treatment failure? Emerging resistance, particularly in species like Trichophyton rubrum and Tinea indotineae, is becoming a global public health concern. This resistance can lead to persistent infections that don’t respond to standard treatments.

Strategies to Overcome Treatment Challenges

• Confirming the diagnosis through laboratory tests before initiating treatment
• Educating patients on the importance of completing the full course of treatment
• Considering combination therapies or alternative antifungal agents in resistant cases
• Addressing potential sources of reinfection in the patient’s environment

How can healthcare providers improve treatment outcomes? Regular follow-ups, patient education, and a willingness to adjust treatment plans based on response can significantly enhance the success rate of ringworm treatment.

Prevention Strategies: Minimizing the Risk of Ringworm Infection

While ringworm is highly treatable, prevention remains the best approach. Understanding and implementing effective prevention strategies can significantly reduce the risk of infection.

Personal Hygiene Practices

• Keeping skin clean and dry, especially in areas prone to sweating
• Thoroughly drying the body after bathing or swimming
• Changing socks and underwear daily
• Avoiding walking barefoot in public areas like locker rooms or pool decks

Environmental Measures

• Regularly cleaning and disinfecting shared spaces and equipment
• Avoiding sharing personal items like towels, clothing, or hairbrushes
• Washing bedding and clothing in hot water if exposed to ringworm

Pet Care

• Regular veterinary check-ups for pets
• Promptly treating any skin conditions in animals
• Limiting contact with animals showing signs of skin infections

Can ringworm be completely prevented? While it’s challenging to eliminate all risk, especially for individuals in high-risk environments, consistent adherence to these preventive measures can significantly reduce the likelihood of infection.

The Global Impact: Emerging Trends and Public Health Concerns

Ringworm, while often considered a minor infection, has significant implications on a global scale. The emergence of antifungal-resistant strains and changing epidemiological patterns are reshaping our understanding of this common condition.

Antifungal Resistance: A Growing Threat

The rise of antifungal-resistant dermatophytes, particularly Trichophyton rubrum and Tinea indotineae, is becoming a major concern. This resistance can lead to persistent infections that are challenging to treat with conventional methods.

What factors contribute to the development of antifungal resistance?

• Overuse or misuse of antifungal medications
• Incomplete treatment courses
• Use of subtherapeutic doses in agriculture and animal husbandry
• Natural evolution of fungal species

Changing Epidemiological Patterns

Globalization, climate change, and shifting human behaviors are altering the epidemiology of ringworm infections. Some notable trends include:

• Increased prevalence in urban areas due to population density
• Emergence of new dermatophyte species in non-endemic regions
• Rising incidence of zoonotic transmission from pets and livestock

How are these trends impacting public health strategies? The evolving nature of ringworm infections necessitates adaptive approaches to prevention, diagnosis, and treatment. Public health initiatives are increasingly focusing on surveillance, education, and research into novel antifungal agents.

Economic and Social Impact

While often overlooked, the economic and social consequences of ringworm infections are significant:

• Healthcare costs associated with diagnosis and treatment
• Lost productivity due to discomfort or embarrassment caused by visible infections
• Stigma and psychological impact, especially in severe or chronic cases

How can society address these broader impacts of ringworm infections? Comprehensive public health strategies that combine medical interventions with social support and education can help mitigate both the direct and indirect effects of these infections.

Future Directions: Innovations in Ringworm Management

As our understanding of ringworm evolves, so too do the approaches to its management. Emerging technologies and research are paving the way for more effective prevention, diagnosis, and treatment strategies.

Advanced Diagnostic Tools

Innovations in diagnostic technology are enhancing the speed and accuracy of ringworm identification:

• Molecular diagnostic techniques for rapid species identification
• AI-assisted image analysis for improved visual diagnosis
• Point-of-care testing devices for immediate results in clinical settings

How will these advancements impact clinical practice? These tools have the potential to reduce misdiagnosis, enable targeted treatment, and improve overall patient outcomes.

