Ringworm: Causes, Symptoms, Diagnosis, Prevention, and Control
The fungi that cause only superficial infection on the skin are called dermatophytes. The infection caused by dermatophytes is called dermatophytosis or ringworm. It is a communicable disease. These terms are applied to mycotic diseases of keratinized areas of the body (skin, hair, and nails). Tinea is divided according to the regions of the body affected: (1) tinea capitis (ringworm of the scalp); (2) tinea barbae (ringworm of the beard); (3) tinea faciei (ringworm of the face). (4) tinea corporis (ringworm of the body); (5) tinea manus (ringworm of the plams); (6) tinea pedis (ringworm of the feet); (7) tinea cruris (ringworm of the groin); (8) tinea unguium. (ringworm of the nails)
Please, read to get the facts and list of infectious diseases types, causes, prevention, and treatment, and learn how they spread.
Epidemiology of Ringworm
occurrence: Fungal infection is very common. The frequency of fungal infection is next to parasitic infection of the skin. Agent: Fungi, dermatophytes are primitive organism which lacks chlorophyll and has a firm cell wall surrounding the nuclei, food vacuoles and cell fluid. They are larger and more complex than bacteria. They may be unicellular, such as yeast or multicellular, such as moulds. Cells may join together in line to form filaments, Since they lack chlorophyll and therefore lack the capacity to manufacture their own organic materials, they must exist as either saprophytes or parasites. They are ubiquitous. Host: Man and animals are the hosts for fungal infection. While the sources of infection are known, virtually nothing is known of the factors which determine the susceptibility or resistance of the host. Environment: Fungal infection mostly occurs in the tropical zone of the world where there is a hot and humid climate. Mode of transmission: Most of the ringworm fungi are transmitted from one person to another through direct or indirect contacts. Floors, furniture, clothing, shoes and barber’s instruments contaminated with infected fragments of skin and hair are sources of infection of ringworm of the feet, body and scalp. Other infections are acquired from animals, cats and dogs being sources of the organism M. canis which causes ringworm of the scalp. Incubation period: Not certainly known; maybe 4 to 14 days.
Tinea capitis. Ringworm of the scalp is an infectious disease occurring chiefly amongst school children and rarely in infants and adults. Boys have tinea capitis more frequently than girls. This infection sometimes is observed in epidemic form in schools and orphanages. It can be caused by all the pathogenic dermatophytes with the exception of Epidermophyton fLoccosu.m and Trichophyton concentric. The affected areas of scalp look like areas without hair and only the roots are visible. In some cases, there is inflammation with the formation of a kerion. Wood’s light examination can screen out the cases with fungal infection.
Tinea barbae. Fungal infection of the beard is a common problem. It is seen chiefly in persons engaged in agricultural works. Lesions are nodular boggy infiltration with abscess formation. The overlying skin is inflamed, and the hairs are loose. The disease may also occur from an infected shaving brush in a barbershop.
Tinea corporis. Tinea corporis is frequently seen in children, particularly those who are exposed to animals with ringworm, especially cats, dogs, and less commonly horses and cattle. In adults, excessive perspiration is the most common predisposing factor. The incidence is especially high in hot and humid areas of the world.
Tinea cruris. Tinea cruris is most prevalent in men who wear tight jockey shorts, which prevent evaporation of the increased perspiration during hot and humid weather.
- The most important clinical manifestations of tinea infection are: (i) Itching; (ii) Annular or circinate lesions with an advancing raised border; there is healing in the center; (iii) Reddish papules with scaling; (iv) Bald patch or boggy swelling over the scalp or beard; there may be bleed area with scaling; (v) Broken off hair; (vi) Brittle, dystrophic, thickened nail.
- Demonstration of the fungus by microscopic examination of the scrapings taken from the involved site establishes the diagnosis. In addition, cultures made in the Dermatophyte Test
- Medium from the affected skin, nail or hair establish the identity of the fungus; but failure to find the fungus does not rule out a fungal cause.
Prevention and Control of Ringworm
Reasonable hygienic condition is important, but it is not possible to totally avoid contact with pathogenic fungi. (1) In treating all fungal infections, it is best to avoid environmental factors that enhance heat, moisture, maceration, and trauma. (2) Hyperhydrosis and trauma are predisposing factors. The reduction of perspiration and the enhancement of evaporation from the affected area are important prophylactic measures.
- The area should be kept as dry as possible by wearing loose clothing and dusting good antiseptic powder on the affected area after bathing. (4) Footwear should be non-occlusive and should fit well.
- The toilet articles of an infested person should not be used by other persons before being sterilized.
- Towels, clothing, and sheets should be changed frequently and laundered in hot water. Unlaundered underwear, sheets, and socks should not be used after treatment, because reinfection may occur.
Specific treatment. All tinea infestations are treated with antifungal agents orally and locally.
Micronized or ultra micronized griseofulvin orally in a dosage of 500mg or 250mg respectively daily for adults will usually cure tinea in 4 to 8 weeks. Dosage for children is half or one-fourth of the adult dose. The period of therapy depends upon the response of the lesions. In case of tinea infection of the fingernail, treatment is to be continued for 6 to 9 months and for toenails for 12 to 18 months. Topical antifungals. such as miconazole, econazole or clotrimazole creams should be applied from the beginning of treatment 2 or 3 times daily. Topical antifungal medications, such as Whitfield’s ointment may be used concurrently.