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Ringworm Infection (Dermatophytosis)

Ringworm or dermatophytosis is a condition caused by a skin fungal infection found in humans, pets, domesticated animals like cattle and sheep. “Ringworm” is a term which is like a nickname because the condition is caused by several species of fungi and not parasitic worms. The fungi causing ringworm feeds on keratin, a material found in skin, hair and nails. These fungi grow in moist and warm skin but they can also penetrate on the shafts outside of hair and in the inner parts.

Up to 20% of the population can be infected of dermatophytosis or ringworm. It is common to people active in sports, wrestling and any activities involving a lot of sweat.

Sometimes misdiagnosis of ringworm is treated with topical steroid which is a standard treatment for pityriasis rosea that may result to Tinea incognito. It is a condition where in the fungus grows without features that are typical like a raised border.

Classification

Ringworm InfectionVarious types of fungi are involved. The common causative agents are Microsporum and Trichophyton dermatophytes. They attack different parts of the body leading to the following conditions:

· Dermatophytes

· Athelet’s foot or tinea pedis

· Toenails and fingernails (Tinea unguium)

· Legs, arms and trunk (Tinea corporis)

· Groin area or jock itch (Tinea cruris)

· Hands and palm (Tinea manuum)

· Scalp (Tinea capitis)

· Facial hair (Tinea barbae)

· Face or face fungus (Tinea faciei)

Signs and Symptoms

Body infections give rise to enlarging red raised ringworm rings, skin infection of the feet (athlete’s foot) and in groin (jock itch). Onychomycosis means nail involvement that may discolor, thicken, crumble and fall out. Ringworms are common in adult people. Up to 20% of population have these infections in their lives.

Dermatophytes are common during summer and alleviates during winter. Cats and dogs may also be infected and transmission from animals to human is possible.

Causes and Prevention

Fungi thrive in warm and moist areas like in locker rooms, swimming pools, tanning beds and in skin folds.

Prevention includes:

· Avoiding sharing of sports equipment, clothing, towel, shower and sheets.

· Washing the clothes in hot water using a fungicidal soap if exposure to ringworm is suspected.

· Wearing protective shoes especially in locker rooms and sandals or slippers at beach. Avoid walking barefoot.

· After exposure to suspected area for contamination risk, wash with antifungal and antibacterial soap containing tea tree oil.

· Avoid touching pets if they have bald spots because they are often fungus carriers.

Treatment

Topical agents like terbinafine, miconazole, clotrimazole, tolnaftate, and ketoconazole are antifungal treatments which should be applied twice a day until the symptoms resolve, usually 1 to 2 weeks. The topical treatments must be continued for 7 days more after symptoms has resolve to prevent fungal infection recurrence. The treatment’s total duration may be 2 weeks or it can be three weeks.

In severe cases like ringworms in the scalp, oral medications for systemic treatment are given.

Lesions are not to be touched to prevent transmission. Regular hand washing and maintaining good hygiene is essential.

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