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Dermatophytosis, also known as tinea and ringworm, is a
fungal infection Fungal infection, also known as mycosis, is a disease caused by fungi. Different types are traditionally divided according to the part of the body affected: superficial, subcutaneous, and systemic. Superficial fungal infections include common ...
of the
skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different ...
(a
dermatomycosis A dermatomycosis is a skin disease caused by a fungus. Most dermatomycoses are mild and resolve without treatment, but many are treated clinically with topical antifungal medicines. Oral antifungals are also an option for treatment. One of the m ...
), that may affect skin, hair, and nails. Typically it results in a red, itchy, scaly, circular rash. Hair loss may occur in the area affected. Symptoms begin four to fourteen days after exposure. The types of dermatophytosis are typically named for area of the body that they affect. Multiple areas can be affected at a given time. About 40 types of fungus can cause dermatophytosis. They are typically of the ''
Trichophyton ''Trichophyton'' is a genus Genus (; : genera ) is a taxonomic rank above species and below family (taxonomy), family as used in the biological classification of extant taxon, living and fossil organisms as well as Virus classification#ICTV c ...
'', ''
Microsporum ''Microsporum'' is a genus of fungi that causes tinea capitis, tinea corporis, ringworm, and other dermatophytoses (fungal infections of the skin). ''Microsporum'' forms both macroconidia (large asexual reproductive structures) and microconid ...
'', or ''
Epidermophyton ''Epidermophyton'' is a genus of fungus causing superficial and cutaneous mycoses, including ''E. floccosum'', and causes tinea corporis (ringworm), tinea cruris (jock itch), tinea pedis (athlete's foot), and tinea unguium Dermatophytosis ...
'' type. Risk factors include using public showers, contact sports such as
wrestling Wrestling is a martial art, combat sport, and form of entertainment that involves grappling with an opponent and striving to obtain a position of advantage through different throws or techniques, within a given ruleset. Wrestling involves di ...
, excessive sweating, contact with animals,
obesity Obesity is a medical condition, considered by multiple organizations to be a disease, in which excess Adipose tissue, body fat has accumulated to such an extent that it can potentially have negative effects on health. People are classifi ...
, and poor immune function. Ringworm can spread from other animals or between people. Diagnosis is often based on the appearance and symptoms. It may be confirmed by either culturing or looking at a skin scraping under a
microscope A microscope () is a laboratory equipment, laboratory instrument used to examine objects that are too small to be seen by the naked eye. Microscopy is the science of investigating small objects and structures using a microscope. Microscopic ...
. Prevention is by keeping the skin dry, not walking barefoot in public, and not sharing personal items. Treatment is typically with
antifungal cream An antifungal medication, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis (thrush), serious systemic infections such as cry ...
s such as
clotrimazole Clotrimazole, sold under the brand name Lotrimin, among others, is an antifungal medication. It is used to treat vaginal yeast infections, oral thrush, diaper rash, tinea versicolor, and types of ringworm including athlete's foot and jock itc ...
or
miconazole Miconazole, sold under the brand name Monistat among others, is an antifungal medication used to treat ring worm, pityriasis versicolor, and yeast infections of the skin or vagina. It is used for ring worm of the body, groin (jock itch), a ...
. If the scalp is involved, antifungals by mouth such as
fluconazole Fluconazole is an antifungal medication used for a number of fungal infections. These include candidiasis, blastomycosis, coccidioidomycosis, cryptococcosis, histoplasmosis, dermatophytosis, and tinea versicolor. It is also used to pr ...
may be needed. Dermatophytosis has spread globally, and up to 20% of the world's population may be infected by it at any given time. Infections of the groin are more common in males, while infections of the scalp and body occur equally in both sexes. Infections of the scalp are most common in children while infections of the groin are most common in the elderly. Descriptions of ringworm date back to
ancient history Ancient history is a time period from the History of writing, beginning of writing and recorded human history through late antiquity. The span of recorded history is roughly 5,000 years, beginning with the development of Sumerian language, ...
.


