Tinea

Background

• Fungal infection caused by dermatophytes that feed on keratin

Tinea Types

• Tinea capitis (head)
• Tinea corporis (body)
• Tinea pedis (foot)
• Tinea cruris (groin)

Tinea Corporis

Tinea Capitis

Clinical Features

Tinea cruris

• Scaly, with variable pruritus
• Corporis: ring appearance with central clearing
• Capitis: patchy alopecia

Differential Diagnosis

• Pityriasis rosea
• Lichen planus
• Psoriasis
• Eczema
• Contact dermatitis

Evaluation

• Clinical diagnosis with Wood's lamp
• Kerion
  • Painful, itchy, eczematous
  • Hair loss
  • Fever, malaise
  • Lymphadenopathy

Management

• Topical antifungal treatment for all except tinea capitis
• Clotrimazole 1% BID x2-3wk
  • Must use for 7-10d beyond resolution of lesions
• Capitis
  • Griseofulvin 20-25mg/kg/d or BID
    • Usually requires 8wk of treatment
  • Selenium or ketoconazole shampoos are adjunct treatment
  • Okay for child to go to school
• Kerion
  • Oral griseofulvin, itraconazole, or terbinafine for 6-8 wks
  • Cephalexin 40mg/kg/d in 4 divided doses in addition to systemic antifungal treatment if there is evidence or high risk of bacterial secondary infection
  • Ketoconazole shampoo, isolated towels decrease spread to household members

Disposition

• Discharge

See Also

• Rashes
• Dermatophytosis

References

Authors

Ross Donaldson