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Tinea Infections (Ringworm): Tinea Corporis and Tinea Capitis

by Carlo Raj, MD
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    00:02 We finally get in to the topic of what’s known as tinea.

    00:04 Now what does tinea mean to you? It is fungi, but these fungi are of the skin.

    00:10 So therefore, these are superficial type of dermatophytosis.

    00:14 Fungal infection of dermatophytes.

    00:16 In other words, of the skin.

    00:18 There are particular organisms that you want to keep in mind, and at this point, I would ask you to hone in on tricophyton, please.

    00:26 Yes, you have microsporum as well, but tricophyton is something that I need you to focus on or at least know the suffix, -phyton.

    00:35 Organisms are capable of using keratin as its source of energy.

    00:41 Now, what are all the different tineas? Now, we’ve mentioned tinea a few times already.

    00:45 We talked about tinea affecting the scalp.

    00:47 It’s called tinea capitis.

    00:49 We’ve talked about how tinea could affect the body.

    00:51 It’s called tinea corporis.

    00:53 Now, the common tineas that we have in the U.S. include athlete’s foot, jock itch, maybe underneath the nail.

    01:00 So therefore, we have tinea unguium, tinea inguinal, and we have tinea that would affect your toes, so therefore, tinea pedis.

    01:10 Let’s take a look.

    01:12 So tinea infection further classified by what part of the body’s been affected.

    01:16 If it’s the scalp, the capitis.

    01:19 Put a cap on your scalp.

    01:20 If it’s corporis, the body, often referred to in layman's terms as ringworm and has nothing to do with the worm.

    01:28 What’s my causative agent? A fungus.

    01:32 And you have tinea pedis, being the feet.

    01:34 Please don’t forget that you could also have tinea cruris, which will be the jock itch or in the inguinal region.

    01:42 And then you can also have what’s known as tinea versicolor that you talked about in micro which means that you have various colors, and by that, I mean, it would be areas that are hypopigmented and areas that are hyperpigmented.

    01:58 And if you remember from micro, the name of that organism is – “I want to call my grandson Malassezia and my I’m going to call my granddaughter furfur.” Malassezia furfur.

    02:09 Can you even believe these are some of the names of your organisms? Tinea versicolor.

    02:16 Now, zoophilic species, acquired from animals, usually more inflammatory.

    02:23 With infections, it varies a bit with the location.

    02:27 Well-demarcated annular plaque, with an active scaling, scaling, scaling.

    02:33 Lesions are often intensely pruritic, let it be the head, let it be – Think about the areas.

    02:38 You have an athlete who might be sweating quite a bit.

    02:42 So therefore you can expect there to be tinea pedis or tinea cruris, either jock itch or athlete’s foot.

    02:48 I also told you about tinea unguium.

    02:50 All the different places where you could have the tinea infection with the capitis.

    02:57 Here, if we take a look at the picture, you’ll notice that we have it between the toes.

    03:03 So obviously, this has to be tinea pedis.

    03:06 Organism for the most part that you’re thinking about is trichophyton.

    03:10 The one exception was a tinea versicolor in which – “I’m naming my grandson Malassezia, and my granddaughter furfur.” Or was it the other way around? Whatever.

    03:20 You get the point.

    03:22 I want you to take a look at this patch of scalp here in which the hair has been lost.

    03:26 So there’s alopecia.

    03:28 However, this has nothing to do with autoimmune disease, which means that this rules out which alopecia? Alopecia areata, right? What if there’s hair that was complete lost on the entire scalp and is autoimmune? That is called alopecia totalis.

    03:44 If it’s the entire body, that’s called universalis.

    03:49 Out topic is tinea capitis.

    03:51 It’s a fungal infection, superficial dermatomycosis or dermatophytosis.

    03:58 And there’s alopecia taking place in which literally, the shaft of the hair is going to then break off.

    04:05 Look for that description.

    04:07 Look for black dots in the patch of the alopecia, which means what? If you take a look at the details in this patch here, you’ll find that black dots referring to the fact that the shaft was then broken off.

    04:20 Diagnosis would be KOH and most commonly here, will be Trichophyton tonsurans.

    04:27 Memorize Trichophyton tonsurans.

    04:31 And something that I wish to bring to your attention, unbelievably, this organism, Trichophyton tonsurans, actually hides within the hair shaft, which means what? Have you ever heard of a diagnostic tool that you’re talking about in micro called a wood lamp? If this organism hides in the hair shaft, tricky little sucker.

    04:54 Then the wood lamp comes back to be negative.

    04:56 Keep that in mind, please, with Trichophyton tonsurans.

    05:00 Fascinating creature.

    05:04 Management: Oral griseofulvin to try to get rid of your organism systemically and anytime that you use or think about griseofulvin, always make sure you check out the liver.

    05:18 Tinea infection on KOH.

    05:20 Well, if you are thinking about finding the organism, you would find these hyphae.

    05:25 So let’s say that you’re dealing with KOH prep, and you’re suspecting tinea capitis, then you would find the hyphae as being your organism, Trichophyton.

    05:36 Management: Ketoconazole, oral antifungals that we talked about and you’re worried about that terminal hair, griseofulvin, terbinafine or oral triazole.


    About the Lecture

    The lecture Tinea Infections (Ringworm): Tinea Corporis and Tinea Capitis by Carlo Raj, MD is from the course Infectious Skin Diseases. It contains the following chapters:

    • Tinea
    • Tinea Infections
    • Tinea Capitis

    Included Quiz Questions

    1. Keratin
    2. Erythrocytes
    3. Biotin
    4. Hemoglobin
    5. Fat
    1. Malassezia furfur
    2. Tricophyton rubrum
    3. Tricophyton tonsurans
    4. Tricophyton interdigitale
    5. Tricophyton verrucosum
    1. Spares the scalp
    2. Pruritic lesions
    3. Annular plaques
    4. Scaling lesions
    5. Most commonly affects the intertriginous areas of the body
    1. Tricophyton tonsurans
    2. Tricophyton interdigitale
    3. Tricophyton verrucosum
    4. Malassezia furfur
    5. Candida albicans
    1. Liver function
    2. Thyroid function
    3. Complete blood count
    4. Electrolytes level
    5. Lipid profile

    Author of lecture Tinea Infections (Ringworm): Tinea Corporis and Tinea Capitis

     Carlo Raj, MD

    Carlo Raj, MD


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