Tinea corporis - Clinicals, Diagnosis, and Management

Dermatology

Clinicals - History

Fact Explanation
Ring like erythematous, scaly plaques over trunk and limbs. Tinea corporis is a dermatophyte fungal infection involving the skin of trunk and limbs. It is a superficial fungal infection which is limited to stratum corneum. Tinea corporis is caused by organisms of genera Trichophyton, Microsporum and epidermophyton. ,,, Ring like erythematous, scaly plaques over trunk and limbs.
Tinea corporis is a dermatophyte fungal infection involving the skin of trunk and limbs. It is a superficial fungal infection which is limited to stratum corneum. Tinea corporis is caused by organisms of genera Trichophyton, Microsporum and epidermophyton. ,,,
Pruritis Most patients complain of pruritis, and it can be mild to intense itching. , Pruritis
Most patients complain of pruritis, and it can be mild to intense itching. ,
Contact history Tinea corporis is a contagious and communicable fungal infection. Therefore contact history with infected family member or sharing clothes, towels, bedlinen or animal contact may be positive in the history. Overcrowding and poor social conditions are possible risk factors in the history. ,, Contact history
Tinea corporis is a contagious and communicable fungal infection. Therefore contact history with infected family member or sharing clothes, towels, bedlinen or animal contact may be positive in the history. Overcrowding and poor social conditions are possible risk factors in the history. ,,
There may be a history of immunosuppression. Protection against fungal infection is mediated by cell mediated immunity. In conditions such as immunosuppression, AIDS, treating with long term corticosteroids and cytotoxics and malnutrition are possible risk factors in the history. , There may be a history of immunosuppression.
Protection against fungal infection is mediated by cell mediated immunity. In conditions such as immunosuppression, AIDS, treating with long term corticosteroids and cytotoxics and malnutrition are possible risk factors in the history. ,

Clinicals - Examination

Fact Explanation
Single or numerous circular ring like erythematous, well marginated scaly plaques on the skin over the trunk and limbs. Dermatophyte lesions appear because of delayed or type-4 hypersensitivity reaction as a host response to the metabolic products of fungus. ,,, Single or numerous circular ring like erythematous, well marginated scaly plaques on the skin over the trunk and limbs.
Dermatophyte lesions appear because of delayed or type-4 hypersensitivity reaction as a host response to the metabolic products of fungus. ,,,
Small vesicles and pustules may be seen within the lesions. Small vesicles and pustules may be seen, specially in the advancing margin due to the acute inflammation. Fungi coming from human sources (anthrophilic organisms) cause lesions with minimal inflammation. Fungi coming from animal sources (zoophilic fungi) induce a more intense inflammation than those spread from person to person. , Small vesicles and pustules may be seen within the lesions.
Small vesicles and pustules may be seen, specially in the advancing margin due to the acute inflammation. Fungi coming from human sources (anthrophilic organisms) cause lesions with minimal inflammation. Fungi coming from animal sources (zoophilic fungi) induce a more intense inflammation than those spread from person to person. ,
Erythema most pronounced at the periphery. Due to acute inflammation in advancing margin erythema most pronounced at the periphery.The lesions expand slowly and healing leaves a typical ring like pattern. , Erythema most pronounced at the periphery.
Due to acute inflammation in advancing margin erythema most pronounced at the periphery.The lesions expand slowly and healing leaves a typical ring like pattern. ,
Dry skin Dry skin is a possible finding during general examination. It may cause skin trauma easily and breaks the protective barrier against superficial fungal infection. Dry skin
Dry skin is a possible finding during general examination. It may cause skin trauma easily and breaks the protective barrier against superficial fungal infection.

Investigations - Diagnosis

Fact Explanation
Woods light examination Uses ultraviolet light to observe skin closely. It reveal some of epidermophytes with green fluorescence. But some causative fungus does not fluoresce. ,, Woods light examination
Uses ultraviolet light to observe skin closely. It reveal some of epidermophytes with green fluorescence. But some causative fungus does not fluoresce. ,,
Light microscopic examination. The skin scrapings should be taken from the scaly margin of a lesion, with a small curette or a scalpel blade. The specimens are cleared in pottassium hydroxide. Branching hyphae and spores can easily be seen. ,,, Light microscopic examination.
The skin scrapings should be taken from the scaly margin of a lesion, with a small curette or a scalpel blade. The specimens are cleared in pottassium hydroxide. Branching hyphae and spores can easily be seen. ,,,
Culture Culture Should be carried out in a mycology or bacteriology laboratory. Transport medium is not necessary, and specimens can be sent in folded black paper and dry petri dish. The report may take as long as a month; microscopy is much quicker. ,, Culture
Culture Should be carried out in a mycology or bacteriology laboratory. Transport medium is not necessary, and specimens can be sent in folded black paper and dry petri dish. The report may take as long as a month; microscopy is much quicker. ,,

