Tinea (Capitis, Corporis, Cruris)
Basics
Description
- Superficial fungal infections of the skin/scalp; various forms of dermatophytosis; the names relate to the particular area affected (1).
- Tinea cruris: infection of crural fold and gluteal cleft
- Tinea corporis: infection involving the face, trunk, and/or extremities; often presents with ring-shaped lesions, hence the misnomer ringworm
- Tinea capitis: infection of the scalp and hair; affected areas of the scalp can show characteristic black dots resulting from broken hairs.
- Dermatophytes have the ability to subsist on protein, namely keratin.
- They cause disease in keratin-rich structures such as skin, nails, and hair.
- Infections result from contact with infected persons/animals.
- Zoophilic infections are acquired from animals.
- Anthropophilic infections are acquired from personal contact (e.g., wrestling) or fomites.
- Geophile infections are acquired from the soil.
- System(s) affected: skin, exocrine
- Synonym(s): jock itch; ringworm
Epidemiology
Incidence
- Tinea cruris
- Predominant age: any age; rare in children
- Predominant sex: male > female
- Tinea corporis
- Predominant age: all ages
- Predominant sex: male = female
- Tinea capitis
- Predominant age: 3 to 9 years; almost always occurs in young children
- Predominant sex: male = female
Prevalence
Common worldwide
Pediatric Considerations
- Tinea cruris is rare prior to puberty.
- Tinea capitis is common in young children.
Geriatric Considerations
Tinea cruris is more common in the geriatric population due to an increase in risk factors.
Pregnancy Considerations
Tinea cruris and capitis are rare in pregnancy.
Etiology and Pathophysiology
Superficial fungal infection of skin/scalp
- Tinea cruris: Source of infection is usually the patient’s own tinea pedis, with agent being transferred from the foot to the groin via the underwear when dressing; most common causative dermatophyte is Trichophyton rubrum; rare cases caused by Epidermophyton floccosum and Trichophyton mentagrophytes
- Tinea corporis: most commonly caused by T. rubrum; Trichophyton tonsurans most often found in patients with tinea gladiatorum
- Tinea capitis: T. tonsurans found in 90% and Microsporum sp. in 10% of patients
Genetics
Evidence suggests a genetic susceptibility in certain individuals.
Risk Factors
- Warm climates; summer months and/or copious sweating; wearing wet clothing/multiple layers (tinea cruris)
- Daycare centers/schools/confined quarters (tinea corporis and capitis)
- Depression of cell-mediated immune response (e.g., individuals with atopy or AIDS)
- Obesity (tinea cruris and corporis)
- Direct contact with an active lesion on a human, an animal, or rarely, from soil; working with animals (tinea corporis)
General Prevention
- Avoidance of risk factors, such as contact with suspicious lesions
- Fluconazole or itraconazole may be useful in wrestlers to prevent outbreaks during competitive season.
Commonly Associated Conditions
Tinea pedis, tinea barbae, tinea manus
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Domino, Frank J., et al., editors. "Tinea (Capitis, Corporis, Cruris)." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116979/all/Tinea__Capitis__Corporis__Cruris_.
Tinea (Capitis, Corporis, Cruris). In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116979/all/Tinea__Capitis__Corporis__Cruris_. Accessed May 29, 2023.
Tinea (Capitis, Corporis, Cruris). (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116979/all/Tinea__Capitis__Corporis__Cruris_
Tinea (Capitis, Corporis, Cruris) [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 May 29]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116979/all/Tinea__Capitis__Corporis__Cruris_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Tinea (Capitis, Corporis, Cruris)
ID - 116979
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116979/all/Tinea__Capitis__Corporis__Cruris_
PB - Wolters Kluwer
ET - 27
DB - Medicine Central
DP - Unbound Medicine
ER -