Dermatophytosis: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
Subtypes of infections include: | Subtypes of infections include: | ||
*Tinea | *[[Tinea corporis]] (ringworm) | ||
**Body except for feet, groin, face, scalp hair or beard hair | **Body except for feet, groin, face, scalp hair or beard hair | ||
**Clinical manifestation: | **Clinical manifestation: | ||
***Pruritic, circular scaly patch or plaque --> central clearing --> annular plaque | ***Pruritic, circular scaly patch or plaque --> central clearing --> annular plaque | ||
*Tinea pedis (athlete's foot) | *[[Tinea pedis]] (athlete's foot) | ||
**Foot | **Foot | ||
**Clinical manifestation: | **Clinical manifestation: | ||
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***Scales | ***Scales | ||
***Bullous | ***Bullous | ||
*Tinea cruris (jock itch) | *[[Tinea cruris]] (jock itch) | ||
**Groin | **Groin | ||
**Clinical manifestation: | **Clinical manifestation: | ||
***Erythematous patch on proximal inner thigh --> central clearing with sharp borders and vesicles | ***Erythematous patch on proximal inner thigh --> central clearing with sharp borders and vesicles | ||
***Scrotum typically spared | ***Scrotum typically spared | ||
*Tinea capitis | *[[Tinea capitis]] | ||
**Scalp hair | **Scalp hair | ||
**Clinical manifestation: | **Clinical manifestation: | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
Tinea pedis | Tinea pedis | ||
*Interdigital | *Interdigital [[candida]] infection | ||
*Erythrasma | *Erythrasma | ||
*Atopic dermatitis | *Atopic dermatitis | ||
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==Management== | ==Management== | ||
Tinea coporis | Tinea coporis | ||
*Topical antifungals (azoles, allylamines, butenafine, ciclopirox, and tolnaftate) | *Topical [[antifungals]] (azoles, allylamines, butenafine, ciclopirox, and tolnaftate) | ||
*Oral antifungals for those who fail topical treatment | *Oral antifungals for those who fail topical treatment | ||
Tinea pedis | Tinea pedis | ||
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Tinea capitis | Tinea capitis | ||
*1st line | *1st line | ||
**Griseofulvin | **[[Griseofulvin]] | ||
**Terbinafine | **[[Terbinafine]] | ||
Tinea unguium | Tinea unguium | ||
*Mild to moderate | *Mild to moderate | ||
Revision as of 16:21, 23 October 2016
Background
- Common fungal infection of the skin, hair and nails
- Mode of transmission via direct contact to the organisms (eg. using unwashed wrestling mats)
- These dermatophytes are filamentous fungi that live off the keratin
Clinical Features
Subtypes of infections include:
- Tinea corporis (ringworm)
- Body except for feet, groin, face, scalp hair or beard hair
- Clinical manifestation:
- Pruritic, circular scaly patch or plaque --> central clearing --> annular plaque
- Tinea pedis (athlete's foot)
- Foot
- Clinical manifestation:
- Between digit spaces
- Pruritic
- Erosions
- Scales
- Bullous
- Tinea cruris (jock itch)
- Groin
- Clinical manifestation:
- Erythematous patch on proximal inner thigh --> central clearing with sharp borders and vesicles
- Scrotum typically spared
- Tinea capitis
- Scalp hair
- Clinical manifestation:
- Scaly patches with alopecia
- Tinea unguium (Dermatophyte onchomycosis)
- Nail
- Clinical manifestation:
Differential Diagnosis
Tinea pedis
- Interdigital candida infection
- Erythrasma
- Atopic dermatitis
- Chronic contact dermatitis
- Acute palmoplantar eczema
- Palmoplantar psoriasis
- Pitted keratolysis
- Juvenile plantar dermatosis
- Keratolysis exfoliativa
- Keratodermas
- Acute palmoplantar eczema
- Acute contact dermatitis
- Palmoplantar pustulosis
- Scabies
Tinea cruris
- Inverse psoriasis
- Erythrasma
- Seborrheic dermatitis
- Candidal intertrigo
Tinea corporis
- Subacute cutaneous lupus erythematosus (SCLE)
- Granuloma annulare
- Erythema annulare centrifugum
Evaluation
KOH prep for diagnosis
Management
Tinea coporis
- Topical antifungals (azoles, allylamines, butenafine, ciclopirox, and tolnaftate)
- Oral antifungals for those who fail topical treatment
Tinea pedis
- Topical antifungals
- Oral antifungals (terbinafine, itraconazole, or fluconazole)
Tinea cruris
- Topical antifungals
Tinea capitis
- 1st line
Tinea unguium
- Mild to moderate
- 1st line
- Oral terbinafine
- Topical efinaconazole, amorolfine, tavaborole, and ciclopirox
- 1st line
- Moderate to severe
- Terbinafine, itraconazole