What is Tinea ?

Tinea also called as Dermatophytosis is a fungal infection that is caused by dermatophytes. Dermatophytes are a group of fungi that hosts on the dead keratin of nails, hair and skin. The infection caused by these dermatophytes can spread from animals to human or from soil to human. Some of these organisms include Microsporum canis, Tricophyton tonsurans, Tricophyton menfragophytes, Tricophyton rubrum, Epidermophyton floccosum etc. All bacteria and fungi are not infectious. They are present in all human bodies. They are infectious only when they multiply and grow. These fungal infections are favored in moist and humid conditions. These infections are contagious and spreads through direct skin to skin contact and even through clothes such as towels, bed spreads etc. The common site of the infection spreading are bathrooms, locker rooms etc.

Types
These infections are classified based on the body region affected or involved. Accordingly following are the types of tinea infections:
If the infection affects the nail it is referred as Tinea unguium or onychomycosis.
If it affects the groin region then it is called Tinea cruris.
If the infection is of scalp hair then it is Tinea capitis.
If it is of the neck or beard area then it is called as Tinea barbae.
If it affects the face then it is referred as Tinea faciale.
If it is of soles and palms it is known as Tinea mannum and Tinea pedis.
If the infection is of the extremities and the trunk it is called Tinea corporis.

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Appearance As the infection grows it forms a circle leaving the middle part of the skin to appear normal. It looks like a ring where in at the edge of the ring, the skin is protruded up giving irritation to the skin and making it look reddish and scaly. It sometimes looks like a worm under the skin. However there is nothing like that present actually. Because of that it is also called as “Ringworm”. Causes The infections are mainly caused by three types of genera which inclued Trichophyton, Microsporum and Epidermophyton. The causes of such infections are: • Moist conditions. • Atopy. • Use of common bathrooms and toilets. • Genetic predisposition. • Immunocompromised states. • Other diseases or conditions such as Cushing syndrome. • Sport activities that cause cuts, lesions, skin tears etc.
Symptoms Symptoms may be mild or severse with tinea infections. Itching is the common symptom of Tinea infections. However, the symptoms depend on various types of tinea infection which are given below: If the infection is Tinea capitis, then the symptoms are • Hair loss. • Breaking of hair at the surface of the scalp. If the infection involved is Tinea manuum, then the symptoms include • Scaling. • Erythema. If the infection is Tinea pedis, the following are the symptoms • Pustules. • Erythema. • Fissuring and macreation. • Sacling of toe-web. • Soles and lateral surface scaling. • Vesicles. • Bullae may be present. If the infection is Tinea unguim (onychomycosis), the symptoms are • Broken and dystropic nails. • Nail plate gets separated from nail bed. • Nail gets discolored like white, black, brown or yellow. • Thickened nails. If the infection is of beard and neck area or Tinea barbae, the symptoms include • Pustules. • Erythema. • Scaling. If the infection is Tinea corporis, then following are the symptoms associated • Vesicles. • Raised edges. • Scaly plaques. • Pustules. If the infection is of the groin area or Tinea crusis, the symptoms include • Raised borders. • Erythematous lesions. Diagnosis Diagnosis is usually based on the clinical appearance and history. Most of the tinea infections are diagnosed by scraping a small part of the infected skin and testing for fungus under a microscope. Usually the fungus glows under an ultraviolet light or Wood’s light. Some involve other tests like blood test.
Treatment Tinea infections are best treated through antifungal agents. Antifungal agents include creams, lotions, sprays, medicines etc. Initially topical medications such as creams or lotions are given to apply on the affected area and suppose the infection does not subside within the given treatment schedule, then oral medicines are the next option. If pets are affected, then they have to be treated with tablets. Care should be taken since the infection is contagious. Since most of the tinea infection involves pain and itching, the goal of the treatment is to reduce these symptoms. In case of the infection of scalp, then certain shampoos are prescribed. The course of the treatment depends on the infection and on the individual. It may take few weeks to few months. In case of infection of nails it is hard to be treated and the course of the treatment may take months together. Care should be taken while applying creams and lotions on the affected areas in the sense it is better to use gloves while applying the medicines as the infection

is contagious and can spread from one place to another. Wash hands with soap and water after applying the creams. If the infections involve inflammation then nonsteroidal anti-inflammatory drugs (NSAIDs) are given. However, it should be taken only by doctor’s advice. There are certain side effects involved in taking NSAIDs such as gastrointestinal problems, bleeding etc. Newer NSAIDs that do not cause side effects have been introduced in the market however they are available only through prescription. Steroids must be avoided as much as possible.

Prevention
Being hygienic is the best way to prevent tinea infections. Tinea infections can be prevented by following certain methods which are given below:
• Walking in barefoot must be avoided in public areas since they are contaminated. Try wearing slippers that cover your foot completely.
• Avoid direct contacts with the infected person since the infection is contagious.
• Change clothes such as under wear, socks everyday.
• Wash your feet with soap and water every time after playing or using locker rooms.
• Keep your feet dried especially between your toes since the fungus can multiply in moist places.
• Use talcum powder or some other medicated powders to dry your feet.
• Use antifungal powders for socks and shoes.
• Try wearing cotton clothes that absorbs moisture content.
• Don’t exchange clothes between others.
• Wash the clothes such as bed spreads, towels etc everyday.
• Wash the bathrooms and floors everyday.
• If your pets have infections take them immediately to a veterinarian.
• Nails should be kept clean and short to prevent itching and spreading of the infections.
• Sexual contact with the affected must be avoided.

Frequency
The infection occurs all over the world. Tinea pedis and onychomycosis is common in the United States where in about 3% males and 1.4% females are affected. In North American children the frequency is about 0.44%. In Nigeria about 13.4% of the children in primary schools suffered with dermatophyte infection. In Saudi Arabia around 1.9% teenage boys suffered with Tinea pedis. Similarly, in Greece about 5% people suffered with skin problems.

Article Contributed By: Shilpa V


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