Types

A number of different species of fungus are involved in dermatophytosis.
Dermatophytes Dermatophyte (from Greek '' derma'' "skin" ( GEN ''dermatos'') and ''phyton'' "plant") is a common label for a group of fungus of '' Arthrodermataceae'' that commonly causes skin disease in animals and humans. Traditionally, these anamorphic ( ...
of the genera ''
Trichophyton ''Trichophyton'' is a genus Genus (; : genera ) is a taxonomic rank above species and below family (taxonomy), family as used in the biological classification of extant taxon, living and fossil organisms as well as Virus classification#ICTV c ...
'' and ''
Microsporum ''Microsporum'' is a genus of fungi that causes tinea capitis, tinea corporis, ringworm, and other dermatophytoses (fungal infections of the skin). ''Microsporum'' forms both macroconidia (large asexual reproductive structures) and microconid ...
'' are the most common causative agents. These fungi attack various parts of the body and lead to the conditions listed below. The Latin names are for the conditions (disease patterns), not the agents that cause them. The disease patterns below identify the type of fungus that causes them only in the cases listed: * Dermatophytosis **
Tinea pedis Dermatophytosis, also known as tinea and ringworm, is a fungal infection of the skin (a dermatomycosis), that may affect skin, hair, and nails. Typically it results in a red, itchy, scaly, circular rash. Hair loss may occur in the area aff ...
(
athlete's foot Athlete's foot, known medically as ''tinea pedis'', is a common skin infection of the feet caused by a fungus. Signs and symptoms often include itching, scaling, cracking and redness. In rare cases the skin may blister. Athlete's foot fungus ...
): fungal infection of the feet **
Tinea unguium Dermatophytosis, also known as tinea and ringworm, is a fungal infection of the skin (a dermatomycosis), that may affect skin, hair, and nails. Typically it results in a red, itchy, scaly, circular rash. Hair loss may occur in the area aff ...
: fungal infection of the
fingernail A nail is a protective plate characteristically found at the tip of the digits (fingers and toes) of all primates, corresponding to the claws in other tetrapod animals. Fingernails and toenails are made of a tough rigid protein called alpha-k ...
s and
toenail A nail is a protective plate characteristically found at the tip of the digits (fingers and toes) of all primates, corresponding to the claws in other tetrapod animals. Fingernails and toenails are made of a tough rigid protein called alpha-k ...
s, and the nail bed **
Tinea corporis Tinea corporis is a fungal infection of the body, similar to other forms of tinea. Specifically, it is a type of dermatophytosis (or ringworm) that appears on the arms and legs, especially on glabrous skin; however, it may occur on any superfici ...
: fungal infection of the arms, legs, and trunk **
Tinea cruris Tinea cruris (TC), also known as jock itch, is a common type of contagious, superficial fungal infection of the groin and buttocks region, which occurs predominantly but not exclusively in men and in hot-humid climates. Typically, over the upper ...
(
jock itch Jock may refer to: Common meanings * Jock (stereotype), a North American term for a stereotypical male athlete * Jock, a derogatory term for Scottish people mostly used by the English * Short for jockstrap, an item of male protective undergarmen ...
): fungal infection of the groin area **
Tinea manuum Tinea manuum is a fungal infection of the hand, mostly a type of dermatophytosis, often part of two feet-one hand syndrome. There is diffuse scaling on the palms or back of usually one hand and the palmar creases appear more prominent. When both h ...
: fungal infection of the
hands A hand is a prehensile, multi-fingered appendage located at the end of the forearm or forelimb of primates such as humans, chimpanzees, monkeys, and lemurs. A few other vertebrates such as the koala (which has two opposable thumbs on each "han ...
and palm area **
Tinea capitis Tinea capitis (also known as "herpes tonsurans", "ringworm of the hair", "ringworm of the scalp", "scalp ringworm", and "tinea tonsurans") is a cutaneous fungal infection ( dermatophytosis) of the scalp. The disease is primarily caused by dermato ...
: fungal infection of the scalp and hair ** Tinea faciei (face fungus): fungal infection of the face **
Tinea barbae Tinea barbae is a fungal infection of the hair. Tinea barbae is due to a dermatophyte, dermatophytic infection around the bearded area of men. Generally, the infection occurs as a follicular inflammation, or as a cutaneous granulomatous lesion, i.e ...
: fungal infestation of facial hair * Other superficial mycoses (not classic ringworm, since not caused by dermatophytes) **
Tinea versicolor Tinea versicolor (also pityriasis versicolor) is a condition characterized by a skin eruption on the trunk and proximal extremities. The majority of tinea versicolor is caused by the fungus '' Malassezia globosa'', although '' Malassezia furfur' ...
: caused by '' Malassezia furfur'' ** Tinea nigra: caused by '' Hortaea werneckii''


