Fungal infections affecting the skin (tinea corporis; tinea versicolor), feet (tinea pedis), scalp (tinea capitis) and nails (tinea unguium). These infections may be contagious.
- Ringworm – tinea corporis
- Athlete’s foot – tinea pedis
- Scalp infections – tinea capitis
- Pityriasis versicolor – tinea versicolor
- Nail infections - tinea unguium
RINGWORM – TINEA CORPORIS
B35.4
DESCRIPTION
Clinical features include:
- itchy ring-like patches
- raised borders
- patches slowly grow bigger
As the patch extends a clear area develops in the center which may become hyper-pigmented in dark skin.
Extensive disease is common in HIV, often with no evidence of the patches developing clear centres
GENERAL MEASURES
- Prevent spreading the infection to others.
- Do not share:
- clothes
- towels
- toiletries, especially combs and hair brushes
- Wash skin well and dry before applying medicine treatment.
MEDICINE TREATMENT
Treat any secondary skin infection with antibiotics. See Impetigo
- Imidazole, e.g.:
- Clotrimazole 1%, cream, topical, apply 3 times daily.
- Continue using cream for at least 2 weeks after lesions have cleared.
REFERRAL
Extensive disease.
ATHLETE'S FOOT – TINEA PEDIS
B35.3
DESCRIPTION
A common contagious fungal infection of the foot, characterised by itching, burning and stinging between the toes or the sole.
The skin between the toes is moist and white (maceration) and may become fissured. There is also associated erythema, scaling and peeling.
Secondary eczema of the hands may be an associated condition. See: Eczema, atopic
Vesicles may occur in inflammatory cases.
Pain and tenderness in the web spaces may indicate secondary bacterial infection.
Re-infection is common.
GENERAL MEASURES
- Discourage the use of shared bathing or swimming areas, whilst infected..
- Keep feet dry:
- wear open sandals
- do not wear socks of synthetic material
- dry between toes after washing the feet or walking in water
- wash and dry feet twice daily before applying medicine treatment
MEDICINE TREATMENT
- Imidazole cream, e.g.:
- Clotrimazole 1%, topical, apply twice daily for 4 weeks.
REFERRAL
No improvement after 4 weeks.
SCALP INFECTIONS – TINEA CAPITIS
B35.0
DESCRIPTION
Round or patchy bald areas with scales and stumps of broken off hair.
GENERAL MEASURES
Avoid shaving head in children.
Do not share toiletries such as combs and hair brushes.
MEDICINE TREATMENT
For scalp infections:
Children
- Fluconazole, oral, 6 mg/kg once daily, for 28 days. See paediatric dosing tool.
Adults
- Fluconazole, oral, 200 mg weekly, for 6 weeks.
Note: Do not give to women of child-bearing age unless they are using an effective contraceptive.
PITYRIASIS VERSICOLOR – TINEA VERSICOLOR
B36.0
DESCRIPTION
Mostly found on the upper chest and back and less commonly on the neck, face, abdomen and upper limbs. Round macules which are usually lighter than normal skin (but may be darker). On the chest and back the more central macules join together and the condition spreads with the formation of new macules on the periphery. After treatment, the pigmentation may take months to return to normal.
Recurrences are common, especially in hot weather.
GENERAL MEASURES
Avoid wearing heavy clothing in hot weather to reduce perspiration.
MEDICINE TREATMENT
Oral antifungal therapy is not indicated.
- Selenium sulfide , 2.5% suspension
- Lather shampoo on affected parts.
- Apply daily for 3 successive days and leave on for 30 minutes, then wash off;
- Alternatively, apply once weekly for 3 weeks and leave on overnight, then wash off