Tinea Disease

DESCRIPTION

A fungal infection of the scalp often called "ringworm." The infection results from contact with infected persons or animals. It is contagious and may become epidemic. Affected areas of the scalp can show characteristic black dots resulting from broken hairs.

System(s) affected: Skin/Exocrine
Genetics: N/A
Incidence/Prevalence in USA: Although still common, the incidence and prevalence have markedly dropped over the past 30 years
Predominant age: Children particularly ages 3 to 9. Adult infection is rare.
Predominant sex: Male = Female

SIGNS AND SYMPTOMS

Infection commonly begins with round patches of scale (alopecia less common)
Frequently, infection will take on the patterns of chronic scaling with little inflammation or marked inflammation and alopecia. Less frequently, patients will present with multiple patches of alopecia and characteristic black dot pattern of broken hairs. Extreme inflammation results in kerion (exudative pustular nodulation).

CAUSES

90% Trichophyton tonsurans
10% Microsporum species (canis, audouinii, gypseum)

RISK FACTORS

Day-care centers or schools
Living in confined quarters
Poor hygiene
Immunosuppression

LABORATORY

Microscopy of a KOH preparation of hairs from affected area can show arthrospores that appear within hair shafts
Fungal culture of hairs from affected areas allows the infection to be confirmed and the causative organism to be identified

Drugs that may alter lab results: N/A
Disorders that may alter lab results: N/A

PATHOLOGICAL FINDINGS

Chronic inflammation
Superficial infection producing lesions with follicular pustules, abscess
Hyphae in follicles, keratin of skin

SPECIAL TESTS

Viewed under a Wood's lamp, the 10% of infections caused by Microsporum species will fluoresce a light green. 90% of tinea capitis infections, those caused by Trichophyton, will NOT fluoresce.

IMAGING

N/A

DIAGNOSTIC PROCEDURES

N/A

APPROPRIATE HEALTH CARE

Outpatient

GENERAL MEASURES

Careful hand washing
Launder towels, clothing, head wear of infected individual
Check other family members

SURGICAL MEASURES

N/A

ACTIVITY

No restrictions

DIET

No special diet except persons treated with griseofulvin should not be on a restricted fat diet

PATIENT EDUCATION

KidsHealth at the AMA: www.ama-assn.org/insight/h_focus/nemours/infectio/childhd/fungi.htm
Information from your family doctor: http://familydoctor.org/handouts/316.html

PREVENTION/AVOIDANCE

Good personal hygiene
Don't share head wear
Identification and treatment of infected individuals and household pets

POSSIBLE COMPLICATIONS

Permanent scarring and hair loss from kerion

EXPECTED COURSE AND PROGNOSIS

Without treatment lesions will usually spontaneously heal in 6 months. Lesions with marked inflammation will spontaneously resolve much more rapidly but are more likely to leave scarring.

ASSOCIATED CONDITIONS

N/A

AGE-RELATED FACTORS

Pediatric: Highest incidence in this age group
Geriatric: N/A
Others: N/A

PREGNANCY

Oral antifungals are contraindicated in pregnancy

OTHER NOTES

N/A

ABBREVIATIONS

N/A

Clinical Investigations

ROLE OF HOMOEOPATHY

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Tinea Disease

Clinical Investigations

ROLE OF HOMOEOPATHY

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