Signs and symptoms

Infection An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...
s on the body may give rise to typical enlarging raised red rings of ringworm. Infection on the skin of the feet may cause
athlete's foot Athlete's foot, known medically as ''tinea pedis'', is a common skin infection of the feet caused by a fungus. Signs and symptoms often include itching, scaling, cracking and redness. In rare cases the skin may blister. Athlete's foot fungus ...
and in the groin,
jock itch Jock may refer to: Common meanings * Jock (stereotype), a North American term for a stereotypical male athlete * Jock, a derogatory term for Scottish people mostly used by the English * Short for jockstrap, an item of male protective undergarmen ...
. Involvement of the nails is termed
onychomycosis Onychomycosis, also known as tinea unguium, is a fungal infection of the nail. Symptoms may include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail bed. Fingernails may be affected, but it is ...
. Animals including dogs and cats can also be affected by ringworm, and the disease can be transmitted between animals and humans, making it a zoonotic disease. Specific signs can be: * red, scaly, itchy or raised patches * patches may be redder on outside edges or resemble a ring * patches that begin to ooze or develop a blister * bald patches may develop when the scalp is affected


Causes

Fungi A fungus (: fungi , , , or ; or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and mold (fungus), molds, as well as the more familiar mushrooms. These organisms are classified as one ...
thrive in moist, warm areas, such as
locker room A locker is a small, usually narrow storage compartment. They are commonly found in dedicated cabinets, very often in large numbers, in various public places such as Changing room, locker rooms, workplaces, schools, transport hubs and the like ...
s,
tanning bed Indoor tanning involves using a device that emits ultraviolet radiation to produce a cosmetic tan. Typically found in tanning salons, gyms, spas, hotels, and sporting facilities, and less often in private residences, the most common device is a h ...
s,
swimming pool A swimming pool, swimming bath, wading pool, paddling pool, or simply pool, is a structure designed to hold water to enable Human swimming, swimming and associated activities. Pools can be built into the ground (in-ground pools) or built abo ...
s, and
skin fold Skin folds or skinfolds are areas of skin that are naturally folded. Many skin folds are distinct, heritable anatomical features, and may be used for identification of animal species, while others are non-specific and may be produced either by in ...
s; accordingly, those that cause dermatophytosis may be spread by using
exercise machine An exercise machine is any machine used for physical exercise. These range from simple spring-like devices to computerized electromechanical devices to recirculating-stream swimming pools. Most exercise machines incorporate an ergometer. An ergome ...
s that have not been disinfected after use, or by sharing towels, clothing, footwear, or hairbrushes.


Diagnosis

Dermatophyte infections can be readily diagnosed based on the history, physical examination, and potassium hydroxide (KOH) microscopy.


Prevention

Advice often given includes: * Avoid sharing clothing, sports equipment, towels, or sheets. * Wash clothes in hot water with
fungicidal Fungicides are pesticides used to kill parasitic fungi or their spores. Fungi can cause serious damage in agriculture, resulting in losses of yield and quality. Fungicides are used both in agriculture and to fight fungal infections in animals, ...
soap after suspected exposure to ringworm. * Avoid walking barefoot; instead wear appropriate protective shoes in locker rooms and sandals at the beach. * Avoid touching pets with bald spots, as they are often carriers of the fungus.


Vaccination

no approved human vaccine exist against dermatophytosis. For
horses The horse (''Equus ferus caballus'') is a domesticated, one-toed, hoofed mammal. It belongs to the taxonomic family Equidae and is one of two extant subspecies of ''Equus ferus''. The horse has evolved over the past 45 to 55 milli ...
,
dogs The dog (''Canis familiaris'' or ''Canis lupus familiaris'') is a domesticated descendant of the gray wolf. Also called the domestic dog, it was selectively bred from a population of wolves during the Late Pleistocene by hunter-gatherers ...
and
cats The cat (''Felis catus''), also referred to as the domestic cat or house cat, is a small domesticated carnivorous mammal. It is the only domesticated species of the family Felidae. Advances in archaeology and genetics have shown that the ...
there is available an approved inactivated vaccine called ''Insol Dermatophyton'' (
Boehringer Ingelheim C.H. Boehringer Sohn AG & Co. is the parent company of the Boehringer Ingelheim group, which was founded in 1885 by Albert Boehringer (1861–1939) in Ingelheim am Rhein, Germany. As of 2018, Boehringer Ingelheim is one of the world's List of la ...
) which provides time-limited protection against several
trichophyton ''Trichophyton'' is a genus Genus (; : genera ) is a taxonomic rank above species and below family (taxonomy), family as used in the biological classification of extant taxon, living and fossil organisms as well as Virus classification#ICTV c ...
and
microsporum ''Microsporum'' is a genus of fungi that causes tinea capitis, tinea corporis, ringworm, and other dermatophytoses (fungal infections of the skin). ''Microsporum'' forms both macroconidia (large asexual reproductive structures) and microconid ...
fungal strains. With cattle, systemic vaccination has achieved effective control of ringworm. Since 1979 a Russian live vaccine (LFT 130) and later on a Czechoslovak live vaccine against bovine ringworm has been used. In Scandinavian countries vaccination programmes against ringworm are used as a preventive measure to improve the hide quality. In Russia, fur-bearing animals (silver fox, foxes, polar foxes) and rabbits have also been treated with vaccines.