Novel Treatment Approaches

Research into new antifungal agents and treatment modalities is ongoing:

• Development of new classes of antifungal drugs to combat resistant strains
• Exploration of natural compounds with antifungal properties
• Investigation of combination therapies for enhanced efficacy
• Research into immunomodulatory approaches to boost the body’s natural defenses against fungal infections

What potential do these new treatments hold? These innovations may offer solutions for resistant infections, reduce treatment duration, and minimize side effects associated with current antifungal medications.

Prevention and Public Health Strategies

Evolving approaches to prevention and public health management include:

• Development of antifungal vaccines for high-risk populations
• Implementation of advanced surveillance systems for early detection of outbreaks
• Integration of ringworm education into broader public health initiatives
• Exploration of environmental interventions to reduce fungal contamination in public spaces

How might these strategies reshape our approach to ringworm control? By focusing on prevention and early intervention, these approaches have the potential to significantly reduce the incidence and spread of ringworm infections on a population level.

Personalized Medicine in Ringworm Management

The concept of personalized medicine is gaining traction in dermatology, including the management of ringworm:

• Genetic testing to identify individuals at higher risk for recurrent infections
• Tailored treatment plans based on individual patient factors and fungal species
• Microbiome analysis to understand the role of skin flora in susceptibility to fungal infections

How could personalized approaches improve ringworm treatment outcomes? By considering individual patient factors and the specific characteristics of the infecting organism, personalized medicine could lead to more effective, targeted treatments with fewer side effects.

As research in these areas continues to progress, the future of ringworm management looks promising. These advancements have the potential to transform our approach to fungal skin infections, leading to better outcomes for patients and reduced burden on healthcare systems worldwide.

Information for Healthcare Professionals | Ringworm | Types of Diseases | Fungal Diseases

Definition and sources of infection

Ringworm, also called “tinea” or “dermatophytosis,” is a common infection of the epidermis (skin, hair, or nails) caused by dermatophyte molds. People can acquire ringworm through direct skin contact with people and animals who are infected. People can also acquire ringworm by sharing personal items (e.g., towels, clothing, bedding) or through contact with surfaces found in moist areas (e.g., shower stalls, locker room floors, pool areas). Ringworm can also spread from one part of the body to another.

Physical examination

The classic ringworm lesion is an erythematous, raised, scaly ring with central clearing. Multiple lesions might be present. The severity of the infection can range from mild, scaly lesions to erythematous, exudative lesions if a bacterial superinfection has developed.

Ringworm may be difficult to distinguish from other skin conditions. ¹ Physical examination and clinical history alone may not be enough to diagnose ringworm. Clinicians should generally use a diagnostic test to confirm suspected ringworm, especially before prescribing antifungal treatment.

Diagnostic testing

Potassium hydroxide preparation

Clinicians can use a potassium hydroxide (KOH) preparation of skin scrapings or nail clippings to confirm a diagnosis of ringworm. This test can provide rapid results, but the test’s accuracy depends on clinician experience and technique.²

Fungal culture

Fungal culture can be used to diagnose ringworm. Fungal culture is more specific than KOH stain, but results may take several weeks.^3,4

Histopathologic examination with a periodic acid-Schiff stain

Histopathologic examination of nail clippings with a periodic acid-Schiff (PAS) stain is a method for confirming the diagnosis for patients with suspected onychomycosis, a fungal nail infection most often caused by dermatophytes.

Polymerase chain reaction

Polymerase chain reaction (PCR) is a quick and increasingly used method for diagnosing ringworm.

Ultraviolet light (Wood’s lamp)

Ultraviolet light can be useful for diagnosing ringworm caused by Microsporum canis and Microsporum audouinii. Although both species fluoresce blue-green under a Wood’s lamp, these species are uncommon causes of ringworm infections in people.

Treatment

Tinea pedis: Athlete’s foot can usually be treated with over-the-counter topical antifungal products. Chronic or extensive tinea pedis may require treatment with systemic antifungal agents such as terbinafine, itraconazole, or fluconazole.⁶ In addition, chronic tinea pedis may require adjunctive therapy such as foot powder or talcum powder to prevent skin maceration.

