| ID | 204 |
|---|---|
| Name | RING-WORM (Tineas) |
| Cause | |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | Investigation: 1. Blood for sugar. 2. Urine for sugar. 3. Stool for R/M/E to see ova of worms. 4. Skin scraping of hairs & nail shavings for M/E & C/S. |
| Management | Management: A. Local management 1 Lotio iodine or pot. permanganate for local application. 2. Unguentum whitfield to apply locally twice daily unitill disappearance of lesions. Composition: Acid salicylic 15gr., acid benzoic 30 gr. & vaseline lOz. Or, 3. 1% Clotrimazole liquid or cream apply 2-3 times daily till the lesions persists. Or, 4. 2% Tolnaftate cream or solution apply 2-3 times daily till the lesion persists. 5. Advice - a. Affected area must be kept dry. b. Apply powder to avoid the contact of water. c. Avoid soap because it removes the seloum from the skin which is a protective layer against fungus. B. Systemic management 1. Fluconazole tablet or syrup- for tinea pedis, corporis, cruris, versicolor & dermal candidiasis 50mg daily, or, 150mg weekly for 4-6 weeks; (for tinea pedis up to 6 weeks). Or, Griseofulvin tablet 500mg or, syrup 250mg/5ml- up to 6 years, 5ml (1 tsf) twice daily after food (p.c); 7-12 years, 5ml (1 tsf) three times daily (p.c); Adult, 500mg (1 tablet) twice daily (morning & evening). These should be given in full stomach or after meal for 4-6 weeks usually. But in case of tinea capitis & tinea unguium for 5-9 months. 2. Chlorpheniramine maleate 5-10mg three times daily. 3. Antibiotic, if there is sign of bacterial infection. 4. Nail avulsion with griseofulvin in tinea unguium. 5. Systemic steroid with griseofulvin in case of inflammatory tinea capitis.2 C. General measures: 1. Avoid using of others comb & clothings. 2. Clothes should be boiled daily. 3. Avoid contact with infected animal e.g. dogs, cats, rats, cows, etc. 4. If diabetic control it. |
| Introduction | This is the inflammatory disease of the skin, hair & nails caused by the superficial fungus called dermatophytes & disease is known as dermatophytosis or superficial fungal infection or superficial mycotic infection or tineasis or ring worm. According to the region of infection, the name varies. Common dermatophytes are Trichophyton, Epidermophyton, Microsporum. Candidias, ptyriasis versicolor and tiniea nigra also caused by mycoses, but are traditionally not termed as dermatophytosis. |
| History | |
| Etiology | |
| Clinical Features | |
| Preventions | |
| Treatment | |
| Complications | |
| Prognosis | |
| Types | A. TINEA CORPORIS (Body ring worm) 1. Adult & older people usually the farmers are commonly affected & infection comes from animals or birds. 2. Lesions consist of itching, reddened and scaly, vesicular or pustular circular patches with well defined, spreading, slightly raised active margin & healed up centre. B. TINEA C APITIS (Ring worm of scalp) 1. It occurs commonly in children. 2. A ring shaped or circular lesion with itching and slight scaly in the scalp. 3. Small area of baldness on the scalp where hairs are found broken at the level of the skin & the root of the hairs look at black spot & this type of lesion is known as black-dot tinea. 4. Slight itching & the hairs can be pulled out without pain. 5. Kerion formation- Multiple inflammatory pustule along the margin of hair root. C. TINEA CRURIS 1. It occurs in younger adults & older people. 2. Erythematous & scaly, vesicular, crusted or pustular circular patch with well defined inflammed margin & healed up centre. 3. It occures mostly in the groin. 4. Severe itching & more in summer. D. TINEA PEDIS: (Athlet’s foot) 1. Affects the younger people & commonly the athlets or sportsman. 2. It also occur in persons who keep foot moist or wearing shoes during whole day with socks. 3. Cracking, scaling of the margin of foot. 4. Thickening of the sole & multiple vesicular lesion. 5. In interdigital types the affection begins from the in between area of 3rd & 4th toe where the skin becomes macerated. E. TINEA UNGUIUM 1. This is commonly seen in great toes. 2. The affected nail becomes whitish & starts breaking from periphery. 3. Nail becomes britle & hypertrophied. F. TINEA VERSICOLOR This is a fungal infection usually of the trunk which causes brownish scaly lesions of varying size which may coaleasce. It may, however resemble vitiligo because only the unaffected skin pigments in sunbathers. Diagosis is made by skin scrapings. An application of 2.5% selenium sulphide repeated after a week may be sufficient. Topical imidazole (miconazole, clotrimazole) may be used for groin for several weeks. Grisofulvin in that case not effective. Fluconazole 400mg single dose is sufficiant to cure. |
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