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Tinea Corporis

Disease Details

Family Health Simplified

Description
Tinea corporis, commonly known as ringworm, is a superficial fungal infection of the skin characterized by red, ring-shaped, itchy rashes.
Type
Tinea corporis is a type of fungal infection, specifically a dermatophyte infection affecting the skin. It is not genetically transmitted; rather, it is acquired through direct contact with infected individuals, animals, or contaminated objects and surfaces.
Signs And Symptoms
It may have a variety of appearances; most easily identifiable are the enlarging raised red rings with a central area of clearing (ringworm). The same appearances of ringworm may also occur on the scalp (tinea capitis), beard area (tinea barbae) or the groin (tinea cruris, known as jock itch or dhobi itch).Other classic features of tinea corporis include:
Itching occurs on infected area.
The edge of the rash appears elevated and is scaly to touch.
Sometimes the skin surrounding the rash may be dry and flaky.
Almost invariably, there will be hair loss in areas of the infection.
Prognosis
Tinea corporis is moderately contagious and can affect both humans and pets. If a person acquires it, the proper measures must be taken to prevent it from spreading. Young children in particular should be educated about the infection and preventive measures: avoid skin to skin contact with infected persons and animals, wear clothing that allows the skin to breathe, and do not share towels, clothing or combs with others. If pets are kept in the household or premises, the animal should be checked for tinea, especially if hair loss in patches is noticed or the pet is scratching excessively. The majority of people who have acquired tinea know how uncomfortable the infection can be. However, the fungus can easily be treated and prevented in individuals with a healthy immune system.
Onset
Tinea corporis, commonly known as ringworm, typically has an onset characterized by red, scaly, and itchy patches on the skin. These patches often take on a circular, ring-like appearance. The infection may begin as a small area that gradually enlarges as the fungus spreads.
Prevalence
The prevalence of tinea corporis varies widely depending on geographic location, climate, and population demographics. It is more common in warm, humid environments and can affect people of all ages, particularly those with close contact with infected individuals or animals. However, exact prevalence rates are not consistently documented.
Epidemiology
Tinea corporis, commonly known as ringworm of the body, is a superficial fungal infection affecting the skin. It is caused by dermatophytes, primarily Trichophyton and Microsporum species. The infection manifests as circular, red, and itchy lesions with a raised edge.

Epidemiology:
1. Global Prevalence: Tinea corporis occurs worldwide, with higher prevalence in warm, humid climates that facilitate fungal growth.
2. Age: It commonly affects children and young adults, but individuals of any age can be infected.
3. Risk Factors: Risk factors include close contact with infected individuals or animals, sharing personal items like towels or clothing, compromised immune system, and participation in contact sports.

The disease is contagious and spreads through direct contact with infected skin or indirect contact with contaminated objects. Treatment typically involves antifungal medications, either topical or oral, depending on the severity of the infection.
Intractability
Tinea corporis, commonly known as ringworm of the body, is generally not considered an intractable disease. It is a fungal infection of the skin that typically responds well to antifungal treatments, including topical creams or oral medications. However, if the infection is not adequately treated or if the individual has a compromised immune system, it may be more challenging to eradicate.
Disease Severity
Tinea corporis, commonly known as ringworm of the body, generally has a mild to moderate severity. It is a superficial fungal infection of the skin that results in red, ring-shaped rashes with a clear center. While uncomfortable and sometimes itchy, it is usually not serious and can be treated effectively with antifungal medications.
Healthcare Professionals
Disease Ontology ID - DOID:12179
Pathophysiology
Pathophysiology:

Tinea corporis, commonly known as ringworm of the body, is a superficial fungal infection caused by dermatophytes. The most common causative organisms are Trichophyton rubrum, Trichophyton mentagrophytes, and Microsporum canis. These fungi thrive on keratin, a protein found in the outer layer of the skin. The infection typically begins with minor skin damage, allowing the fungi to invade the stratum corneum and spread centrifugally, creating an expanding, ring-like erythematous border. This border is often raised, with a clear central area, giving it the classic ring-like appearance. The infection commonly spreads through direct skin-to-skin contact or contact with contaminated objects (fomites).
Carrier Status
Carrier status is not applicable to tinea corporis, as it is a fungal infection, not a condition related to a carrier state.
Mechanism
Tinea corporis, also known as ringworm of the body, is a dermatophytic infection caused by fungi, primarily Trichophyton and Microsporum species.