Tinea capitis: Treatment with systemic antifungal medication is required, as topical antifungal products are ineffective for treatment of tinea capitis. Many experts consider griseofulvin to be the drug of choice.⁶ Terbinafine is also FDA-approved for the treatment of tinea capitis in patients four years of age and older. Itraconazole and fluconazole have been shown to be safe and effective, but are not FDA-approved for this indication.⁶ Selenium sulfide shampoos can be used as adjunctive therapy.^6-7 Clinicians should generally confirm the diagnosis of tinea capitis using a laboratory test.⁸

Tinea corporis/cruris: Tinea corporis and tinea cruris can usually be treated with topical antifungal products.⁶ Patients who have tinea cruris should be advised to keep the groin area clean and dry and to wear cotton underwear. Patients who have extensive or recurrent infections may require systemic antifungal therapy.⁶

Get information about the treatment of tinea unguium.

Treatment failure

Most ringworm infections improve with antifungal treatment, but treatment failure may occur. Common reasons for treatment failure may include incorrect diagnosis and inadequate treatment. Clinicians should counsel patients on the importance of taking antifungal medications as prescribed.

Emerging resistance is another potential cause of treatment failure. Antifungal resistant Trichophyton rubrum and Tinea indotineae are emerging global public health concerns.

Tinea Corporis – StatPearls – NCBI Bookshelf

Continuing Education Activity

Tinea corporis is a superficial fungal skin infection of the body caused by dermatophytes. Tinea corporis can be found worldwide. It is specifically defined by the location of the lesions that may involve the trunk, neck, arms, and legs. Alternative names are used for dermatophyte infections that affect the other areas of the body. These include the scalp (tinea capitis), the face (tinea faciei), hands (tinea manuum), the groin (tinea cruris), and feet (tinea pedis). This activity highlights the evaluation, diagnosis, treatment, and complications of tinea corporis.

Objectives:

• Identify the etiology of tinea corporis.

• Review the evaluation on examination of tinea corporis.

• Summarize the management options available for tinea corporis.

• Explain the importance of an interprofessional team when evaluating, treating, and educating patients in regards to tinea corporis.

Access free multiple choice questions on this topic.

Introduction

Tinea corporis is a superficial fungal skin infection of the body caused by dermatophytes. Tinea corporis is present worldwide. It is defined explicitly by the location of the lesions that may involve the trunk, neck, arms, and legs. Alternative names exist for dermatophyte infections that affect the other areas of the body. These include the scalp (tinea capitis), the face (tinea faciei), hands (tinea manuum), the groin (tinea cruris), and feet (tinea pedis).

Etiology

The dermatophyte’s ability to attach to the keratinized tissue of skin forms the basis for the dermatophytoses (superficial fungal skin infections). [1] The dermatophytes causing tinea corporis belong to genera Trichophyton, Epidermophyton, and Microsporum. Trichophyton rubrum is the most common species to cause dermatophyte infections in the last 70 years. T. Rubrum accounts for 80 to 90% of the strains.[2] Other common isolates include Trichophyton mentagrophytes and Microsporum audouinii. Infection typically occurs with direct contact with the skin from the soil, animals, or the skin of other humans.

In some individual cases, the most common etiologic species is dependent on the method of transmission. Tinea corporis secondary to Trichophyton tonsurans (T. tonsurans) commonly results from direct contact with a patient with tinea capitis. In tinea capitis, T. tonsurans is the most common causative agent in the United States and the United Kingdom.[3][4] T. tonsurans is also a typical finding in cases of tinea corporis gladiatorum.[5] Tinea corporis gladiatorum can present in athletes with extensive direct skin-to-skin contact (classically wrestlers). Patients with tinea corporis with close contact with cats or dogs commonly are infected with Microsporum canis.