Treatment

Antifungal treatments include topical agents such as
miconazole Miconazole, sold under the brand name Monistat among others, is an antifungal medication used to treat ring worm, pityriasis versicolor, and yeast infections of the skin or vagina. It is used for ring worm of the body, groin (jock itch), a ...
,
terbinafine Terbinafine, sold under the brand name Lamisil among others, is an antifungal medication used to treat pityriasis versicolor, onychomycosis, fungal nail infections, and ringworm including jock itch and athlete's foot. It is either oral adminis ...
,
clotrimazole Clotrimazole, sold under the brand name Lotrimin, among others, is an antifungal medication. It is used to treat vaginal yeast infections, oral thrush, diaper rash, tinea versicolor, and types of ringworm including athlete's foot and jock itc ...
,
ketoconazole Ketoconazole, sold under the brand name Nizoral, among others, is an antiandrogen, antifungal drug, antifungal, and antiglucocorticoid medication used to treat a number of fungal infections. Applied to the skin it is used for fungal skin inf ...
, or
tolnaftate Tolnaftate (INN), sold under the brand name TAGRID, among others, is a synthetic thiocarbamate used as an anti-fungal agent that may be sold without medical prescription in most jurisdictions. It is supplied as a cream, powder, spray, liquid, ...
applied twice daily until symptoms resolve — usually within one or two weeks. Topical treatments should then be continued for a further 7 days after resolution of visible symptoms to prevent recurrence. The total duration of treatment is therefore generally two weeks, but may be as long as three. In more severe cases or scalp ringworm, systemic treatment with oral medications (such as
itraconazole Itraconazole, sometimes abbreviated ITZ, is an antifungal medication used to treat a number of fungal infections. This includes aspergillosis, blastomycosis, coccidioidomycosis, histoplasmosis, and paracoccidioidomycosis. It may be given ...
,
terbinafine Terbinafine, sold under the brand name Lamisil among others, is an antifungal medication used to treat pityriasis versicolor, onychomycosis, fungal nail infections, and ringworm including jock itch and athlete's foot. It is either oral adminis ...
, and
ketoconazole Ketoconazole, sold under the brand name Nizoral, among others, is an antiandrogen, antifungal drug, antifungal, and antiglucocorticoid medication used to treat a number of fungal infections. Applied to the skin it is used for fungal skin inf ...
) may be given. To prevent spreading the infection, lesions should not be touched, and good hygiene maintained with washing of hands and the body. Misdiagnosis and treatment of ringworm with a topical steroid, a standard treatment of the superficially similar
pityriasis rosea Pityriasis rosea is a type of skin rash. Classically, it begins with a single red and slightly scaly area known as a "herald patch". This is then followed, days to weeks later, by an eruption of many smaller scaly spots; pinkish with a red edge ...
, can result in tinea incognito, a condition where ringworm fungus grows without typical features, such as a distinctive raised border.


History

Dermatophytosis has been prevalent since before 1906, at which time ringworm was treated with compounds of mercury or sometimes
sulfur Sulfur ( American spelling and the preferred IUPAC name) or sulphur ( Commonwealth spelling) is a chemical element; it has symbol S and atomic number 16. It is abundant, multivalent and nonmetallic. Under normal conditions, sulfur atoms ...
or
iodine Iodine is a chemical element; it has symbol I and atomic number 53. The heaviest of the stable halogens, it exists at standard conditions as a semi-lustrous, non-metallic solid that melts to form a deep violet liquid at , and boils to a vi ...
. Hairy areas of skin were considered too difficult to treat, so the
scalp The scalp is the area of the head where head hair grows. It is made up of skin, layers of connective and fibrous tissues, and the membrane of the skull. Anatomically, the scalp is part of the epicranium, a collection of structures covering th ...
was treated with
X-rays An X-ray (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...
and followed up with
antifungal An antifungal medication, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis (thrush), serious systemic infections such as ...
medication. Another treatment from around the same time was application of Araroba powder.


