P. Treadwell et al. (eds.)Atlas of Adolescent Dermatologyhttps://doi.org/10.1007/978-3-030-58634-8_5

5. Tinea Infections

Patricia Treadwell¹

(1)

Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA

Patricia Treadwell

Email: ptreadwe@iupui.edu

Keywords

Tinea corporisTinea facieiTinea pedisTinea crurisDermatophyteAntifungals

5.1 Introduction

Infections caused by dermatophytes are known as tinea. They are specifically named by the areas in which they are located. In adolescents, some of the most frequent infections are tinea corporis, tinea pedis, and tinea cruris.

5.2 Epidemiology

Tinea corporis can affect any age group. It is most often found on exposed skin, but not exclusively. Typical etiologic organisms are Trichophyton species and Microsporum species. Tinea pedis (dermatophytes affecting the feet) is seen most commonly in adolescents and adults, and it tends to be uncommon in prepubertal children. Typical etiologic agents are Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum. Tinea cruris often has onset in adolescence. The organisms seen most often are Epidermophyton floccosum, Trichophyton rubrum, and Trichophyton mentagrophytes.

5.3 Clinical Findings

Tinea corporis: Erythematous circular or annular lesions which have accompanying scale (Fig. 5.1). May be itchy. Less commonly the lesions may become vesicular or pustular (Fig. 5.2).

Tinea pedis: Scaly patches of the feet – especially noted in the toe web spaces (Fig. 5.3). May develop vesicles. A secondary bacterial infection may become superimposed.

Tinea cruris: Scaly patches of the inguinal areas. Often itchy.

../images/446896_1_En_5_Chapter/446896_1_En_5_Fig1_HTML.jpg — Fig. 5.1
Multiple tinea corporis lesions of the right neck and mandibular areas due to contact with and affected kitten

../images/446896_1_En_5_Chapter/446896_1_En_5_Fig2_HTML.jpg — Fig. 5.2
Vesicular tinea corporis lesion of the arm

../images/446896_1_En_5_Chapter/446896_1_En_5_Fig3_HTML.png — Fig. 5.3
Scaly patch of toe web in tinea pedis

5.4 Laboratory

The diagnosis is usually made based on the clinical findings. However, a positive potassium hydroxide preparation and/or positive culture can confirm the diagnosis.

5.5 Treatment

Topical antifungals (e.g., terbinafine, clotrimazole, miconazole) are applied bid for 10–14 days. If the lesions are widespread, involve a hair-bearing area, or have significant inflammation, oral medications are prescribed. Griseofulvin – 2–3 week course; Fluconazole – 1–2 week course; Itraconazole – 1–2 week course; Terbinafine – 1–2 week course.

Treating any hyperhidrosis accompanying tinea pedis may be useful as adjunctive therapy.

5.6 Prognosis

Prognosis is good with treatment; however, with tinea corporis, dyspigmentation may occur in skin of color.