Epidemiology

Tinea corporis is exceedingly common worldwide. Dermatophytes are the most prevalent agents of superficial fungal infections. Excessive heat, high relative humidity, and fitted clothing have correlations to more severe and frequent disease.[6] Specific populations can also be more predisposed to tinea corporis; for example, children. Tinea capitis and tinea corporis are the most common dermatophytic infections in prepubertal children.[7] Children are also more likely to contract zoophilic infections.  Zoophilic infections get transmitted via contact with animals such as cats and dogs. Another vulnerable population includes patients with compromised immune systems.  The immunocompromised patients also have an increased prevalence in developing Majocchi granuloma, a type of tinea corporis folliculitis that invades the deep dermal layers in contrast to the more superficial traditional tinea corporis. [8]

Pathophysiology

All people do not have equal susceptibility to fungal infection, and there are familial and genetic predispositions possibly mediated by specific defects in innate and adaptive immunity. Patients with low defensin beta 4 may demonstrate a predisposition to all dermatophytes.  Some other predisposing factors include underlying diseases such as diabetes mellitus, lymphomas, immunocompromised status, Cushing syndrome, excess sweating, or old age. The currently held view is that a cell-mediated immune response is responsible for the control of dermatophytosis.

Histopathology

Microscopic examination takes place after administration of 10% to 20% potassium hydroxide (KOH) solution to the skin scrapings.  Gentle heating, in addition to the KOH preparation, serves to dissolve the keratin and emphasize the dermatophyte itself. Microscopic visualization reveals septate and branching long, narrow hyphae without constriction.

History and Physical

Patients commonly present with an itchy, red rash.   These typically present on the exposed skin of the neck, trunk, and/or extremities.

On physical exam, single or multiple lesions are usually circular or ovoid in appearance with patches and plaques.  These annular lesions demonstrate sharp marginations with a raised erythematous scaly edge which may contain vesicles.  The degree of inflammation is variable.

The lesions advance centrifugally from a core, leaving a central clearing and mild residual scaling; this appears as a “ring” shape giving rise to the term “ringworm.”

Evaluation

The diagnosis of tinea corporis is usually clinically based on a thorough history and physical examination.  However, testing can be done to confirm the diagnosis.  Skin scrapings examined under a microscope with a potassium hydroxide (KOH) preparation will reveal septate and branching long narrow hyphae.  However, up to 15% of cases may yield false negatives when only using KOH preparations for diagnosis.[9]

Therefore another method for confirmation is a fungal culture.   Fungal cultures are possible but take time for definitive identification.  Cultures may begin to see growth in about five days but may take up to four weeks in certain species.  Therefore at least four weeks are needed to deem a sample as “no growth.”  The most common isolation medium used for fungal cultures is a Sabourad dextrose agar (1% glucose, 4% mycological peptone agar, water).  Identification is by examining the morphology, pigmentation, and surface topography of the culture.

Treatment / Management

The treatment of dermatophyte infections usually involves the use of topical or oral preparations.

Localized tinea corporis commonly responds to topical therapy typically applied once or twice daily, usually for two to three weeks. However, the endpoint of therapy is a clinical resolution of the symptoms.  In general, nystatin topical is not effective for tinea corporis.

Suggested topical regimens include one of the following:

• Clotrimazole: 1% cream/ointment/solution applied topically twice daily

• Ketoconazole: 2% cream/shampoo/gel/foam applied once daily

• Miconazole: 2% cream/ointment/solution/lotion/powder applied twice daily

• Naftifine: 1% cream, applied once daily or 1% or 2% gel twice daily

• Terbinafine: 1% cream/gel/spray solution once or twice daily

Oral therapy is necessary in more widespread infections or cases that have failed topical treatment.   Oral terbinafine or itraconazole is usually the preferred first-line treatments and is expected to clear the condition in about 2 to 3 weeks.

Suggested oral regimens include one of the following (for adults):

• Terbinafine: 250 mg orally once daily for two weeks

• Itraconazole: 100 mg once daily for 2 weeks or 200 mg once daily for one week; give capsules with food

• Fluconazole: 150 to 200 mg once weekly or 50 to 100 mg/day for 2 to 4 weeks

• Griseofulvin: 500 to 1000 mg once daily for 2 to 4 weeks

Differential Diagnosis

Diseases that are in the differential diagnosis may mimic the appearance of tinea corporis. These also typically present with annular lesions. Cases that are refractory to antifungal treatment or have a negative potassium hydroxide microscopic examination should warrant further investigation.  Also, the clinician must rule out other, more serious conditions if there is a severe disease such as extensive skin involvement.