Terminology

The most common term for the infection, "ringworm", is a
misnomer A misnomer is a name that is incorrectly or unsuitably applied. Misnomers often arise because something was named long before its correct nature was known, or because an earlier form of something has been replaced by a later form to which the nam ...
, since the condition is caused by
fungi A fungus (: fungi , , , or ; or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and mold (fungus), molds, as well as the more familiar mushrooms. These organisms are classified as one ...
of several different
species A species () is often defined as the largest group of organisms in which any two individuals of the appropriate sexes or mating types can produce fertile offspring, typically by sexual reproduction. It is the basic unit of Taxonomy (biology), ...
and not by
parasitic worm Parasitic worms, also known as helminths, are a polyphyletic group of large macroparasites; adults can generally be seen with the naked eye. Many are intestinal worms that are soil-transmitted and infect the gastrointestinal tract. Other par ...
s.


Other animals

Ringworm caused by ''
Trichophyton verrucosum ''Trichophyton verrucosum'', commonly known as the cattle ringworm fungus, is a dermatophyte largely responsible for fungal skin disease in cattle, but is also a common cause of ringworm in donkeys, dogs, goat, sheep, and horses. It has a worldw ...
'' is a frequent clinical condition in
cattle Cattle (''Bos taurus'') are large, domesticated, bovid ungulates widely kept as livestock. They are prominent modern members of the subfamily Bovinae and the most widespread species of the genus '' Bos''. Mature female cattle are calle ...
. Young animals are more frequently affected. The lesions are located on the head, neck, tail, and
perineum The perineum (: perineums or perinea) in placentalia, placental mammals is the space between the anus and the genitals. The human perineum is between the anus and scrotum in the male or between the anus and vulva in the female. The perineum is ...
. The typical lesion is a round, whitish crust. Multiple lesions may coalesce in "map-like" appearance. File:Toplin des dieles tiesse vea.jpg, Multiple lesions, head File:Dieles åtoû d' l' ouy åmea.JPG, Around the eyes and on ears File:2 dieles mashale.jpg, On cheeks: crusted lesion (right) File:Viye diele did près.JPG, Old lesions, with regrowing hair File:Diele vea waerot.jpg, On neck and withers File:Dieles cawî åmea.JPG, On perineum Clinical dermatophytosis is also diagnosed in
sheep Sheep (: sheep) or domestic sheep (''Ovis aries'') are a domesticated, ruminant mammal typically kept as livestock. Although the term ''sheep'' can apply to other species in the genus '' Ovis'', in everyday usage it almost always refers to d ...
,
dog The dog (''Canis familiaris'' or ''Canis lupus familiaris'') is a domesticated descendant of the gray wolf. Also called the domestic dog, it was selectively bred from a population of wolves during the Late Pleistocene by hunter-gatherers. ...
s,
cat The cat (''Felis catus''), also referred to as the domestic cat or house cat, is a small domesticated carnivorous mammal. It is the only domesticated species of the family Felidae. Advances in archaeology and genetics have shown that the ...
s, and
horse The horse (''Equus ferus caballus'') is a domesticated, one-toed, hoofed mammal. It belongs to the taxonomic family Equidae and is one of two extant subspecies of ''Equus ferus''. The horse has evolved over the past 45 to 55 mi ...
s. Causative agents, besides ''Trichophyton verrucosum, are'' ''T. mentagrophytes'', ''T. equinum'', ''Microsporum gypseum'', ''M. canis'', and ''M. nanum''. Dermatophytosis may also be present in the
holotype A holotype (Latin: ''holotypus'') is a single physical example (or illustration) of an organism used when the species (or lower-ranked taxon) was formally described. It is either the single such physical example (or illustration) or one of s ...
of the
Cretaceous The Cretaceous ( ) is a geological period that lasted from about 143.1 to 66 mya (unit), million years ago (Mya). It is the third and final period of the Mesozoic Era (geology), Era, as well as the longest. At around 77.1 million years, it is the ...
eutriconodont Eutriconodonta is an order (biology), order of early mammals. Eutriconodonts existed in Asia (including Insular India, pre-contact India), Africa, Europe, North America, North and South America during the Jurassic and the Cretaceous periods. The ...
mammal ''
Spinolestes ''Spinolestes'' is an extinct mammal genus from the Early Cretaceous of Spain. A gobiconodontid eutriconodont, it is notable for the remarkable degree of preservation, offering profound insights to the biology of non-therian mammals.Thomas Marti ...
'', suggesting a
Mesozoic The Mesozoic Era is the Era (geology), era of Earth's Geologic time scale, geological history, lasting from about , comprising the Triassic, Jurassic and Cretaceous Period (geology), Periods. It is characterized by the dominance of archosaurian r ...
origin for this disease.


