Microbiology department Grand Round- Tinea infections

You are invited to a Microbiology department Grand Round, title  Tinea infections

Program:

1. Opening Remarks-Session- Chair/Co-chair
2. Disease spectrum and clinical presentation, differential diagnosis -Dr. Grace Mulyowa
3. Causes, Epidemiology, Risk factors –Dr(C). Barbra Tuhamize PhD(c)
4. Laboratory Diagnosis-Ms. Pauline Nalumaga
5. Treatment considerations and options-Dr. Denis Ocaya
6. Disease prevention and closing Remarks-Session Chair/Co-chair

Session chair– Assoc.Prof. Joel Bazira

Session Co-chair -Dr(c) Kennedy Kasaza PhD ©

Tinea is a fungal infection of the skin. Tinea on the body or scalp is sometimes known as ringworm. This is because it can cause red patches on the skin in the shape of rings. However, worms do not cause it. Different types of fungi cause it.

Tinea infection can affect any part of the body. Tinea infections of the feet, nails, and genital area. Nevertheless, it most often occurs in moist areas of the body and around hair. The fungus can be spread from person to person.

Different types of fungal (tinea) infections are named for where they occur on the body. The most common types are:

• Athlete’s foot (tinea pedis).This common type occurs on the feet and between the toes. It may be caused by sweating, not drying the feet after swimming or bathing, wearing tight socks and shoes, and warm weather.
• Jock itch (tinea cruris).This rash occurs in the groin. Jock itch may be hard to cure. This condition is more common in men and rare in women. It happens more often in warm weather.
• Scalp ringworm (tinea capitis). Scalp ringworm occurs on the head. It’s very contagious but rare in adults.
• Nail infection (tinea unguium or onychomycosis). This is an infection of the toenails, and sometimes fingernails. It causes thickened, deformed, and discolored nails instead of a rash.
• Body ringworm (tinea corporis). This occurs anywhere on the body. However, it is more common in skin folds. It is also more common in warmer climates

What causes tinea infection?

The fungus that causes tinea is very common all over the world. It is very contagious. The fungus is spread through direct contact with:

• An infected person
• Infected objects such as towels, clothing, and combs
• An infected animal
• Infected soil

It can take days or up to 2 weeks before you develop the infection after being in contact with the fungus. The fungi that cause ringworm can live for a long time on objects. Because of this, you may not know the exact source.

Who is at risk for tinea infection?

You are more at risk for tinea infection if you:

• Live in a warm climate (Like here in Africa – Uganda)
• Have contact with people or pets that have tinea
• Play contact sports, such as wrestling
• Use communal baths or locker rooms
• Share towels, clothing, combs, or brushes
• Have poor hygiene
• Have a depressed immune system because of disease or medicine
• Don’t have good nutrition

Symptoms of tinea infection?

• Symptoms can occur a bit differently in each person.

Symptoms of athlete’s foot (tinea pedis) may include:

• Itchy, burning rash on the feet
• Whitening and breakdown of the skin between the toes
• Scaling of the feet
• Blisters on the feet

Symptoms of jock itch (tinea cruris) may include:

• Red/dark, ring-like patches in the groin area and inner thighs, but not scrotum
• Itching in the groin area
• Pain in the groin area

Symptoms of scalp ringworm (tinea capitis) may include:

• Red, scaly rash on the scalp
• Itching of the scalp
• Hair loss on the scalp
• Enlarged lymph node

Symptoms of nail infection (tinea unguium, onychomycosis) may include:

• Thickening of the ends of the nails
• Yellow color to the nails

Symptoms of body ringworm (tinea corporis) may include:

• Red, ring-shaped patches with raised, scaly edges
• Itching

The symptoms of tinea infection can be like other health conditions. Psoriasis, pityriasis rosea, and atopic dermatitis all look similar. Make sure to see your healthcare provider for a diagnosis.

How is tinea infection diagnosed?

Your healthcare provider will ask about your symptoms and health history. They will give you a physical exam. The physical exam will include looking closely at your skin or nails. You may also have tests, such as:

• Skin scraping.The healthcare provider may scrape the top of your skin with a small tool. This does not hurt. The scraped tissue is looked at with a microscope. This test can confirm the diagnosis.
• If the infection is on the scalp or in the nails, the provider will take samples of hair or nail clippings to look at with a microscope to identify the fungus.
• Skin culture.A sample of skin may be sent to a lab to see what kind of fungus is growing. This is called a culture

How is tinea infection treated?

Tinea may be hard to cure. Scalp ringworm and nail infection are hardest to treat. The length of the treatment depends on the location of the tinea. Fungi can live for a long time on the skin. Because of this, tinea infection is hard to cure and can come back easily. Treatment may need to be repeated.

Treatment of athlete’s foot (tinea pedis) may include:

• Antifungal cream
• Antifungal Tablets

Treatment of scalp ringworm (tinea capitis) may include:

• Antifungal medicine by mouth for weeks or months
• A special shampoo to help kill the fungus. Shampoos are used along with oral medicine. They will not get rid of the fungus by themselves.

Treatment of nail infection (tinea unguium) may include:

• Antifungal medicine tablets for weeks or months. This is the most effective treatment.
• Medicated nail lacquers. These are occasionally helpful.
• Treatment of body ringworm (tinea corporis) may include:
  • Antifungal cream
  • Antifungal medicine by mouth

During treatment:

• Do not scratch at the rash or pick at the rash. This can cause infection and scarring, or spread the rash to other areas.
• Take medicine as prescribed. If you were prescribed a cream, apply it exactly as directed. Put the cream on the rash and on the skin 1 or 2 inches around the rash.
• Scrub your hands with warm water and soap for at least 20 seconds before and after you use the medicine on the rash. This will keep from spreading the fungus.
• Take medicine tablets as directed until your healthcare provider says to stop.
• Keep tinea from spreading to others. It can be spread by skin-to-skin contact and sharing personal items, such as brushes, shoes, or towels.
• When you wash the area of your body that has ringworm, wash your hands before touching any other part of your body. Use a different towel to dry the rest of your body to prevent spreading the ringworm. Wash towels in hot, soapy water.
• Keep the part of your body that has ringworm clean and dry.
• Wear shower shoes in public pools, gyms, locker rooms, and public showers. Ringworm can live on gym equipment for a long time.
• Talk with your healthcare providers about the risks, benefits, and possible side effects of all treatments.

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