Other common diseases that may present similarly include nummular eczema, erythema annulare centrifugum, tinea versicolor, cutaneous candidiasis, subacute cutaneous lupus erythematosus, pityriasis rosea, contact dermatitis, atopic dermatitis, seborrheic dermatitis, psoriasis.

Some of the severe diseases that must be ruled out are secondary syphilis, mycosis fungoides, or parapsoriasis.

Prognosis

Prognosis is usually good with proper treatment and patient compliance.

Complications

Complications are uncommon in dermatophytic infections.

One such complication includes Majocchi granuloma, is a rare condition in which the dermatophyte invades via a follicle and advances deeper into the dermis or subcutaneous tissue.  Minor skin trauma such as shaving can predispose patients to Majocchi granuloma.  Lesions involve the hair follicles and appear as erythematous nodules or papules.  These may even progress to abscesses.  Oral antifungals such as terbinafine 250 mg once daily for 2 to 4 weeks are the recommended therapy in cases of Majocchi granuloma.

Deterrence and Patient Education

Education is paramount is preventing tinea corporis.  Patients may be encouraged to wear light and loose fitting clothing.  Also keeping the skin clean and dry will help prevent the development of tinea corporis.

Also, upon initiation of topical antifungal treatment, compliance needs to be encouraged; however, the results are typically not immediate.  The patient may need reminders that even with proper treatment, it may take weeks to begin seeing the resolution of symptoms.

Pearls and Other Issues

Hepatitis is a proven complication with ketoconazole, so baseline liver panel is necessary before initiating oral antifungals, especially the azole group. Terbinafine is associated with a lupus-like reaction, so it should be given cautiously in patients with systemic lupus erythematosus. Additionally, allergic contact dermatitis to topicals is possible but rare, which means irritant effects may occur.

Enhancing Healthcare Team Outcomes

Tinea corporis can be diagnosed clinically based on history and exam. If there is an atypical appearance, further testing such as a KOH test or fungal culture should be the diagnostic test plan. [Level III]

After diagnosing tinea corporis, the standard treatment is with topical antifungals. Due to the possibility of side effects and adverse reactions from systemic therapy, topical treatment is the usual recommendation over systemic therapy. [Level I]

Tinea corporis requires an interprofessional team approach, including physicians, specialists, specialty-trained nurses, and pharmacists, all collaborating across disciplines to achieve optimal patient results. [Level V] In most cases, the clinician (physician, NP, PA) will diagnose and prescribe treatment. Pharmacists can verify agent antifungal coverage and dosing, and report back to the nurse or clinician if they have any concerns. Pharmacists and nurses can both ensure that the patient has had baseline LFTs and report back to the prescriber if not. The pharmacist should also verify the patient’s current regiment has no other drugs that could contribute to hepatotoxicity because of potential add-on effects of many oral antifungal agents. If present, the pharmacist should alert the nurse or prescriber so they can arrange for appropriate changes to the therapeutic regimen. Pharmacists can also check for drug-drug interactions, as these are common with azole antifungals. Nurses and pharmacists can both verify patient compliance and counsel patients on their medications or the dosing/administration of the same, and report any issues back to the prescribing clinician, who can make changes to the patient’s drug regimen based on patient needs.

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Figure

Tinea Corporis. Contributed by DermNetNZ

Figure

Ringworm, Tinea corporis, Fungi, Fungal infection involving the skin, dermatophytic fungal organism, tinea capitis, Skin Disease. Contributed by Dr. Lucille K. Georg, The Centers for Disease Control and Prevention (CDC)

References

1.

Aly R. Ecology and epidemiology of dermatophyte infections. J Am Acad Dermatol. 1994 Sep;31(3 Pt 2):S21-5. [PubMed: 8077503]

2.

