Tinea
Tinea (superficial dermatophyte) infections are one of the most common infections seen in dermatology. Tinea may occur in many different body areas such as:
- Scalp (tinea capitis, "scalp ringworm")
- Face (tinea faceii)
- Beard Area (tinea barbae)
- Body (tinea corporis, "ringworm")
- Hands (tinea manuum)
- Groin (tinea cruris, "jock itch")
- Feet (tinea pedis, "athlete's foot"
- Nails (onychomycosis, "nail fungus")
The presentation varies depending on the site involved, but is usually characterized by scaling, red patches with central clearing. Transmission is usually by direct contact with broken skin, or contact with contaminated objects. Use of topical steroids such as hydrocortisone (or stronger) seems to make the condition temporarily better, but rather causes the affected area to subtly increase as the fungus grows more quickly and silently.
Treatment of tinea is usually by topical or oral antifungal medications. Some topical antifungals are available over-the-counter and should be applied twice daily for at least two weeks. A similar regimen is followed for topical prescription antifungals.
Over-the-counter treatment:
Lamisil cream, lotrimin (clotrimazole) cream, or mycolog (ketoconazole) cream twice daily for 3 weeks
Zeabsorb AF powder to all shoes and sandals
Prescription treatment:
Lamisil pills once daily for 2 weeks for fungus on the skin, or for 3 months for nail fungus. For treatment of nail fungus, screening laboratory tests may be done to confirm no previous liver damage as lamisil has rarely been associated with liver toxicity. Please alert your dermatologist if youÕve had a history of liver damage. Also, while undergoing treatment, stop taking Lamisil if abdominal pain, nausea, vomiting, or jaundice ensue.
Fluconazole every Sunday for 6-12 weeks, or Itraconzole therapy for one week every month for 3-4 months. Screening laboratory tests may be done to confirm no previous liver damage as these treatments have been associated with liver toxicity. Please alert your dermatologist if youÕve had a history of liver damage. Also, while undergoing treatment, stop taking Lamisil if abdominal pain, nausea, vomiting, or jaundice ensue.
Penlac laquer applied nightly for one year. This treatment has a 30-40% success rate compared to oral tablet therapy.
Don Mehrabi MD, FAAD
Dermatologist, Certified by the American Board of Dermatology
Los Angeles, California
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© Physician's Skincare Group, LLC. 2006. All Rights Reserved. This material may not be reproduced, published, or distributed in any form without express written consent of DermZone.com. DermZone.com does not assume any financial, legal, or medical liability for any content on this site. Please review any condition or treatment plan with your physician.