Dermatophyte (ring worm)
fungi
Definition
Dermatophytes or ringworm fungi invade keratin and cause skin and nail
infections.
Tinea Capitis: Tinea capitis is a ringworm infection of the scalp, which
occurs in small children especially of African origin. Infection is spread by
close contact. Lesions are single or multiple erythematous, scaly,
well-demarcated patches on the scalp that gradually spread. Hairs within the
patch break off giving a patch of alopecia. A kerion is a boggy swollen mass
containing pus and exudate. It is a form of immune response to the fungus.
Prolonged courses of oral terbinafine, itraconazole or griseofulvin are
effective even in kerion.
Tinea Pedis: Tinea pedis or athlete’s foot is the most common
dermatophyte infection. Infection is spread by contact with shed spores.
Patients develop itchy or painful, erythematous scaling lesions between the
toes. It may be acute self-limiting or a persistent chronic infection. Topical
antifungal agents are usually effective if applied regularly.
Tinea Unguium: Nail infection with ringworm is common especially in the
elderly. Patients develop asymmetrical discoloured (white/yellowish black)
thickened nails with crumbling white material under the nail plate. This
condition may respond to a prolonged course of systemic antifungals as for
tinea capitis.
Tinea Cruris: Tinea cruris affects the groin with erythema and scaling
is surrounded by a well-defined edge. Infection may extend over the perianal
region. If mild, treatment is with topical antifungals. Severe or refractory
cases require oral antifungals as for tinea capitis.
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