tinea unguium


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Related to tinea unguium: scabies, Trichophyton rubrum

tinea

 [tin´e-ah]
ringworm; any of numerous different fungal infections of the skin; the specific type (depending on characteristic appearance, etiologic agent and site) usually is designated by a modifying term.
tinea bar´bae ringworm of the beard, seen on bearded parts of the face and neck; caused by Trichophyton.
tinea ca´pitis ringworm of the scalp, a fungal infection caused by various species of Microsporum and Trichophyton. Generally it is characterized by one or more small, round, elevated patches, scaling of the scalp, and dry and brittle hair.
tinea cor´poris a fungal infection of the glabrous (smooth) skin, usually due to species of Microsporum or Trichophyton.
tinea cru´ris ringworm of the groin area, starting in the perineal folds and extending onto the inner surface of the thighs; it is more common in males and is caused by Epidermophyton floccosum or species of Trichophyton; called also eczema marginatum, epidermophytosis cruris, and jock itch.
tinea fa´ciei ringworm of the face, seen on non-hairy areas of the face, often with a similar presentation to that of tinea corporis.
tinea imbrica´ta a distinctive type of tinea corporis occurring in tropical countries and caused by Trichophyton concentricum. The early lesion is circular, surrounded by a ring of scales attached along one edge; several new and larger scaling rings form later.
tinea ma´nus (tinea ma´nuum) ringworm of the hand, usually involving the interdigital spaces and palmar surfaces of the hands; it almost always accompanies tinea pedis, with the same etiologic agent for both infections.
tinea pe´dis athlete's foot.
tinea profun´da trichophytic granuloma.
tinea syco´sis an inflammatory, deep type of tinea barbae, due to Trichophyton violaceum or T. rubrum.
tinea un´guium tinea involving the nails; the invasion may be restricted to white patches or pits on the nail surface, or the lateral or distal edges of the nail may be involved first, followed by establishment of the infection beneath the nail plate.
tinea versi´color a chronic, usually asymptomatic disorder due to Malassezia furfur, marked only by multiple macular patches. Called also pityriasis versicolor.

tin·e·a un·gui·um

ringworm of the nails due to a dermatophyte.

tinea unguium

[un′gwē·əm]
a superficial fungal infection of the nails caused by various species of Trichophyton and occasionally by Candida albicans. It is more common on the toes than the fingers and can cause complete crumbling and destruction of the nails. Itraconazole and terbinafine are the drugs of choice, but they must be continued until the nail has regrown completely. See also onychomycosis.
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Tinea unguium

tinea unguium

A dermatophyte infection of the nail plate, usually caused by Trichophyton rubrum or Trichophyton mentagrophytes var. interdigitale.

tin·e·a un·gui·um

(tin'ē-ă ūng-gwī'ŭm)
Ringworm of the nails due to a dermatophyte.

tinea

(tin'e-a ) [L. tinea, bookworm]
Any fungal skin disease occurring on various parts of the body. See: dermatomycosis

Findings

There are two types of findings. Superficial findings are marked by scaling, slight itching, reddish or grayish patches, and dry, brittle hair that is easily extracted with the hair shaft. The deep type is characterized by flat, reddish, kerion-like tumors, the surface studded with dead or broken hairs or by gaping follicular orifices. Nodules may be broken down in the center, discharging pus through dilated follicular openings.

Treatment

Griseofulvin, terbinafine, or ketoconazole is given orally for all types of true trichophyton infections. Local treatment alone is of little benefit in ringworm of the scalp, nails, and in most cases the feet. Topical preparations containing fungicidal agents are useful in the treatment of tinea cruris and tinea pedis.

Personal hygiene is important in controlling these two common diseases. The use of antiseptic foot baths to control tinea pedis does not prevent spread of the infection from one person to another. Persons affected should not let others use their personal items such as clothes, towels, and sports equipment.

Tinea of the scalp, tinea capitis, is particularly resistant if due to Microsporum audouinii. It should not be treated topically. Systemic griseofulvin is quite effective.

tinea amiantacea

Sticky scaling of the scalp following infection or trauma.

tinea barbae

Barber's itch.
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TINEA CAPITIS

tinea capitis

A fungal infection of the scalp. It may be due to one of several types of Microsporum or to Trichophyton tonsurans.
See: illustration; kerion
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TINEA CORPORIS

tinea corporis

Tinea of the body. It begins with red, slightly elevated scaly patches that on examination reveal minute vesicles or papules. New patches spring from the periphery while the central portion clears. There is often considerable itching. See: illustration
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TINEA CRURIS

tinea cruris

A fungus skin disease of surfaces of contact in the scrotal, crural, anal, and genital areas.
Synonym: dhobie itch; jock itch See: illustration

tinea imbricata

Chronic tinea caused by Trichophyton concentricum. It is present in tropical regions. The annular lesions have scales at their periphery.

tinea incognita

Tinea corporis that grows rapidly and in unusual patterns after the use of topical steroids.

tinea kerion

Kerion.

