tinea A common fungal INFECTIONof the SKIN,
involving the layers (including the hair and nails)
that are cornified (composed of dead ker-
atinocytes). Several species of fungi, known col-
lectively as dermatophytes, cause tinea infection
(also called dermatophytosis). People commonly
refer to some forms of tinea as ringworm because
the lesions have the appearance of worms ringed
beneath the surface of the skin. Though descrip-
tive this is a misnomer as tinea has nothing to do
with worms. There are numerous designations of
tinea based on where it appears on the body,
though the same group of dermatophytes can
cause any of tinea’s presentations.
Tinea Common Body Region
Infection Name Affected
tinea barbae ringworm beard area of the face
tinea capitis ringworm scalp
tinea cruris jock itch genitals
tinea corporis ringworm central trunk, arms,
and legs
tinea pedis athlete’s foot bottom of the foot and
between the toes
Tinea is fairly contagious and spreads from per-
son to person as well as through contact with sur-
faces, such as shower floors or soil, that can
harbor the fungi. Dermatophytes can exist outside
the body for a considerable length of time and
thrive in environments that are warm and moist.
Symptoms and Diagnostic Path
The symptoms of tinea vary somewhat according
to the part of the body affected, though generally
include
- itching (PRURITUS), which may be intense, or
PAIN - redness (erythema)
- lesions that may appear as papules, vesicles, or
plaques - cracking or scaling of the lesions
- irregular HAIRloss (ALOPECIA) when the site of
the infection is the scalp
The diagnostic path is generally straightfor-
ward. The doctor may take small scrapings of
affected tissue to examine under a microscope.
Such examination reveals the dermatophytes or
evidence of their presence, which is conclusive for
diagnosis. Inability to identify evidence of der-
matophytes points to other causes for the symp-
toms.Treatment Options and Outlook
Topical ANTIFUNGAL MEDICATIONS often effectively
treat all forms of tinea except those involving the
hair or NAILS. Prescription antifungal medications
produce the most reliable results; over-the-
counter products may require multiple applica-
tions. Because many people who acquire tinea
continue the activities that resulted in exposure,
reinfection is common. Pervasive or resistant tinea
may require oral antifungal medications to attack
the infection systemically. Oral antifungal therapy
is necessary to eradicate tinea that involves the
hair or the nails. Treatment may require up to
eight weeks for some infections, particularly those
involving the nails and the feet (tinea pedis).COMMON ANTIFUNGAL MEDICATIONS
FOR TREATING TINEA
econazole (topical) fluconazole (oral)
griseofulvin (oral) itraconazole (oral)
ketoconazole (topical and oral) miconazole (topical)
naftifine (topical) oxiconazole (topical)
sertaconazole (topical) terbinafine (topical and oral)Risk Factors and Preventive Measures
Common environmental settings in which der-
matophytes thrive include communal showers,
spas, and swimming pools. Wearing water socks or
sandals when walking on wet surfaces helps pro-
tect the feet from contact with the fungi. Tinea
can be an opportunistic infection in people who
are IMMUNOCOMPROMISED, such as those taking
IMMUNOSUPPRESSIVE THERAPYfollowing ORGAN TRANS-
PLANTATIONor who have HIV/AIDS.
See also ALOPECIA AREATA; CANDIDIASIS; DERMATI-
TIS; ERYSIPELAS; FUNGUS; IMPETIGO; KERATINOCYTE;
LESION; ONYCHOMYCOSIS; PAPULE; PSEUDOFOLLICULITIS
BARBAE; PSORIASIS; TINEA VERSICOLOR; VESICLE.tinea versicolor A fungal INFECTION of the SKIN
that causes areas of altered pigmentation, usually
darkened patches. Unlike other forms of TINEA,204 The Integumentary System