Fungal Skin diseases & Homoeopathic Managements

         

“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.