Ringworm: Introduction, symptoms, types, causative agent, lab diagnosis

Ringworm: Introduction, Symptoms, Types, Causative Agent, Lab Diagnosis, Treatment and Prevention

Ringworm its causative agent,lab diagnosis and treatment

Introduction of Ringworm

Ringworm or tinea is synonyms for each other. It is a fungal infection of the skin. The name is “ringworm” but the infection is due to a fungus, not a worm. The infection initially presents with red patches on affected areas of the skin and later spreads to other parts of the body. It can affect anyone. The infection may affect the skin of the scalp, groin, beard, feet, or other parts of the body.

Symptoms of Ringworm

Symptoms depend on the site of infection. In skin infection, you may experience the following-

Red, itchy, scaly, or raised patches
Patches that develop later blisters or begin to ooze.
Patches that may be redder on the outside edges or resemble ring patches.
If there is dermatophytosis in your nails, that may become thicker or discolored, or that may begin to crack.
In the case of scalp infection, the hair around it may break or fall off, and bald patches may develop.

Types of Ringworm

Clinically ringworm is of the following types depending on the site of the body involvement-
e.g. Tinea axillaries: axilla
Tinea barbae: beard area
Tinea corporis: Non-hair skin
Tinea capitis: The hair and scalp of the body often appear as patches with the characteristic round “ring” shape.
Tinea corporis: in the groin
Tinea pedis: foot (Athlete’s foot)
Tinea pedis is common in people who go barefoot in public places where the infection can spread, for e.g. locker rooms, showers, swimming pools, etc.

The Causative Agent of Ringworms

Dermatophyte is the causative agent of ringworm that infects only superficial keratinized tissues and infection of the skin, hair, and nail.
They are a group of three genera.

a. Trichophyton ( skin, hair, and nail)
b. Microsporum (Hair and skin)
c. Epidermophyton (skin and nail)
Causative agents of ringworm do not involve in living tissue.
Spores of these fungi may live for a longer period in soil. Direct contact with soil causes us infection. It can also spread through contact with an infected person. The infection is commonly spread among children and by sharing items that may dirty.

Diagnosing of Ringworm

Your clinician or doctor or dermatologist will diagnose ringworm by examining your skin and possibly using a black light to view your skin in the affected area.
The fungus will fluoresce under black light. In case of infection, the areas of the skin where the fungus is located will glow. For confirmatory diagnosis your dermatologist will request the following tests:

skin biopsy

fungal culture

Potassium Hydroxide(KOH) mount

Treatment of Ringworm

Both medications and lifestyle adjustments are necessary to treat it. Your doctor may prescribe various medications depending on the severity of the infection. Ringworm on the skin like athlete’s foot and jock itch (tinea cruris) can usually treat with non-prescription antifungal creams, lotions, or powders applied to the skin for 2 to 4 weeks. There are many non-prescription products available to treat it, including clotrimazole, miconazole, terbinafine, and ketoconazole. Ringworm on the scalp (tinea capitis) usually needs to treat with prescription antifungal oral medication for 1 to 3 months. Creams, lotions, or powders don’t work for ringworm on the scalp. Prescription antifungal medications used to treat it on the scalp include griseofulvin, terbinafine, itraconazole, and fluconazole.

Lifestyle Adjustment

We should practice some of the following behaviors and the is-

Do not use a cloth that irritates the infected area.
Wash bedding and clothes daily during an infection to help disinfect your surroundings.
Clean and dry your skin regularly.
Cover it with a bandage if you’re unable to avoid clothing that irritates the area.
If you’ve been scratching your skin frequently due to the infection, you may also develop a Staphylococcus or Streptococcus infection of the skin.
Your doctor may prescribe antibiotics to treat this bacterial infection as you continue your treatment for the ringworm.

How long does ringworm last?

Skin ointment may clear ringworm in 2 to 4 weeks. If there is severe dermatophytosis that isn’t responding to over-the-counter treatments or treatment at home, your doctor may prescribe antifungal tablets to clear up the infection. However, most people respond positively to treatment.

Prevention

As you know, “prevention is better than cure”. To maintain this, practice healthy and hygienic behaviors. To avoid ringworm, follow the following tips-

Always wash your hands after interacting with an animal.
A person who is Immunocompromized or immunocompetent should avoid people or animals with ringworm.
Never ignore, disinfect and clean pet living areas.
Never forget to wear shoes if showering in community areas.
Don does not share personal items like clothing or hairbrushes with people who are with this infection.
Always try to keep your feet clean and dry.
Use shower and shampoo in your hair regularly.

Trichophyton mentagrophyte (dermatophyte, causative agent of ringworm) growth on DTM and its structures in LPCB mount

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