Seebacher C, Bouchara JP, Mignon B. Updates on the epidemiology of dermatophyte infections. Mycopathologia. 2008 Nov-Dec;166(5-6):335-52. [PubMed: 18478365]

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Mirmirani P, Tucker LY. Epidemiologic trends in pediatric tinea capitis: a population-based study from Kaiser Permanente Northern California. J Am Acad Dermatol. 2013 Dec;69(6):916-21. [PubMed: 24094452]

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Fuller LC, Child FC, Midgley G, Higgins EM. Scalp ringworm in south-east London and an analysis of a cohort of patients from a paediatric dermatology department. Br J Dermatol. 2003 May;148(5):985-8. [PubMed: 12786830]

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Adams BB. Tinea corporis gladiatorum. J Am Acad Dermatol. 2002 Aug;47(2):286-90. [PubMed: 12140477]

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Taplin D. Dermatophytosis in Vietnam. Cutis. 2001 May;67(5 Suppl):19-20. [PubMed: 11398256]

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Ely JW, Rosenfeld S, Seabury Stone M. Diagnosis and management of tinea infections. Am Fam Physician. 2014 Nov 15;90(10):702-10. [PubMed: 25403034]

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Elgart ML. Tinea incognito: an update on Majocchi granuloma. Dermatol Clin. 1996 Jan;14(1):51-55. [PubMed: 8821157]

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Panasiti V, Borroni RG, Devirgiliis V, Rossi M, Fabbrizio L, Masciangelo R, Bottoni U, Calvieri S. Comparison of diagnostic methods in the diagnosis of dermatomycoses and onychomycoses. Mycoses. 2006 Jan;49(1):26-9. [PubMed: 16367815]

Disclosure: Garrett Yee declares no relevant financial relationships with ineligible companies.

Disclosure: Ahmad Al Aboud declares no relevant financial relationships with ineligible companies.

Ringworm, a description of the disease on the Medihost.ru portal

Ringworm or trichophytosis is one of the most common ailments on our planet, second only to foot fungus in frequency of occurrence. Most often, the risk of contracting this disease is in young children and adolescents. Adults, on the other hand, rarely suffer from ringworm, since their hairline contains a special acid that inhibits the development of the fungus.

Causes of ringworm

This type of trichophytosis occurs when infected with a fungus. Infection occurs through contact with a host, sick person or animal. Most often, these are dogs or cats, since they are the ones who carry the disease. You can also get infected through personal hygiene products, towels, toothbrushes, etc. The likelihood of the disease increases many times if a person has a weakened immune system.

Symptoms of ringworm

The incubation period of this disease usually lasts 3-4 days, after which a noticeable manifestation of the symptoms of this disease begins. Symptoms vary by type depending on the place where the lesion has arisen, on the skin covered with hair, on the nail plates or on smooth skin.

When smooth skin is affected, scaling centers appear in the form of pinkish-red circles. There is a slight thickening along the edges of these circles. Bubbles can periodically form on this thickening, which burst over time and form a crust.

If the lesion is located on the scalp, then it first begins to peel off slightly without causing discomfort to the patient. Then itching and more severe peeling begin to appear. After some time, the hair on the affected area becomes brittle or completely falls out.

If the nail plates were affected, then after a while lines and spots of gray or greenish color appear on them, they gradually cover the entire nail and make it brittle and brittle.

Diagnosis of ringworm

There are no clinical diagnostic methods due to their uselessness. Doctors venereologists diagnose ringworm during a visual examination of the patient and based on his testimony and complaints.

Ringworm treatment

Various topical antifungal or topical agents are used to treat a ringworm lesion on the skin that does not involve the hair. The affected area is lubricated with a five percent iodine tincture, and in the evening with antifungal ointments. Twice a day, ointments such as bifonazole, ciclopirox, clotrimazole, isocanazole and many other ointments of similar action can be used. If the lesion is pronounced, then the patient may be prescribed drugs of combined action containing hormones. If the disease itself is also complicated by a bacterial infection, then antibacterial creams are prescribed.

