“RING WORM”
(Dermatophyte
infections) (Tinea)
·
Ringworm is a common fungal infection of the skin and is not due
to a worm.
·
The medical term for ringworm is tinea. The condition is further named for the site
of the body where the infection occurs.
·
Ringworm causes a scaly, crusted rash that may itch.
·
Ringworm occurs in people of
all ages, but it is particularly common in children. Ringworm is contagious and
can be passed from person to person by contact with infected skin areas or by
sharing combs and brushes, other personal care items, or clothing. It is also
possible become infected with ringworm after coming in contact with locker room
or pool surfaces. The infection can also affect dogs and cats, and pets may
transmit the infection to humans. It is common to have several areas of
ringworm at once in different body areas.
Causative
organism:
Ø 3
species are responsible
-
Trichophyton ( Skin,
Hair, Nail)
-
Microsporum (Skin,
Hair)
-
Epidermophyton (Skin,
Nail)
Predisposing
factors:
-
Warm humid climate
-
Poor hygienic &
Nutrition
-
Contact with infected
person
-
Obesity
-
Debilitating diseases –
Age of patient, Cancers, Tuberculosis
-
Areas more prone to
friction e.g.- Axilla, Thighs.
Types:
-
Tinea capitis
-
Tinea corporis
-
Tinea barbae
-
Tinea faciei
-
Tinea cruris
-
Tinea pedis &
Mannum
-
Tinea unguium (
Onychomycosis)
General
features:
•
The word Tinea means “Moth
eaten”
• In
this condition circular “Ring like” lesions are produced which progress
to the periphery while the central parts is healed. They are seen on the
advancing periphery.
• It
is a pea sized, pale, red, well defined slightly raised macule, it becomes
Scaly soon.
• Clears
in the centre & Spreads, peripherally presenting vesicles & Macular.
• Itching
is severe
Types:
Ø
Tinea capitis – Scalp
ring worm (Occipital & Temporal
region).
Mode
of transmission - Spreads by caps, Barber’s instruments, Hair brushes,
combs
Ringworm
of the scalp commonly affects children, mostly in late childhood or
adolescence. This condition may spread in schools. Tinea capitis appears as scalp scaling that is
associated with bald spots (in contrast to seborrhea or dandruff, for instance,
which do not cause hair loss).
Type:
§ Black
dot patch
§ Gray
patch with scales.
§ Inflammatory
lesion with itching, redness.
§ “Favus”-
Circular yellow cups made of fungus material surround the hair follicles. (which from Honey comb like masses)
Ø
Tinea corporis: (Body ring worm)
Can
appear anywhere on the body.
When fungus affects the skin of the body, it often
produces the round spots of classic ringworm. Sometimes, these spots have an
"active" outer border as they slowly grow and advance. It is
important to distinguish this rash from other even more common rashes, such as
nummular eczema. This condition, and others, may appear similar to ringworm,
but they are not due to a fungal infection and require different treatment.
Ø
Tinea faciei (faciale):
Ringworm on the face except in the area of the
beard. On the face, ringworm is rarely ring shaped. Characteristically, it
causes red, scaly patches with indistinct edges.
Ø
Tinea barbae
( Face) “barber's itch”
Mode
of transmission - Barber’s
instrument
Ringworm of the bearded area of the face and neck,
with swelling and marked crusting, is often accompanied by itching, sometimes
causing the hair to break off. In the days when men went to the barber daily
for a shave, tinea barbae was called barber's itch. Common in adult male.
Type:
§ Non
inflammatory type spreading peripherally & clear at centre.
§ Inflammatory
type – Deeper infection containing pustules.
Ø
Tinea cruris:
“Dhobi’s itch”- (jock
itch).
This is often called 'jock itch'
because it occurs in sportspeople and is common among young men. It causes an
itchy, red rash in your groin and the surrounding area and is usually seen in
men who’ve been sweating a lot. Often you’ll also have athlete's foot, as the
infection can be spread by scratching your groin after scratching your infected
feet. Inner parts of thighs, Groin.
Ø
Tinea pedis ( Foot)
Athlete's foot & Tinea Mannum( Hands):
Plantar surface of foot & palmar surface
of Hands.
Mode
of transmission - The infection is
contacted from the bath rooms or urinals.
Athlete's foot (tinea pedis and tinea manuum).
Around one in four adults have athlete's foot (tinea pedis) at some time in
their lives. It can be caused by a combination of fungi and bacteria, which
makes your skin itchy, dry, scaly and red. Sometimes it causes blisters and
cracked skin. It’s especially common between your toes. You often pick up
athlete's foot from coming into contact with contaminated skin left behind in
swimming pools, showers and saunas. If you don't wash your hands after touching
a contaminated area, it can spread to your hands where it's known as tinea
manuum. This mostly affects the creases on your palms and sides of your
fingers.
Ø Tinea
unguium ( Fungal Nail)
“Onychomycosis” - is the name for any fungal
nail infection.
