Tinea

What is Tinea?

Tinea is a skin infection caused by several different kinds of fungus. It can occur in different areas of the body. The infections are collectively known as tinea or ringworm (even though worms or parasites are not involved).

Most people in the US have had at least one form of tinea, which is moderately infectious. The infection is usually spread by sharing towels, shoes or socks; prolonged exposure in warm, moist environments such as around swimming pools; or contact with an infected pet. It is readily treatable.

How is it diagnosed?

History is of an itchy, red rash that can grow in a ring-shaped pattern (hence the name ringworm). The most common location is between the toes, especially for males ("athlete's foot"); it can also be reported in the beard area, the groin ("jock itch"), under the fingernails or toenails, the trunk, or, in children, the scalp.

Physical exam may reveal scaly, round patches on various parts of the body including the scalp, groin, nails, feet, and the skin under the beard. As the fungus grows outward, the central area heals, leaving a red ring where the infection is active.

Some forms of tinea cause discoloration of the skin after exposure to the sun. On the skin, round, red patches grow to about an inch in diameter. On the scalp, infections may produce bald patches or scaly skin. Under a beard, an itchy scaly rash may develop. If untreated, pustules or follicular infections may develop.

Infections of the groin often show concentric rings. On the feet, dry scaling is apparent. Cracking of the skin between the toes and on the arch of the foot may occur. The nails of the toes or fingers may become red, swollen and painful. A nonspecific dermatitis may develop at other sites on the hands or feet.

Tests: Microscopic examination of skin scrapings or fungal culture may be needed to confirm the diagnosis.

How is Tinea treated?

Tinea is often treated with over-the-counter antifungal creams or solutions. If over-the-counter medications fail, more powerful oral agents are used. Topical steroid creams may be used to ease itching.

Infected skin should be kept clean and dry. Talcum or medicated powders may be used. Damp compresses may be used to clean blistered or oozing lesions. The clothing in contact with infected skin should be changed and cleaned frequently, as should towels and linen.

Medications

Information	Brand	Generic	Label	Rating
	Diflucan	Fluconazole
	Lamisil	Terbinafine
	Gyne-lotrimin	Clotrimazole
	Nizoral	Ketoconazole

What might complicate it?

Left untreated, tinea may spread across infected areas and cause allergic dermatitis, loss of hair, or extensive cracking or eroding of the skin between toes and fingers. Secondary bacterial infections can develop in cracks in the skin or in hair follicles.

Predicted outcome

The prognosis for tinea infection is excellent. There may be cosmetic damage if the infection is not treated immediately, but many of these effects are short-lived.

Alternatives

Other viral or bacterial infections may resemble a more severe tinea infection. Non-infectious skin diseases include psoriasis and seborrheic dermatitis.

Appropriate specialists

Dermatologist and infectious disease specialist.

Last updated 20 December 2011