Tinea is caused by cutaneous infection by specific fungi known as dermatophytes. These fungal species metabolize and subsist upon keratin in the skin, hair, and nails.
Trichophyton is one of the fungal dermatophytes known to cause tinea.
Microsporum is one of the fungal dermatophytes known to cause tinea.
Epidermophyton is one of the known causes of tinea.
Patients with tinea commonly present with a pruritic (itchy) rash. The exact appearance of the rash depends on the location of the body affected, but most commonly the rash appears as scaly erythematous rings with central clearing.
Diagnosis of tinea can be confirmed with a KOH prep, which will demonstrate segmented hyphae. This preparation can be done in minutes in the office and is therefore a relatively convenient and easy way to confirm clinical suspicion.
Typical management for tinea consists of a topical antifungal agent, most commonly an azole such as clotrimazole, though other topical agents may be used as well. Oral antifungals and nystatin are not generally recommended for uncomplicated tinea.
Patients with tinea unguium, fungal infection of the nails, may require treatment with oral terbinafine. This is because topical creams such as azoles may not always reach the tissue under the nail where the infection is located. Oral medications, such as terbinafine, are distributed systemically and therefore do not have the same problem.
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