Tinea is a type of superficial fungal infection affecting the top layer of the skin, scalp, and nails caused by a group of fungus known as dermatophytes. They are commonly known as ‘ringworm’ given by their annular (ring-like) or serpiginous border.
HOW DO WE GET INFECTED?
Transmission occurs from an infected host, which may be human to human (anthropophilic), animal to human(zoophilic), or soil to human (geophilic). Dermatophytes can live on exfoliated skin or hair, moist surfaces, and environment for 12-15 months. Once exposed the incubation period is 1-2 weeks.
WHO GETS INFECTED?
There are many factors that predispose a person to tinea.
- Crowded living conditions
- Poor hygiene
- High humidity
- People with topical or systemic corticosteroids
- Contact with an infected person, animal or soil
- People with the suppressed immune system (old age, diabetes, etc)
TYPES OF TINEA
There are different types of tinea depending on the site of involvement
- TineaPedis: Known as an athlete’s foot is the most common disease affecting the foot and toes. It’s transmitted by direct contact with contaminated shoes, socks, showers, locker rooms, etc.
2.TineaCruris: Often referred to as “jock itch” is the dermatophytic infection of the groin but also affects inner thigh and buttocks
3.TineaCorporis: dermatophytic infection of the trunk and extremities excluding groin, palm, soles.Symptoms include:
- a rash with a ring-like appearance
- the skin may be red and inflamed around the outside of the ring, but look fine in the middle
- merging rings
- rings feel slightly raised
- itchiness, especially under the rash.
4.Tineamanuum: this is the dermatophytic infection involving dorsum of handss, palms and interdigital space.
5.TineaFaciei: Dermatophytic infection of the glabrous (non-hair bearing ) skin of the face is known as tineafaciei.
6.Tineabarbae: this affects the hair follicles or beard or moustache
- redness, swelling, and pus-filled bumps
- hair loss, which usually resolves after treatment
- swollen glands
- raw, open skin and raised, soft, spongy patches that weep
7.TineaCapitis: This is dermatophytic infection of scal and hair and commonly occurs in children in low socioeconomic and crowded living conditions. They present with following features:
- small patches of scaly skin appear on the scalp.
- patches may feel tender or painful and be inflamed.
- hair breaks away on or near the patches
- kerion, or large inflamed sores, form on the scalp, and they may ooze pus
Dermatophytic infections are usually diagnosed by your dermatologist on clinical grounds.They may take a small scraping of the skin, which will not hurt, and examine it under a microscope to look for characteristics of fungi.
The doctor will assess whether the skin problem is being caused by some other disorder, such as psoriasis.. Further testing is not usually needed unless symptoms are particularly severe.
If symptoms have not improved after treatment, the doctor may remove a small piece of infected skin and send it to the lab to be analyzed.
Fungal infections rarely spread below the surface of the skin. The risk of any serious illness is very small. However, without treatment, ringworm can spread from one part of the body to another.
If the skin is broken, bacteria may enter and cause an infection.
People with HIV and other conditions that weaken the immune system are more likely to experience a spreading of ringworm. It is more difficult to get rid of the infection if the immune system is weak.
Treatment depends on the site of involvement. There are various systemic antifungals( like terbinafine, griseofulvin, itraconazole and fluconazole), topical antifungals (luliconazole, amorolfine, eberconazole, etc), shampoos, soaps. Often different modalities of treatments are combined for a better clearance of the infection.
Patients are adviced to refrain from self medication and usinf OTC medications as the condition may worsen due to the steroids present in many OTC medications
The following tips may help prevent ringworm if it occurs in a household:
- If a pet is the source of the infection, it should be treated by a vet.
- Everyone should wash their hands regularly and thoroughly with soap.
- All household members should check themselves for signs of ringworm.
- People should not share combs, hairbrushes, clothing, bed linen, towels, or footwear.
- Anyone who has ringworm should not scratch affected areas as this increases the risk of spreading the infection.
- People should avoid walking around the house with bare feet.
- Clothes should be washed in hot water with fungicidal soap. Keeping cool and wearing loose clothing may help reduce the risk.