- It is a fungal infection common on Nails,
Characterized by brittleness, and thickening of Nails.
- The inflammation usually starts free
margin & slowly progresses to the Nail bed.
- This
commonly affects the Great toe, Nails, but other nails are also affected.
Investigation:
Ø
“Skin scraping for
Fungal”:
- Scraping of skin lesion dissolved in 20%
potassium hydroxide (20%KOH) & can also be demonstrated by Culture.
Gen
Management:
ü Avoid
soap & keep the part dry.
ü Change
the under garments frequently.
ü Clothes
should be washed in hot water.
ü Foot
wear should have sufficient aeration.
ü Apply
powder & keep that area dry.
“TINEA VERSICOLOR”
(Pityriasis Versicolor)
Caused
by: “Malassezia furfur” @ “Pityrosporum
orbiculare”
Predisposing
factors:
-
Freely sweating individuals, Especially Athletes.
Features
:
- It is characterized by Scaly white or
Brown, In this condition small white spots appear on the trunk,
Neck, upper arms, & Face.
- The lesion is Velvety,
faintly brown or chamois colored, there is No itching, the lesions
are most frequently distributed over trunk.
Gen
Management:
- Change of dress frequently
- Avoid sharing soaps, towels etc.
-
Personal hygiene is most important.
-
The inner garments should be Boiled & changed daily.
Homoeopathic
Management:
The following are the most indicated remedies in fungal
infections of skin:
Tinea in
general – Bacillinum,
Natrum Mur, Phytolacca, Sepia, Tellurium, Thuja, Tuberculinum, Arsalb, Chrysar.
Tinea barbae – Thuja,
Bacillinum, Calc carb, Cicuta, Graphitis, Kali bich, Nit acid, Platina,
Staphysagria, Sulphur.
Tinea Capitis –
Calc carb,
Dulcamara, Phyto, Sepia, Mezerum, Psorinum, Tellurium.
Tinea on face –
Tuberculinum,
Sepia, Graphitis, Natrum carb, Natrum Mur, Tellurium, Thuja.
Tinea
versicolor – Thuja, Natrum ars, Sepia.
Rubrics
in Murphy’s Repertory:
• Skin - TINEA, general
Ail.
arg-n. CALC. Carb-an. Carb-v. carbn-s.
chin. cina cupr. cupr-act. cur. Fil. Form. frag. Gran. Graph. grat.
kali-c. kali-i. mag-m. merc. Nat-c. nat-s. nux-v. petr. phos. Plat.
Puls. Sabad. santin. Sep. Sil. Stann. sulph. ter. thuj. valer.
• Skin - TINEA, general - tinea, capitis, favosa
aethi-a.
agar. ars. ars-i. Brom. calc. calc-i. Calc-m. calc-s. Dulc. ferr-i.
graph. Hep. jug-r. Kali-c. kali-s. lappa Lyc. med. Mez.
nit-ac. olnd. phos. Sep. Sil. sul-ac. sulph. ust. vinc. Viol-t.
• Skin - TRICHOPHYTOSIS
ant-c.
ant-t. Ars. Bac. calc. calc-i. Chrysar. Graph. hep. jug-c. jug-r.
kali-s. lyc. mez. psor. rhus-t. semp. Sep. sulph. Tell. tub.
viol-t.
• Skin
- RINGWORM, general
anac.
anag. ars-s-f. BAC. Bar-c. Calc. calc-act. chrysar. clem. dulc.
dys. equis-h. Eup-per. Graph. hell. hep. iod. Lith-c. mag-c. med.
Nat-c. NAT-M. phos. PHYT. Sanic. SEP. spong.
sulph. syc. TELL. THUJ. tor. TUB.
• Skin - RINGWORM, general - ringworm, beard
ant-t. anthraci. ars. aur-m. Bac.
Calc. calc-s. chrysar. Cic. cinnb. cocc. cypr. Graph. Kali-bi. kali-m.
lith-c. Lyc. mag-p. med. merc-pr-r. nat-s. Nit-ac. petr. phyt.
plan. Plat. rhus-t. sabad. sep. sil. Staph. stront-c. sul-i. Sulph.
tell. THUJ.
• Skin - RINGWORM, general - ringworm, face
anag. Bac. bar-c. calc.
cinnb. clem. dulc. Graph. hell. kali-chl. lith-c. lyc. Nat-c. Nat-m. phos.
SEP. sulph. tarent. Tell. Thuj. TUB.
• Skin - RINGWORM, general - ringworm, head
CALC. DULC. Phyt.
Sep. tell. thuj. tub.
• Skin - TINEA, general - tinea, versicolor
ars. ars-i. bac. calc. carb-an.
carb-v. chrysar. kali-s. mez. Nat-act. nit-ac. phos. phyt. psor. Sep.
sil. sulph. tell. THUJ.
|
|