Diagnosis

Ringworm in pets may often be asymptomatic, resulting in a carrier condition which infects other pets. In some cases, the disease only appears when the animal develops an
immunodeficiency Immunodeficiency, also known as immunocompromise, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that aff ...
condition. Circular bare patches on the skin suggest the diagnosis, but no lesion is truly specific to the fungus. Similar patches may result from
allergies Allergies, also known as allergic diseases, are various conditions caused by hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include Allergic rhinitis, hay fever, Food allergy, food al ...
,
sarcoptic mange Mange () is a type of skin disease caused by parasitic mites. Because various species of mites also infect plants, birds and reptiles, the term "mange", or colloquially "the mange", suggesting poor condition of the skin and fur due to the infecti ...
, and other conditions. Three species of fungi cause 95% of dermatophytosis in pets: these are ''
Microsporum canis ''Microsporum canis'' is a pathogenic, asexual fungus in the phylum Ascomycota that infects the upper, dead layers of skin on domesticated cats, and occasionally dogs and humans. The species has a worldwide distribution. Taxonomy and evolution ...
'', ''
Microsporum gypseum ''Microsporum gypseum'' is a soil-associated dermatophyte that occasionally is known to colonise and infect the upper dead layers of the skin of mammals. The name refers to an asexual "form-taxon" that has been associated with four related biol ...
'', and ''
Trichophyton mentagrophytes ''Trichophyton mentagrophytes'' is a species in the fungal genus '' Trichophyton''. It is one of three common fungi which cause ringworm in companion animals. It is also the second-most commonly isolated fungus causing tinea infections in human ...
''.
Veterinarian A veterinarian (vet) or veterinary surgeon is a medical professional who practices veterinary medicine. They manage a wide range of health conditions and injuries in non-human animals. Along with this, veterinarians also play a role in animal r ...
s have several tests to identify ringworm infection and identify the fungal species that cause it: Woods test: This is an
ultraviolet light Ultraviolet radiation, also known as simply UV, is electromagnetic radiation of wavelengths of 10–400 nanometers, shorter than that of visible light, but longer than X-rays. UV radiation is present in sunlight and constitutes about 10% of th ...
with a magnifying lens. Only 50% of ''M. canis'' will show up as an apple-green fluorescence on hair shafts, under the UV light. The other fungi do not show. The fluorescent material is not the fungus itself (which does not fluoresce), but rather an excretory product of the fungus which sticks to hairs. Infected skin does not fluoresce. Microscopic test: The veterinarian takes hairs from around the infected area and places them in a staining solution to view under the microscope. Fungal spores may be viewed directly on hair shafts. This technique identifies a fungal infection in about 40%–70% of the infections, but cannot identify the species of dermatophyte. Culture test: This is the most effective, but also the most time-consuming, way to determine if ringworm is on a pet. In this test, the veterinarian collects hairs from the pet, or else collects fungal spores from the pet's hair with a toothbrush, or other instrument, and inoculates fungal media for culture. These cultures can be brushed with transparent tape and then read by the veterinarian using a microscope, or can be sent to a pathological lab. The three common types of fungi which commonly cause pet ringworm can be identified by their characteristic spores. These are different-appearing
macroconidia A conidium ( ; : conidia), sometimes termed an asexual chlamydospore or chlamydoconidium (: chlamydoconidia), is an Asexual reproduction, asexual, non-motility, motile spore of a fungus. The word ''conidium'' comes from the Ancient Greek word f ...
in the two common species of ''Microspora'', and typical microconidia in ''Trichophyton'' infections.David W. Scott, Colour Atlas of Animal Dermatology, Blackwell Publishing Professional 2121 State Avenue, Ames, Iowa 50014, USA; ISBN 978-0-8138-0516-0/2007. Identifying the species of fungi involved in pet infections can be helpful in controlling the source of infection. ''M. canis'', despite its name, occurs more commonly in domestic cats, and 98% of cat infections are with this organism. It can also infect dogs and humans, however. ''T. mentagrophytes'' has a major reservoir in
rodent Rodents (from Latin , 'to gnaw') are mammals of the Order (biology), order Rodentia ( ), which are characterized by a single pair of continuously growing incisors in each of the upper and Mandible, lower jaws. About 40% of all mammal specie ...
s, but can also infect pet
rabbit Rabbits are small mammals in the family Leporidae (which also includes the hares), which is in the order Lagomorpha (which also includes pikas). They are familiar throughout the world as a small herbivore, a prey animal, a domesticated ...
s, dogs, and horses. ''M. gypseum'' is a soil organism and is often contracted from gardens and other such places. Besides humans, it may infect rodents, dogs, cats, horses, cattle, and
swine Suina (also known as Suiformes) is a suborder of omnivorous, non-ruminant artiodactyl mammals that includes the domestic pig and peccaries. A member of this clade is known as a suine. Suina includes the family Suidae, termed suids, known in ...
.


