ringworm

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Ringworm

 

Definition

Ringworm is a common fungal infection of the skin. The name is a misnomer since the disease is not caused by a worm.

Description

More common in males than in females, ringworm is characterized by patches of rough, reddened skin. Raised eruptions usually form the circular pattern that gives the condition its name. Ringworm may also be referred to as dermatophyte infection.
As lesions grow, the centers start to heal. The inflamed borders expand and spread the infection.

Types of ringworm

Ringworm is a term that is commonly used to encompass several types of fungal infection. Sometimes, however, only body ringworm is classified as true ringworm.
Body ringworm (tinea corporis) can affect any part of the body except the scalp, feet, and facial area where a man's beard grows. The well-defined, flaky sores can be dry and scaly or moist and crusty.
Scalp ringworm (tinea capitis) is most common in children. It causes scaly, swollen blisters or a rash that looks like black dots. Sometimes inflamed and filled with pus, scalp ringworm lesions can cause crusting, flaking, and round bald patches. Most common in black children, scalp ringworm can cause scarring and permanent hair loss.
Ringworm of the groin (tinea cruris or jock itch) produces raised red sores with well-marked edges. It can spread to the buttocks, inner thighs, and external genitals.
Ringworm of the nails (tinea unguium) generally starts at the tip of one or more toenails, which gradually thicken and discolor. The nail may deteriorate or pull away from the nail bed. Fingernail infection is far less common.

Causes and symptoms

Ringworm can be transmitted by infected people or pets or by towels, hairbrushes, or other objects contaminated by them. Symptoms include inflammation, scaling, and sometimes, itching.
Diabetes mellitus increases susceptibility to ringworm. So do dampness, humidity, and dirty, crowded living areas. Braiding hair tightly and using hair gel also raise the risk.

Diagnosis

Diagnosis is based on microscopic examination of scrapings taken from lesions. A dermatologist may also study the scalp of a patient with suspected tinea capitis under ultraviolet light.

Treatment

Some infections disappear without treatment. Others respond to such topical antifungal medications as naftifine (Caldesene Medicated Powder) or tinactin (Desenex) or to griseofulvin (Fulvicin), which is taken by mouth. Medications should be continued for two weeks after lesions disappear.
A person with body ringworm should wear loose clothing and check daily for raw, open sores. Wet dressings applied to moist sores two or three times a day can lessen inflammation and loosen scales. The doctor may suggest placing special pads between folds of infected skin, and anything the patient has touched or worn should be sterilized in boiling water.
Infected nails should be cut short and straight and carefully cleared of dead cells with an emery board.
Patients with jock itch should:
  • wear cotton underwear and change it more than once a day
  • keep the infected area dry
  • apply antifungal ointment over a thin film of antifungal powder
Shampoo containing selenium sulfide can help prevent spread of scalp ringworm, but prescription shampoo or oral medication is usually needed to cure the infection.

Alternative treatment

The fungal infection ringworm can be treated with homeopathic remedies. Among the homeopathic remedies recommended are:
  • sepia for brown, scaly patches
  • tellurium for prominent, well-defined, reddish sores
  • graphites for thick scales or heavy discharge
  • sulphur for excessive itching.
Topical applications of antifungal herbs and essential oils also can help resolve ringworm. Tea tree oil (Melaleuca spp.), thuja (Thuja occidentalis), and lavender (Lavandula officinalis) are the most common. Two drops of essential oil in 1/4 oz of carrier oil is the dose recommended for topical application. Essential oils should not be applied to the skin undiluted. Botanical medicine can be taken internally to enhance the body's immune response. A person must be susceptible to exhibit this overgrowth of fungus on the skin. Echinacea(Echinacea spp.) and astragalus (Astragalus membranaceus) are the two most common immune-enhancing herbs. A well-balanced diet, including protein, complex carbohydrates, fresh fruits and vegetables, and good quality fats, is also important in maintaining optimal immune function.

Prognosis

Ringworm can usually be cured, but recurrence is common. Chronic infection develops in one patient in five.
It can take six to 12 months for new hair to cover bald patches, and three to 12 months to cure infected fingernails. Toenail infections do not always respond to treatment.

Prevention

Likelihood of infection can be lessened by avoiding contact with infected people or pets or contaminated objects and staying away from hot, damp places.

Resources

Other

"Ringworm." YourHealth.com Page. April 7, 1998. 〈http://www.yourhealth.com〉.

ringworm

 [ring´werm]
the popular name for tinea, a fungal infection of the skin, even though it is not caused by a worm and is not always ring-shaped in appearance. (See types under tinea.) It is caused by a group of related fungi that feed on the body's waste products of dead skin and perspiration; they attack the skin in various areas, especially body folds such as the armpit and crotch. One type found between the toes is tinea pedis or athlete's foot; another affects the soles and toenails. Some forms, usually found in children and traceable to exposure to infected pets, attack the scalp or exposed areas of the body such as the arms or legs. These infections appear as reddish patches, often scaly or blistered, with itching, soreness, and sometimes destruction of hair shafts. They may become ring-shaped as the infection spreads out while its center heals or seems to heal.



The fungi are highly contagious and are spread by humans, animals, and even objects, such as combs or towels handled by infected persons. Scratching is almost certain to pass the infection from one part of the body to another.