tinea nigra

An asymptomatic superficial fungal infection that affects the skin of the palms. Caused by Hortaea werneckii, it is characterized by deeply pigmented, macular, nonscaly patches.
Synonym: pityriasis nigra

tinea nodosa

Sheathlike nodular masses in the hair of the beard and mustache from growth of either Piedraia hortae, which causes black piedra, or Trichosporon beigelii, which causes white piedra. The masses surround the hairs, which become brittle; hairs may be penetrated by fungus and thus split.
Synonym: piedra

tinea pedis

Athlete's foot.

tinea profunda

Majocchi's disease.

tinea sycosis

Barber's itch (2).

tinea tonsurans

Tinea capitis.

tinea unguium

Onychomycosis.
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TINEA VERSICOLOR (on back)
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TINEA VERSICOLOR (on back)

tinea versicolor

A fungus infection of the skin producing yellow or fawn-colored branny patches. A topically applied azole antifungal cream or 2% selenium sulfide lotion is effective in treating the causative agent, the fungus Malassezia furfur.
Synonym: pityriasis versicolor See: illustrationillustration

tinea unguium

onychomycosis due to fungal infection of nail plate and surrounding soft tissue (see onycho, mycosis; Table 1 and Table 2)
Table 1: Treatment of fungal infections of skin and nails
Infection siteAgent
Antimycotic agent (for the treatment of dermatophytosis)
SkinTopical allylamine (e.g. 1% terbinafine cream for 7 days)
Topical imidazoles (e.g. 2% miconazole or 1% clotrimazole for 28 days)
Topical 0.25% amorolfine
Topical 1% econazole
Topical griseofulvin spray (400 μg puff daily for 14 days)
Topical 1% sulconazole
Topical tea tree (manuka) oil
Topical undecenoate (20% zinc undecenoate + 5% undecenoic acid)
Topical Whitfield's ointment (6% benzoic acid + 3% salicylic acid)
Other topicals include: weak iodine solution 2.5%; potassium permanganate paint 1%; salicylate acid cream or alcoholic solution 3-5%; benzoic acid (Whitfield's) ointment; sodium polymetaphosphate dusting powder
Systemic terbinafine (250 mg daily for 2 weeks)
Systemic itraconazole (100 mg daily for 15 days)
Systemic griseofulvin (500 mg daily )
NailTopical amorolfine 0.25% lacquer as an adjunct to systemic treatment
Topical borotannic acid complex acid; Phytex paint (1.46% salicylic acid + 4.89% tannic acid + 3.12% boric acid)
Topical 28% tioconazole lacquer
Topical undecenoate lacquer; Monphytol paint (5% methyl undecenoate + 0.7% propyl undecenoate + 3% salicylic acid + 25% methyl salicylate + 5% propyl salicylate + 3% chlorambucil)
Other topicals: strong iodine 10% solution
Systemic terbinafine (250 mg daily for 12-16 weeks)
Systemic itraconazole (400 mg for 1 week in a month, repeated overall 3 or 4 times)
Anticandidal agent (for the treatment of candidiasis)
SkinTopical antimycotic creams (1% clotrimazole; 1% econazole; 2% miconazole)
Topical nystatin (100 000 units ± 1% tolnaftate)
Antipityriasis versicolor agent (for the treatment of pityriasis versicolor)
SkinTopical 2% ketoconazole
Topical 2.5% selenium sulphide
Topical antimycotic agents (1% clotrimazole; 1% econazole; 2% miconazole; 1% sulconazole; 1% terbinafine)
Systemic fluconazole/itraconazole/ketoconazole/miconazole/voriconazole
Table 2: Clinical presentations of onychomycosis
OnychomycosisFeature
DLSODistal and lateral subungual onychomycosis: commonest presentation of onychomycosis; hyponychium is infected by the fungus leading to hyperkeratosis of the distal nail bed; spreads proximally to cause hyperkeratosis of the proximal nail bed and onycholysis
SWOSuperficial white onychomycosis: less common than DLSO; caused by infection with Trichophyton mentagrophytes ; affecting the dorsal nail plate; may respond to topical treatments
PSOProximal subungual onychomycosis: involvement of the proximal nail bed, spreading distally; due to infection with Candida sp. , T. rubrum and Scropulariopsis brevicaulis
TDOTotal dystrophic onychomycosis: the end result of untreated DLSO, SWO or PSO
COCandidal onychomycosis: nail involvement due to local spread from a chronic paronychia (typical of patients whose hands are habitually wet), distal nail plate infection (rare - mainly affecting patients with Raynaud's), chronic mucocutaneous candidiasis (due to an inborn defect of cell-mediated immunity) or due to opportunist yeast infection of psoriatic nails
EOEndonyx onychomycosis: a rare form of onychomycosis caused by infection with T. soudanense

tin·e·a un·gui·um

(tin'ē-ă ǔng-gwī'ŭm)
Ringworm of the nails due to a dermatophyte.
References in periodicals archive ?
Morita and colleagues treated 11 patients with diabetes and tinea unguium with oral itraconazole pulse therapy.
He presented a pilot study evaluating his PCR method in 10 patients who were KOH positive for tinea unguium.