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Australian Journal of General Practice Oct 2019Tinea is a common fungal infection that can affect the skin, nails and hair. Tinea infection has a variety of clinical manifestations and affects all age groups,... (Review)
Review
BACKGROUND
Tinea is a common fungal infection that can affect the skin, nails and hair. Tinea infection has a variety of clinical manifestations and affects all age groups, ranging from tinea pedis in adults to tinea capitis in pre-pubertal children.
OBJECTIVE
This article provides an updated overview of the common clinical manifestations and practical approaches to the diagnosis and management of tinea infections.
DISCUSSION
While tinea may be suspected on the basis of clinical grounds, it is important to be aware of the various conditions considered in the differential diagnosis that may mimic tinea infections. Topical and systemic antifungal modalities are available and are selected on the basis of the subtypes and severity of tinea infection. Untreated, tinea can cause significant morbidity and predispose to complications, including cellulitis and ulcers on the feet and alopecia on the scalp.
Topics: Alopecia; Antifungal Agents; Diagnosis, Differential; Humans; Laser Therapy; Secondary Prevention; Tinea
PubMed: 31569324
DOI: 10.31128/AJGP-05-19-4930 -
Revista Chilena de Pediatria Oct 2020Tinea capitis (TC) is a dermatophyte infection with a high prevalence in the pediatric population. Its epidemiology has changed in recent decades due to increasing... (Review)
Review
Tinea capitis (TC) is a dermatophyte infection with a high prevalence in the pediatric population. Its epidemiology has changed in recent decades due to increasing population migration worldwide. Environmental and host-specific risk factors have been identified which are with the development of this infection. The clinical manifestations are variable and depend on the causal agent. Dermatosco- py and Wood's lamp are useful tools for the diagnostic approach; however, the confirmation of in fection is based on mycological tests. The identification of the causal agent allows guiding the appro priate antifungal treatment, which is specific and safe in the pediatric population. Treatment focuses on systemic antifungal therapy combined with local measures. The objective of this paper is to carry out an updated review of the clinical and therapeutic approach to TC in the pediatric population.
Topics: Antifungal Agents; Child; Child, Preschool; Dermoscopy; Diagnosis, Differential; Global Health; Humans; Prevalence; Tinea Capitis
PubMed: 33399644
DOI: 10.32641/rchped.vi91i5.1345 -
American Family Physician Nov 2014Tinea infections are caused by dermatophytes and are classified by the involved site. The most common infections in prepubertal children are tinea corporis and tinea...
Tinea infections are caused by dermatophytes and are classified by the involved site. The most common infections in prepubertal children are tinea corporis and tinea capitis, whereas adolescents and adults are more likely to develop tinea cruris, tinea pedis, and tinea unguium (onychomycosis). The clinical diagnosis can be unreliable because tinea infections have many mimics, which can manifest identical lesions. For example, tinea corporis can be confused with eczema, tinea capitis can be confused with alopecia areata, and onychomycosis can be confused with dystrophic toenails from repeated low-level trauma. Physicians should confirm suspected onychomycosis and tinea capitis with a potassium hydroxide preparation or culture. Tinea corporis, tinea cruris, and tinea pedis generally respond to inexpensive topical agents such as terbinafine cream or butenafine cream, but oral antifungal agents may be indicated for extensive disease, failed topical treatment, immunocompromised patients, or severe moccasin-type tinea pedis. Oral terbinafine is first-line therapy for tinea capitis and onychomycosis because of its tolerability, high cure rate, and low cost. However, kerion should be treated with griseofulvin unless Trichophyton has been documented as the pathogen. Failure to treat kerion promptly can lead to scarring and permanent hair loss.
Topics: Adolescent; Antifungal Agents; Diagnosis, Differential; Foot Dermatoses; Hand Dermatoses; Humans; Onychomycosis; Scalp Dermatoses; Tinea; Tinea Pedis
PubMed: 25403034
DOI: No ID Found -
American Family Physician Sep 2017Hair loss is often distressing and can have a significant effect on the patient's quality of life. Patients may present to their family physician first with diffuse or...
