Superficial fungal infection of the skin : Tine Corporis and Tinea Pedis

Superficial fungal infection of the skin : Tine Corporis and Tinea Pedis

Tinea corporis

Tinea corporis is dermatophytosis of the glabrous skin of the trunk and extremities. Lesions are round, scaly patches that have a well defined, enlarging border and a relatively clear central portion. The active edge often contains follicular papules. Itching is variable and not diagnostic
Tinea corporis can assume a giant size (Tinea incognito) when steroids are applied for cosmetic reasons or as a result of miss diagnosis.

Differential Diagnosis (DDx) Lichen simplex chronicus, numular eczema, atopic eczema, psoriasis, lichen planus.

Investigation

KOH from active edge of lesion.
Culture for fungus only in doubtful cases if the KOH is negative.

Treatment

Small and single lesion can be treated with topical agents. Clotrimazole 1%, ketoconazole 2%, meconazole 1%. BID for two weeks Systemic: ketoconazole 2-4mg per kg of weight for 10 days. Itraconazole and fluconazole are choices if available. Griseofulvin is also effective for the treatment of Tinea corporis.

Tinea pedis

Tinea pedis is fungal infection of the feet and is usually related to sweating and warmth, and use of occlusive footwear. Men between 20 and 40 years of age are most frequently affected.

The infection often presents as white, macerated areas in the 3rd or 4th toe webs. It may also present with a classic pattern on the dorsal surface of the foot or as chronic dry, scaly hyperkeratosis of the soles and heels. Itching is also common with vesicular or hullous lesion.

It is transmitted by direct contact or sharing of shoes, towels or bath.

Treatment

Topical anti fungal creams or ointments applied regularly for 4 - 6 wks. Systemic treatments provide better skin penetration than most topical preparations, Itraconazole, terbinafine and griseofulvin are good choices for oral therapy.

Itraconazole and terbinafine are more effective than griseofulvin. Once-weekly dosing with fluconazole is another option, especially in noncompliant patients.

Personal hygiene (foot hygiene) is highly advised.

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Superficial fungal infection of the skin : Tine Corporis and Tinea Pedis 2018-12-23T07:38:00-08:00 Rating: 4.5 Diposkan Oleh: David Maharoni