Management - Supportive

Fact Explanation
Educate the patient. Tinea corporis is a common superficial fungal infection which can be treated successfully. ,, Educate the patient.
Tinea corporis is a common superficial fungal infection which can be treated successfully. ,,
Advise regarding hygiene. Tinea corporis is a contagious and communicable fungal infection. Therefore advise not to share clothes, towels, bedlinen, etc. Advise regarding importance of daily bathing and wearing clean dry clothes. ,, Advise regarding hygiene.
Tinea corporis is a contagious and communicable fungal infection. Therefore advise not to share clothes, towels, bedlinen, etc. Advise regarding importance of daily bathing and wearing clean dry clothes. ,,
Take measures to prevent dry skin. Advise regarding measures can be taken to avoid dry skin such as avoiding detergents, using moisturizing cream etc. Take measures to prevent dry skin.
Advise regarding measures can be taken to avoid dry skin such as avoiding detergents, using moisturizing cream etc.

Management - Specific

Fact Explanation
Local imidazole preparations An imidazole containing preparation (such as miconazole, econazole and clotrimazole) used twise daily for 3-4 week period is usually adequate. Imidazoles interfere with fungal oxidative enzymes to cause lethal accumulation of hydrogen peroxide. They also reduce the formation of ergosterol, an important constituent of fungal cell wall which thus becomes permeable to intracellular constituents. When topical treatment has failed or for extensive infections systemic drugs needs to be considered. ,,, Local imidazole preparations
An imidazole containing preparation (such as miconazole, econazole and clotrimazole) used twise daily for 3-4 week period is usually adequate. Imidazoles interfere with fungal oxidative enzymes to cause lethal accumulation of hydrogen peroxide. They also reduce the formation of ergosterol, an important constituent of fungal cell wall which thus becomes permeable to intracellular constituents. When topical treatment has failed or for extensive infections systemic drugs needs to be considered. ,,,
Terbinafin Has now largely superseded griseofulvin. It acts by inhibiting fungal squalane epoxidase and does not interact with cytochrome p-450 system. It is fungicidal and so cures chronic dermatophyte infections more quickly and more reliably than griseofulvin. 250mg daily given for2-6 weeks. ,,, Terbinafin
Has now largely superseded griseofulvin. It acts by inhibiting fungal squalane epoxidase and does not interact with cytochrome p-450 system. It is fungicidal and so cures chronic dermatophyte infections more quickly and more reliably than griseofulvin. 250mg daily given for2-6 weeks. ,,,
Itraconazole Is now preferred to ketconazole, which occasionally damages the liver and is a reasonable alternative to terbinafin if this is contraindicated. Fungistatic rather than fungicidal, It interfere with cytochrome p-450 system, so review of any other medication being taken is needed before prescription is issued. 100mg daily given for 2-6weeks . ,,, Itraconazole
Is now preferred to ketconazole, which occasionally damages the liver and is a reasonable alternative to terbinafin if this is contraindicated. Fungistatic rather than fungicidal, It interfere with cytochrome p-450 system, so review of any other medication being taken is needed before prescription is issued. 100mg daily given for 2-6weeks . ,,,
Ketconazole This drug should be reserved for patients with severe and resistant disease because of the possibility of serious hepatotoxicity and occurrence of other side effects, including rashes, Thrombocytopenia and gastrointestinal disturbances. 200mg daily given for 2-6weeks . ,,, Ketconazole
This drug should be reserved for patients with severe and resistant disease because of the possibility of serious hepatotoxicity and occurrence of other side effects, including rashes, Thrombocytopenia and gastrointestinal disturbances. 200mg daily given for 2-6weeks . ,,,
Griseofulvin Was for many years drug of choice for chronic dermatophyte infections, but is now largely reserved for treatment of tinea capitis. Griseofulvin prevents fungal growth by inhibiting mitosis. The therapeutic efficacy of griseofulvin depends on its capacity to bind to keratin. ,,, Griseofulvin
Was for many years drug of choice for chronic dermatophyte infections, but is now largely reserved for treatment of tinea capitis. Griseofulvin prevents fungal growth by inhibiting mitosis. The therapeutic efficacy of griseofulvin depends on its capacity to bind to keratin. ,,,

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