If the patient’s hairline is affected, systemic antifungal treatment is carried out. The main drug in the treatment of ringworm of the scalp is griseofulvin, a special antibiotic produced by mold fungi. The way it is taken is also quite unusual. It is taken up to four times a day, with meals. At the same time, it should be washed down with sunflower or some other vegetable oil. The full course of therapy with this drug is from 1.5 to 2 months. After indications of positive dynamics, griseofulvin is taken at the same dose 2 times a day, and then reduced to two times a week. During this therapy, the patient is completely removed hair and thoroughly washed head with a special shampoo. After treatment with griseofulvin tablets, they are replaced with terbinafine tablets similar in action.

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Ringworm – litter in Kiev

Ringworm (trichomycosis, trichophytosis of the head, microsporia) tsіyne zahvoryuvannya, scho vrazhє pilar part of the head, beard, vus and eyebrows. The name “ringworm” is metaphorical and indicates the importance of the damage to the hairy parts, although sometimes it gets smooth and smooth. The more correct term is trichomycosis, which combines an object and an agent of infection.

The problem of wiccan parasitic fungi-dermatomycetes of the family Trichophyton and Microsporum. In medical terminology, this trichomycosis is subdivided into Trichophytia and Microsporia. Offenses may be highly contagious (infective health) and may indicate the presence of clinical symptoms.

Fallow in the area and the depths of the infection, as well as in the fungus and peculiarities of overcoming illness, ringworm can manifest itself clinically. Most of the times we are superficial, which is less than hairy, but in some depressions we are afraid of pustules, as well as heavy fuses.

Children of the young and middle age (ages 3-12), as well as creatures – cats and dogs, are most often infected with dzherelami. Infection starts with direct contact or through clothing and hygiene items (smuts, towels, bedding). Infection in the species of creatures is more common and, as a rule, occurs in more important forms.

For some time the fungus can survive in the body in an inactive state and does not manifest itself. The transition to the active phase can be caused by damage to the immune system, endocrine system illness, stress, lack of vitamins, important work in unfriendly minds, lack of sanitary and hygienic rules. Vishchevkazanі causes priyayat also more swedish peripheral expansion of the fungus on the surface of the skin or deep in the lymphatic and blood vessels.

Ringworm symptoms

As it has already been said, it is possible to get infected with ringworm by human beings. Nezalezhno vyd dzherela zarazheniya, zahvoryuvannya can prot_kat in gostrіy chi hronіchnіy formі. In the first type, the incubation period becomes 1 day, in the other – from 3 to 6 days.

Symptoms may be severe or mild. In times of relapse, symptoms tend to present acutely and then progressively degrade. On the hairy parts of one or the other close quarters, the shkiri are covered with red ring-shaped and slightly stinger-like patches near the look of “medallions”. The color of the follicles may be clear contours and the rosemary is close to 2 cm. Then, in these places, knots and puffies are established, as if with a year they burst and turn into dry picks, which are peeled. It is possible to have a peripheral growth of the follicles in the view “kіltsya in kіltsі” up to a width of 5-7 cm.

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If the immune system of a person works properly, they will cope with the illness on their own, not allowing it to be active. It is possible to provoke the development of an ailment:

• non-resistant water-lipid mantle, presence on the skin of microtraumas;
• trivaliy contact from germline infection;
• high temperature and moisture level;
• avitaminosis;
• chronic ailments.

Treatment of ringworm

Ringworm is at least one of the variants due to the large number of fungal infections of the skin and її appendages (hair, nails, sebaceous and sweat deposits). Therefore, the diagnosis is established not only on the basis of the clinical picture, but also on the basis of the lingual examination of the luminescent (hardware) examination, microscopy of pathological material, and also on the observation of that identification of the patient by a microbiologist ichnіy laboratory.

For the therapy of vicarious, there is a whole complex of approaches, which includes the accumulation of active active agents and systemic preparations. Under systemic preparations, such faces are known, as if they are introduced into the body with different ways, and they are further expanded by the bloodstream, reaching tissue damage. As a rule, there is an effective combination of antimycotic, hyposensitizing and antihistamine agents.

Treatment and prevention of ringworm to achieve more medical and social goals. In the majority of moods, it is connected with the unsatisfactory patients, contact with the sick creature, the rules of hygiene are underestimated, otherwise I will manifest some sort of chronic illness.

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