Hair loss is often distressing and can have a significant effect on the patient's quality of life. Patients may present to their family physician first with diffuse or patchy hair loss. Scarring alopecia is best evaluated by a dermatologist. Nonscarring alopecias can be readily diagnosed and treated in the family physician's office. Androgenetic alopecia can be diagnosed clinically and treated with minoxidil. Alopecia areata is diagnosed by typical patches of hair loss and is self-limited. Tinea capitis causes patches of alopecia that may be erythematous and scaly and must be treated systemically. Telogen effluvium is a nonscarring, noninflammatory alopecia of relatively sudden onset caused by physiologic or emotional stress. Once the precipitating cause is removed, the hair typically will regrow. Trichotillomania is an impulse-control disorder; treatment is aimed at controlling the underlying psychiatric condition. Trichorrhexis nodosa occurs when hairs break secondary to trauma and is often a result of hair styling or overuse of hair products. Anagen effluvium is the abnormal diffuse loss of hair during the growth phase caused by an event that impairs the mitotic activity of the hair follicle, most commonly chemotherapy. Physician support is especially important for patients in this situation.
Topics: Alopecia; Hair; Humans; Medical History Taking; Physical Examination; Tinea Capitis; Trichothiodystrophy Syndromes; Trichotillomania
PubMed: 28925637
DOI: No ID Found -
Dermatology and Therapy Feb 2020An increased incidence of tinea capitis has been observed over the last few decades. Trichoscopy is a non-invasive, in-office method helpful in establishing the correct... (Review)
Review
INTRODUCTION
An increased incidence of tinea capitis has been observed over the last few decades. Trichoscopy is a non-invasive, in-office method helpful in establishing the correct diagnosis in patients with hair loss and inflammatory hair disorders. The objective was to review and analyze current data on the trichoscopy of tinea capitis.
METHODS
A systematic review of the literature was conducted using the PubMed, EBSCO and Scopus databases. The search terms included 'tinea capitis' combined with 'trichoscopy', 'dermatoscopy', 'dermoscopy', 'videodermatoscopy' or 'videodermoscopy'.
RESULTS
Of 326 articles, 37 were considered eligible for the quantitative analysis. The most characteristic (with a high predictive value) trichoscopic findings of tinea capitis included comma hairs (51%), corkscrew hairs (32%), Morse code-like hairs (22%), zigzag hairs (21%), bent hairs (27%), block hairs (10%) and i-hairs (10%). Other common, but not characteristic, trichoscopic features were broken hairs (57%), black dots (34%), perifollicular scaling (59%) and diffuse scaling (89%). Morse code-like hairs, zigzag hairs, bent hairs and diffuse scaling were only observed in Microsporum tinea capitis (8/29, 28%; 6/29, 21%; 4/29, 14% and 4/29, 14%, respectively). In Trichophyton tinea capitis, corkscrew hairs were more commonly detected compared to Microsporum tinea capitis (21/38, 55% vs 3/29, 10%).
CONCLUSION
The presence of characteristic trichoscopic features of tinea capitis is sufficient to establish the initial diagnosis and introduce treatment before culture results are available. Trichoscopy may be useful in distinguishing between Microsporum and Trichophyton tinea capitis.
PubMed: 31907867
DOI: 10.1007/s13555-019-00350-1 -
American Family Physician Aug 2009Physicians should be careful not to underestimate the emotional impact of hair loss for some patients. Patients may present with focal patches of hair loss or more... (Review)
Review
Physicians should be careful not to underestimate the emotional impact of hair loss for some patients. Patients may present with focal patches of hair loss or more diffuse hair loss, which may include predominant hair thinning or increased hair shedding. Focal hair loss can be further broken down into scarring and nonscarring. Scarring alopecia is best evaluated by a dermatologist. The cause of focal hair loss may be diagnosed by the appearance of the patch and examination for fungal agents. A scalp biopsy may be necessary if the cause of hair loss is unclear. Alopecia areata presents with smooth hairless patches, which have a high spontaneous rate of resolution. Tinea capitis causes patches of alopecia that may be erythematous and scaly. Male and female pattern hair losses have recognizable patterns and can be treated with topical minoxidil, and also with finasteride in men. Sudden loss of hair is usually telogen effluvium, but can also be diffuse alopecia areata. In telogen effluvium, once the precipitating cause is removed, the hair will regrow.
Topics: Administration, Topical; Alopecia; Alopecia Areata; Diagnosis, Differential; Female; Hair; Humans; Male; Minoxidil; Tinea Capitis
PubMed: 19678603
DOI: No ID Found