**Mechanism:**
1. **Transmission and Invasion:** The fungus infects the keratinized outer layer of the skin (stratum corneum) through direct contact with infected individuals, animals, or contaminated objects (fomites).
2. **Adhesion:** The fungi adhere to the skin through specific adhesins.
3. **Keratin Degradation:** Dermatophytes secrete keratinases and other proteolytic enzymes to degrade keratin, allowing them to invade deeper layers of the stratum corneum.

**Molecular mechanisms:**
1. **Keratinase Production:** Genes coding for keratinases (e.g., Sub3, Sub6) are upregulated, facilitating keratin degradation.
2. **Immune Evasion:** Dermatophytes can evade the host immune response by secreting molecules that modulate the host's immune system, such as proteases that degrade host immune factors.
3. **Iron Acquisition:** These fungi acquire iron from the host using siderophores, which are small, high-affinity iron-chelating compounds. This is crucial for their growth and metabolism.

The fungi’s ability to attach to keratin, degrade it, and evade host defenses underpins their pathogenicity in tinea corporis.
Treatment
Most cases are treated by application of topical antifungal creams to the skin, but in extensive or difficult to treat cases, systemic treatment with oral medication may be required. The over-the-counter options include tolnaftate, as well as ketoconazole (available as Nizoral shampoo that can be applied topically).Among the available prescription drugs, the evidence is best for terbinafine and naftifine, but other agents may also work.Topical antifungals are applied to the lesion twice a day for at least 3 weeks. The lesion usually resolves within 2 weeks, but therapy should be continued for another week to ensure the fungus is completely eradicated. If there are several ringworm lesions, the lesions are extensive, complications such as secondary infection exist, or the patient is immunocompromised, oral antifungal medications can be used. Oral medications are taken once a day for 7 days and result in higher clinical cure rates. The antifungal medications most commonly used are itraconazole, terbinafine, and ketoconazole.The benefits of the use of topical steroids in addition to an antifungal is unclear. There might be a greater cure rate but no guidelines currently recommend its addition. The effect of Whitfield's ointment is also unclear.
Compassionate Use Treatment
Compassionate use treatments for tinea corporis (ringworm of the body) are typically not common, as this fungal infection is generally treatable with standard antifungal medications. However, in cases where standard treatments are ineffective or not suitable, some off-label or experimental treatments can be considered:

1. **Itraconazole**: Though commonly used for onychomycosis, itraconazole can be prescribed off-label for severe or resistant cases of tinea corporis.

2. **Voriconazole or Posaconazole**: These antifungal agents are primarily used for more serious fungal infections but can be considered in recalcitrant cases.

3. **Luliconazole**: This is a newer antifungal cream that has shown effectiveness in treating tinea infections and may be considered off-label in some regions.

4. **Photodynamic Therapy (PDT)**: This is an emerging, experimental treatment involving photosensitizing agents and light exposure, showing some promise in treating various fungal infections.

Always consult with a healthcare provider for personal medical advice and before starting any off-label or experimental treatments.
Lifestyle Recommendations
**Lifestyle Recommendations for Tinea Corporis:**

1. **Maintain Good Hygiene:**
- Bathe regularly and keep skin clean and dry.
- Change clothes, especially underwear and socks, daily.

2. **Avoid Sharing Personal Items:**
- Do not share towels, clothing, or sports equipment.