Treatment


Pet animals

Treatment requires both systemic oral treatment with most of the same drugs used in humans—terbinafine, fluconazole, or itraconazole—as well as a topical "dip" therapy. Because of the usually longer hair shafts in pets compared to those of humans, the area of infection and possibly all of the longer hair of the pet must be clipped to decrease the load of fungal spores clinging to the pet's hair shafts. However, close shaving is usually not done because nicking the skin facilitates further skin infection. Twice-weekly bathing of the pet with diluted lime sulfur dip solution is effective in eradicating fungal spores. This must continue for 3 to 8 weeks. Washing of household hard surfaces with 1:10 household
sodium hypochlorite Sodium hypochlorite is an alkaline inorganic chemical compound with the formula (also written as NaClO). It is commonly known in a dilute aqueous solution as bleach or chlorine bleach. It is the sodium salt of hypochlorous acid, consisting of ...
bleach Bleach is the generic name for any chemical product that is used industrially or domestically to remove color from (i.e. to whiten) fabric or fiber (in a process called bleaching) or to disinfect after cleaning. It often refers specifically t ...
solution is effective in killing spores, but it is too irritating to be used directly on hair and skin. Pet hair must be rigorously removed from all household surfaces, and then the
vacuum cleaner A vacuum cleaner, also known simply as a vacuum, is a device that uses suction, and often agitation, in order to remove dirt and other debris from carpets, hard floors, and other surfaces. The dirt is collected into a dust bag or a plastic bin. ...
bag, and perhaps even the vacuum cleaner itself, discarded when this has been done repeatedly. Removal of all hair is important, since spores may survive 12 months or even as long as two years on hair clinging to surfaces.


Cattle

In
bovine Bovines (subfamily Bovinae) comprise a diverse group of 10 genera of medium to large-sized ungulates, including Bos, cattle, bison, African buffalo, Bubalus, water buffalos, and the four-horned and spiral-horned antelopes. The members of this gro ...
s, an infestation is difficult to cure, as systemic treatment is uneconomical. Local treatment with
iodine Iodine is a chemical element; it has symbol I and atomic number 53. The heaviest of the stable halogens, it exists at standard conditions as a semi-lustrous, non-metallic solid that melts to form a deep violet liquid at , and boils to a vi ...
compounds is time-consuming, as it needs scraping of crusty lesions. Moreover, it must be carefully conducted using
glove A glove is a garment covering the hand, with separate sheaths or openings for each finger including the thumb. Gloves protect and comfort hands against cold or heat, damage by friction, abrasion or chemicals, and disease; or in turn to provide a ...
s, lest the worker become infested.


Epidemiology

Worldwide, superficial fungal infections caused by dermatophytes are estimated to infect around 20-25% of the population and it is thought that dermatophytes infect 10-15% of the population during their lifetime.Pires, C. A. A., Cruz, N. F. S. da, Lobato, A. M., Sousa, P. O. de, Carneiro, F. R. O., & Mendes, A. M. D. (2014). Clinical, epidemiological, and therapeutic profile of dermatophytosis. ''Anais Brasileiros de Dermatología'', ''89''(2), 259–264

/ref>Oumar Coulibaly, Coralie L'Ollivier, Renaud Piarroux, Stéphane Ranque, Epidemiology of human dermatophytoses in Africa, ''Medical Mycology'', Volume 56, Issue 2, February 2018, Pages 145–161. The highest Incidence (epidemiology), incidence of superficial mycoses result from dermatophytoses which are most prevalent in tropical regions.Rajagopalan, M., Inamadar, A., Mittal, A., Miskeen, A. K., Srinivas, C. R., Sardana, K., Godse, K., Patel, K., Rengasamy, M., Rudramurthy, S., & Dogra, S. (2018). Expert Consensus on The Management of Dermatophytosis in India (ECTODERM India). ''BMC dermatology'', ''18''(1), 6

