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Tinea Corporis / Ringworm of the Scalp

Definition :
Ringworm of the body is one of several forms of ringworm, a fungal infection that develops on the top layer of your skin. It's characterized by an itchy, red circle of rash with healthy-looking skin in the middle.

Also called tinea corporis, ringworm of the body is closely related to other skin conditions with similar names. "Tinea" is a type of fungus, and "corporis" is the Latin word for "body." Other common tinea infections include :

  • Athlete's foot (tinea pedis). This form affects the moist areas between your toes and sometimes on your foot itself.
  • Jock itch (tinea cruris). This form affects your genitals, inner upper thighs and buttocks.
  • Ringworm of the scalp (tinea capitis). This form is most common in children and involves red, itchy patches on the scalp, leaving bald patches.

Tinea corporis affects your arms, legs, trunk and face. Ringworm gets its name from the characteristic ring that can appear, but it has nothing to do with an actual worm under your skin.

Although unsightly, ringworm usually isn't serious, except potentially for people with weak immune systems. Treatment usually consists of antifungal medications that you apply to your skin.

Causes :
Fungal infections, such as ringworm, are caused by microorganisms that become parasites on your body. These mold-like fungi (dermatophytes) live on the cells in the outer layer of your skin.

Ringworm is contagious and can be spread in the following ways :

  • Human to human. Ringworm often spreads by direct, skin-to-skin contact with an infected person.
  • Animal to human. You can contract ringworm by touching an animal with ringworm. Ringworm can spread while petting or grooming dogs or cats. You can also get ringworm from ferrets, rabbits, goats, pigs and horses.
  • Object to human. Ringworm can spread by contact with objects or surfaces that an infected person or animal has touched, such as clothing, towels, bed linens, combs or brushes.
  • Soil to human. In rare cases, ringworm can be spread to humans by contact with infected soil. Infection would most likely occur only from prolonged contact with highly infected soil.

Risk Factor :
The organisms that cause ringworm thrive in damp, close environments. Warm, humid settings that promote heavy sweating also favor its spread. Excessive perspiration washes away fungus-killing oils in your skin, making it more prone to infection. Athletes are at higher risk of ringworm.

Ringworm often occurs in young children. Outbreaks of ringworm are common in schools, child care centers and infant nurseries. Children with pets are at increased risk of ringworm.

Others at increased risk of ringworm include people with weakened immune systems, such as people with diabetes or HIV/AIDS. If you have atopic dermatitis — a chronic, skin disease characterized by itchy, inflamed skin — you may be more susceptible to ringworm. The barrier in your skin that normally protects you from viral, bacterial and fungal infections is often weakened or compromised. Some people may be genetically prone to this type of infection.

When to seek medical advice :
See your doctor if you have a rash on your skin that doesn't improve within two weeks. You may need prescription medication. If excessive redness, swelling, drainage or fever occurs, see your doctor immediately.

Symptoms :
The signs and symptoms of ringworm include :

  • A circle of rash on your skin that's red and inflamed around the edge and healthy looking in the middle
  • Slightly raised expanding rings of red, scaly skin on your trunk or face
  • A round, flat patch of itchy skin

More than one patch of ringworm may appear on your skin, and patches or red rings of rash may overlap. You can have tinea infection without having the common red ring of ringworm.

Dignosis :
Your doctor will determine if you have ringworm or another skin disorder, such as psoriasis or atopic dermatitis. He or she will ask you about possible exposure to contaminated areas or contact with people or animals with ringworm.

Your doctor may take skin scrapings or samples from the infected area and look at them under a microscope. If a sample shows fungus, treatment may include an antifungal medication. If the test is negative but your doctor still suspects that you have ringworm, a sample may be sent to the laboratory for testing. This test is known as a culture. Your doctor may also order a culture if your condition doesn't respond to treatment.

Complications :
A fungal infection rarely spreads below the surface of the skin to cause serious illness. However, people with weak immune systems, such as those with HIV/AIDS, may find it difficult to get rid of the infection.

Treatment:
If ringworm of the body covers a large area, is severe or doesn't respond to over-the-counter medicine, you may need a prescription-strength topical or oral medication. These include :

Topical

  • Econazole (Spectazole)
  • Miconazole (Monistat-Derm)

Oral

  • Itraconazole (Sporanox)
  • Fluconazole (Diflucan)
  • Terbinafine (Lamisil)
  • Ketoconazole (Nizoral)

Side effects from oral medications include gastrointestinal upset, rash and abnormal liver functioning. Taking other medications, such as antacid therapies for ulcer disease or gastroesophageal reflux disease (GERD), may interfere with the absorption of these drugs. Oral medications for ringworm may alter the effectiveness of warfarin, an anticoagulant drug that decreases the clotting ability of your blood.

Prevention:
Ringworm is difficult to prevent. The fungus that causes ringworm is common and contagious even before symptoms appear. However, you can help reduce your risk of ringworm by taking these steps :

  • Educate yourself and others. Be aware of the risk of ringworm from infected persons or pets. Tell your children about ringworm, what to watch for and how to avoid the infection.
  • Keep clean. Wash your hands often to avoid the spread of infection. Keep common or shared areas clean, especially in schools, child care centers, gyms and locker rooms.
  • Stay cool and dry. Don't wear thick clothing for long periods of time in warm, humid weather. Avoid excessive sweating.
  • Avoid infected animals. The infection often looks like a patch of skin where fur is missing. In some cases, though, you may not notice any signs of the disease. Ask your veterinarian to check your pets and domesticated animals for ringworm.
  • Don't share personal items. Don't let others use your clothing, towels, hairbrushes or other personal items. Refrain from borrowing these items from others as well.
 
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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