Dermatophytosis: Difference between revisions

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==Background==
==Background==
*Common fungal infection of the skin, hair and nails
*Also known as ringworm
*Common [[fungal infection]] of the skin, hair and nails
*Mode of transmission via direct contact to the organisms (eg. using unwashed wrestling mats)
*Mode of transmission via direct contact to the organisms (eg. using unwashed wrestling mats)
*These dermatophytes are filamentous fungi that live off the keratin
*These dermatophytes are filamentous fungi that live off the keratin
==Clinical Features==
==Clinical Features==
[[File:Dermatophytosis.png|thumb|]]
Subtypes of infections include:
Subtypes of infections include:
*Tinea coporis (ringworm)
*[[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
***[[Pruritus|Pruritic]], circular scaly [[rash|patch]] or plaque → central clearing → annular plaque
*Tinea pedis
*[[Tinea pedis]] (athlete's foot)
**Foot
**Foot
**Clinical manifestation:
**Clinical manifestation:
***Between digit spaces
***Pruritic
***Pruritic
***Erosions
***Erosions
***Scales
***Scales
***Bullous
***Bullous
*Tinea cruris
*[[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 Candida infection
*Interdigital [[candida]] infection
*Erythrasma
*Erythrasma
*Atopic dermatitis
*[[Atopic dermatitis]]
*Chronic contact dermatitis
*Chronic [[contact dermatitis]]
*Acute palmoplantar eczema
*Acute palmoplantar [[eczema]]
*Palmoplantar psoriasis
*Palmoplantar [[psoriasis]]
*Pitted keratolysis
*Pitted keratolysis
*Juvenile plantar dermatosis
*Juvenile plantar dermatosis
*Keratolysis exfoliativa
*Keratolysis exfoliativa
*Keratodermas
*Keratodermas
*Acute palmoplantar eczema  
*Acute palmoplantar [[eczema]]
*Acute contact dermatitis
*Acute [[contact dermatitis]]
*Palmoplantar pustulosis
*Palmoplantar pustulosis
*Scabies
*[[Scabies]]
Tinea cruris
===[[Tinea cruris]]===
*Inverse psoriasis
*Inverse psoriasis
*Erythrasma
*Erythrasma
*Seborrheic dermatitis
*Seborrheic dermatitis
*Candidal intertrigo
*Candidal intertrigo
Tinea corporis
===[[Tinea corporis]]===
*Subacute cutaneous lupus erythematosus (SCLE)
*Subacute cutaneous [[lupus]] erythematosus (SCLE)
*Granuloma annulare
*Granuloma annulare
*Erythema annulare centrifugum
*Erythema annulare centrifugum
==Evaluation==
==Evaluation==
KOH prep for diagnosis
KOH prep for diagnosis
==Management==
==Management==
Tinea coporis
===Tinea corporis===
*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===
*Topical antifungals
*Topical antifungals
*Oral antifungals (terbinafine, itraconazole, or fluconazole)
*Oral antifungals ([[terbinafine]], [[itraconazole]], or [[fluconazole]])
Tinea cruris
===Tinea cruris===
*Topical antifungals
*Topical antifungals
Tinea capitis
===Tinea capitis===
*1st line
*1st line
**Griseofulvin
**[[Griseofulvin]]
**Terbinafine  
**[[Terbinafine]]
Tinea unguium
===Tinea unguium===
*Mild to moderate
*Mild to moderate
**1st line
**1st line
***Oral terbinafine
***Oral [[terbinafine]]
***Topical efinaconazole, amorolfine, tavaborole, and ciclopirox
***Topical efinaconazole, amorolfine, tavaborole, and ciclopirox
*Moderate to severe
*Moderate to severe
**Terbinafine, itraconazole
**[[Terbinafine]], [[itraconazole]]
 
==Disposition==
==Disposition==
*Discharge


==See Also==
==See Also==
*[[Rashes]]
*[[Tinea]]


==External Links==
==External Links==
[[Category:Dermatology]]


==References==
==References==
<references/>https://www.uptodate.com/contents/dermatophyte-tinea-infections?source=search_result&search=dermatophytosis&selectedTitle=1~150#H68628070<references/>
*https://www.uptodate.com/contents/dermatophyte-tinea-infections?source=search_result&search=dermatophytosis&selectedTitle=1~150#H68628070
 
*https://www.uptodate.com/contents/onychomycosis-epidemiology-clinical-features-and-diagnosis?source=search_result&search=tinea%20unguium&selectedTitle=2~15#H522098449
<references/>https://www.uptodate.com/contents/onychomycosis-epidemiology-clinical-features-and-diagnosis?source=search_result&search=tinea%20unguium&selectedTitle=2~15#H522098449<references/>
*https://www.uptodate.com/contents/onychomycosis-management?source=search_result&search=tinea%20unguium&selectedTitle=1~15
 
*https://www.uptodate.com/contents/tinea-capitis?source=search_result&search=tinea%20capitis&selectedTitle=1~39
<references/>https://www.uptodate.com/contents/onychomycosis-management?source=search_result&search=tinea%20unguium&selectedTitle=1~15<references/>
<references/>
 
<references/>https://www.uptodate.com/contents/tinea-capitis?source=search_result&search=tinea%20capitis&selectedTitle=1~39<references/>

Latest revision as of 01:47, 9 February 2021

Background

  • Also known as ringworm
  • 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

Dermatophytosis.png

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

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 corporis

  • Topical antifungals (azoles, allylamines, butenafine, ciclopirox, and tolnaftate)
  • Oral antifungals for those who fail topical treatment

Tinea pedis

Tinea cruris

  • Topical antifungals

Tinea capitis

Tinea unguium

Disposition

  • Discharge

See Also

External Links

References

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