/ref> Onychomycosis, a common infection caused by dermatophytes, is found with varying prevalence rates in many countries.Hayette, M.-P., & Sacheli, R. (2015). Dermatophytosis, Trends in Epidemiology and Diagnostic Approach. ''Current Fungal Infection Reports'', ''9''(3), 164–179

/ref> ''Tinea pedis'' + onychomycosis, ''Tinea corporis'', ''Tinea capitis'' are the most common dermatophytosis found in humans across the world. ''Tinea capitis'' has a greater prevalence in children. The increasing prevalence of dermatophytes resulting in ''Tinea capitis'' has been causing
epidemic An epidemic (from Greek ἐπί ''epi'' "upon or above" and δῆμος ''demos'' "people") is the rapid spread of disease to a large number of hosts in a given population within a short period of time. For example, in meningococcal infection ...
s throughout Europe and America. In pets, cats are the most affected by dermatophytosis.Gordon, E., Idle, A., & DeTar, L. (2020). Descriptive epidemiology of companion animal dermatophytosis in a Canadian Pacific Northwest animal shelter system. ''The Canadian veterinary journal = La revue veterinaire canadienne'', ''61''(7), 763–770. Pets are susceptible to dermatophytoses caused by ''Microsporum canis'', ''Microsporum gypseum'', and ''Trichophyton''. For dermatophytosis in animals, risk factors depend on age, species, breed, underlying conditions, stress, grooming, and injuries. Numerous studies have found ''Tinea capitis'' to be the most prevalent dermatophyte to infect children across the continent of Africa. Dermatophytosis has been found to be most prevalent in children ages 4 to 11, infecting more males than females. Low
socioeconomic status Socioeconomic status (SES) is a measurement used by economics, economists and sociology, sociologsts. The measurement combines a person's work experience and their or their family's access to economic resources and social position in relation t ...
was found to be a risk factor for ''Tinea capitis''. Throughout Africa, dermatophytoses are common in hot- humid climates and with areas of overpopulation.
Chronicity A chronic condition (also known as chronic disease or chronic illness) is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term ''chronic'' is often applied when the ...
is a common outcome for dermatophytosis in India. The prevalence of dermatophytosis in India is between 36.6 and 78.4% depending on the area, clinical subtype, and dermatophyte isolate. Individuals ages 21–40 years are most commonly affected. A 2002 study looking at 445 samples of dermatophytes in patients in Goiânia, Brazil found the most prevalent type to be ''
Trichophyton rubrum ''Trichophyton rubrum'' is a dermatophytic fungus in the phylum Ascomycota. It is an exclusively clonal, anthropophilic saprotroph that colonizes the upper layers of dead skin, and is the most common cause of athlete's foot, fungal infection of ...
'' (49.4%), followed by ''Trichophyton mentagrophytes'' (30.8%), and ''Microsporum canis'' (12.6%). A 2013 study looking at 5,175 samples of ''Tinea'' in patients in Tehran, Iran found the most prevalent type to be ''Tinea pedis'' (43.4%), followed by ''Tinea unguium''. (21.3%), and ''Tinea cruris'' (20.7%).Rezaei-Matehkolaei, A., Makimura, K., de Hoog, S., Shidfar, M. R., Zaini, F., Eshraghian, M., Naghan, P. A., & Mirhendi, H. (2013). Molecular epidemiology of dermatophytosis in Tehran, Iran, a clinical and microbial survey. ''Medical Mycology (Oxford)'', ''51''(2), 203–207

/ref>


See also

*
Lichen planus Lichen planus (LP) is a chronic inflammatory and autoimmune disease that affects the skin, nails, hair, and mucous membranes. It is not an actual lichen, but is named for its appearance. It is characterized by polygonal, flat-topped, violaceous p ...
—An autoimmune disease that produces similar skin blotching to ringworm. * Mycobiota—A group of all the
fungi A fungus (: fungi , , , or ; or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and mold (fungus), molds, as well as the more familiar mushrooms. These organisms are classified as one ...
present in a particular niche like the human body.


References


Further reading

* Pietro Nenoff, Constanze Krüger, Gabriele Ginter-Hanselmayer, Hans-Jürgen Tietz (2014). ''Mycology'' – an update
Part 1: Dermatomycoses: Causative agents, epidemiology and pathogenesis
*


External links


Tinea photo library at Dermnet
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