3. **Wear Loose-fitting Clothes:**
- Opt for fabrics that allow your skin to breathe, like cotton.

4. **Stay Cool and Dry:**
- Avoid excessive heat and humidity.
- Use talcum powder to keep areas prone to moisture dry.

5. **Keep Nails Short and Clean:**
- This minimizes the risk of spreading the infection through scratching.

6. **Treat Pets:**
- If you have pets, ensure they are checked for fungal infections and treated if necessary, as they can be a source of infection.

7. **Avoid Walking Barefoot in Public Places:**
- Use flip-flops in communal showers or locker rooms.

8. **Boost Immune System:**
- Eat a balanced diet, get adequate sleep, and manage stress.

Adherence to these recommendations can significantly reduce the risk of spreading or exacerbating tinea corporis.
Medication
The primary medications for treating tinea corporis (ringworm of the body) include antifungal agents. These can be topical or oral, depending on the severity of the infection.

Topical treatments:
- Clotrimazole
- Miconazole
- Terbinafine
- Ketoconazole
- Econazole

Oral treatments (for more severe or widespread infections):
- Terbinafine
- Itraconazole
- Fluconazole
- Griseofulvin

Treatment typically continues for 1 to 4 weeks, with improvement often seen within a few days of starting the medication. It is important to follow the full course of therapy to prevent recurrence.
Repurposable Drugs
For tinea corporis, also known as ringworm, several drugs originally intended for other uses are repurposable for treatment. These include:

1. **Terbinafine (LamISIL):** An antifungal that can be used topically or orally.
2. **Itraconazole (Sporanox):** An oral antifungal also used for systemic mycoses.
3. **Fluconazole (Diflucan):** Another oral antifungal used for various fungal infections.

These medications work by disrupting the synthesis of ergosterol, an essential component of fungal cell membranes, effectively treating the infection. Always consult a healthcare provider for appropriate treatment options.
Metabolites
Tinea corporis, commonly known as ringworm, is a fungal infection of the skin caused by dermatophytes. Generally, fungi, including dermatophytes, produce a variety of metabolites that can contribute to their survival and pathogenicity.

1. **Primary Metabolites**: These are essential for the basic functioning of fungi. Examples include amino acids, nucleotides, and carbohydrates.

2. **Secondary Metabolites**:
- **Mycotoxins**: Some dermatophytes can produce harmful secondary metabolites known as mycotoxins, although they are more commonly associated with other fungi.
- **Antibiotics**: Some species produce substances that inhibit bacterial growth, which can be considered a form of defense.
- **Siderophores**: These are compounds that bind and transport iron, which is essential for fungal growth but often limited in the host environment.

The specificity and impact of these metabolites can vary depending on the exact species causing the infection.
Nutraceuticals
There is limited scientific evidence directly supporting the use of nutraceuticals for the treatment of tinea corporis. Tinea corporis, commonly known as ringworm, is a fungal infection of the skin. The primary treatment involves antifungal medications, either topical or oral.

However, some nutraceuticals may support overall skin health and immune function, which can aid in the body's ability to fight infections. These include:

1. **Probiotics**: These support gut health and potentially the immune system.
2. **Vitamin D**: Adequate levels play a role in immune response.
3. **Omega-3 Fatty Acids**: These can help reduce inflammation.

Discuss any alternative treatments with a healthcare provider to ensure they don't interfere with conventional treatments.
Peptides
Tinea corporis, commonly known as ringworm, is a fungal infection of the skin. Peptides and nanotechnology are areas of ongoing research in various infectious diseases, including fungal infections. Antimicrobial peptides (AMPs) are being studied for their potential use in treating fungal infections like tinea corporis due to their ability to disrupt fungal cell membranes. Nanotechnology is also being explored to enhance the delivery and efficacy of antifungal treatments. Both fields hold promise but are mainly experimental in the context of tinea corporis treatment.