Tinea Corporis and Tinea Capitis

Rosemary Shy, MD* 1. *Assistant Professor of Pediatrics, Wayne State University, Children's Hospital of Michigan, Detroit, Mich After completing this article, readers should be able to: 1. Recognize the wide variation in presentations of tinea capitis and corporis. 2. Describe that treatment of hair, nails, and beard compared with that for other body sites. 3. Discuss the causes and management of tinea capitis and corporis. 4. Explain why systemic therapy is necessary to eradicate tinea capitis. Tinea is a geographically widespread group of fungal infections caused by dermatophytes. Predominance of type depends on the organism, its hosts, and local factors. Infection may occur through contact with infected humans and animals, soil, or inanimate objects. Tinea should be suspected in any red, scaly, pruritic, enlarging lesion or in pruritic scalp lesions that manifest scaling, folliculitis, or an inflammatory reaction. Gruby, Remak, and Schonlein described the causes of favic tinea in the early 1800s. In the early 1900s, Saboraud classified the dermatophytic fungi. In the 1950s, Kligman further described the natural course and pathogenesis of these infections. In 1958, treatment with oral griseofulvin was introduced, obviating the need to use epilation with radiography or thallium. More recent antifungal medications, the azoles, allylamines, and benzylamines, offer new options of shorter and more convenient dosing regimens. Tinea is a superficial infection of the skin, scalp, nails, or hair caused by dermatophytic fungi that invade the stratum corneum and use keratin as a nutrient source. Dermatophytes have three genera: Trichophyton , Epidermophyton , and Microsporum . The site of formation of arthroconidia, the spore-forming bodies of the dermatophyte, classifies the species causing tinea capitis. Ectothrix species form conidia around the hair shaft and beneath the cuticle of hair. Endothrix species have arthrospores present within the hair shaft. The favic species have hyphae arranged in parallel within and around the hair shaft. For example, T tonsurans is endothrix, M audouini is ectothrix, and T schoenleinii is favic. …