Ringworm is treated with antifungal drugs. Prevention is largely a matter of cleanliness. All parts of the body should be washed with soap and water, especially hairy areas and body folds where perspiration is likely to collect. Thorough drying is as important as bathing, for the fungi thrive in warm dampness.

tin·e·a

(tin'ē-ă),
A fungus infection (dermatophytosis) of the keratin component of hair, skin, or nails. Genera of fungi causing such infection are Microsporum, Trichophyton, and Epidermophyton.
Synonym(s): ringworm, serpigo (1)
[L. worm, moth]

ringworm

/ring·worm/ (ring´-werm) tinea.

ringworm

(rĭng′wûrm′)
n.
Any of a number of contagious skin diseases caused by several related fungi, characterized by ring-shaped, scaly, itching patches on the skin and generally classified by the location on the body. Also called tinea.

ringworm

See tinea.
A skin infection by mould-like fungi known as dermatophytes—e.g., Trichophyton rubrum, T mentagrophytes, Microsporium canis, M gypsum, rarely also Epidermophyton spp; in children, T canis is the most common agent
DiffDx Nonfungal dermatopathies—e.g., erythema annulare, ‘herald patch’ of pityriasis rosea, atopic dermatitis, other dermatitides
Management Most resolve without therapy—otherwise, miconazole; if severe, griseofulvin

ringworm

Tinea corporis, dermatophytid; dermatophytosis Dermatology A skin infection by mold-like fungi known as dermatophytes–eg, Trichophyton rubrum, T mentagrophytes, Microsporium canis, M gypsum, rarely also Epidermophyton; in children, T canis is the most common agent Clinical types Tinea corporis; tinea capitis–scalp; tinea cruris–groin, aka jock itch; tinea pedis–feet, aka athlete's foot DiffDx Nonfungal dermatopathies–eg, erythema annulare, 'herald patch' of pityriasis rosea, atopic dermatitis, other dermatitides Treatment Most resolve without therapy; otherwise, miconazole, if severe, griseofulvin. See Black dot ringworm, Gray patch ringworm, Tinea capitis, Tinea corporis, Tinea cruris, Tinea pedis.

tin·e·a

(tin'ē-ă)
A fungus infection (dermatophytosis) of the keratin component of hair, skin, or nails. Genera of fungi causing such infection are Microsporum, Trichophyton, and Epidermophyton.
Synonym(s): ringworm, serpigo (1) .
[L. worm, moth]

ringworm

(rĭng′wŭrm)
Enlarge picture
RINGWORM
Any contagious skin infection caused by fungi of the genera Microsporum or Trichophyton. The hallmark of these conditions is a well-defined red rash, with an elevated, wavy, or worm-shaped border. Ringworm of the scalp is called tinea capitis; of the body, tinea corporis; of the groin, tinea cruris; of the hand, tinea manus; of the beard, tinea barbae; of the nails, tinea unguium; and of the feet, tinea pedis or athlete's foot. illustration;
illustration

ringworm

See TINEA.

athlete's foot

or

tinea

or

ringworm

a fungal disease caused by Epidermophyton floccosum. The fungus can cause irritation of other parts of the body apart from the feet and is parasitic or pathogenic on nails and skin in general. Athlete's foot is most common in adolescent males and infection is caused usually by walking barefoot on infected floors.

tin·e·a

(tin'ē-ă)
Fungal infection of keratin component of hair, skin, or nails.

ringworm

an infection of the superficial layers of the skin and the hair fibers with one of a group of dermatophytic fungi. Some of the fungi are obligate parasites of animals, others have the same relationship with humans, and some are freeliving in the soil and only invade animal skins in unusual circumstances. See also tinea. The common species are trichophytonverrucosum in cattle, T. equinum in horses; in dogs and cats the infections are microsporumcanis, M. gypseum and T. mentagrophytes. In sheep and goats the infection is usually T. verrucosum and in pigs M. nanum.
The infection is very superficial and does almost no injury to animals but efforts are usually made to prevent its spread because it is highly infectious, including for humans. In companion animals this zoonotic aspect is very important in management of cases. Called also dermatophytosis.
Enlarge picture
Ringworm lesions in a horse. By permission from Knottenbelt DC, Pascoe RR, Diseases and Disorders of the Horse, Saunders, 2003

honeycomb ringworm
see favus.
References in periodicals archive ?
32) With its demonstrated inferiority to the azoles and allylamines, tolnaftate should not be considered a first- or second-line treatment for tinea infections.
Griseofulvin is taken by adults once daily at 500 mg, for 4 to 6 weeks, and has demonstrated efficacy in the treatment of tinea infections.
Tolnaftate may have some utility as a prophylactic against epidermal tinea infections in susceptible individuals.
For patients with complicated epidermal tinea infections as described above, or for those with confirmed infection and treatment failure using topical agents, oral antifungal medications should be used.
Oral ketoconazole has a limited role in the treatment of tinea infections.
Tinea infections are among the most common of all skin diseases.
1) Tinea infections occur in all age groups and in both genders; however, males have a higher incidence of tinea pedis and tinea cruris.
Table 1 reviews published data on the diagnostic value of selected clinical signs in suspected tinea infection.
Figure 3 presents a simple algorithm for diagnosis and treatment of suspected tinea infection.
Table 2 summarizes the utility of clinical diagnosis and KOH preparation in diagnosis of tinea infection.
In cases where clinical suspicion of tinea infection is high, and the result of a K0H prep is negative, tissue should be submitted for fungal culture.