Aulia Rahmatun NufusRaihanun Nisa Dinur

Sri Rizki

Supervisor :Nanda Earlia

Tinea Facialis

3%-4% of tinea corporis is tinea facialis

Introduction

Tinea corpori

s

Tinea facialis

Introduction Risk factor

Age

Sex

Genetic

Racial factor

Life style

Drug therapy

Endocrine

Contact with animal

environmental

Identity of patientName : Mr. RSex : MaleAge : 56 years oldWeigth : 62 kgJob : Selling vegetables Address : Tungkop, Aceh BesarPhone number : 085277466610Registration number : 87-06-35Examination date : December 31th 2013

Case Report

HistoryThe Chief Complain:Rash followed by itching on the face, upper back, palmars and plantars since two month ago. 

History of present illness:The patient came to the hospital complaint the appearance of rash followed by itching on the face, upper back, palmars and plantars since two month ago. At first, the patient found red spots that felt very itchy on the upper back area, the rash was getting wider and spreaded to the face, palmars and plantars area. Then, about one month ago the appearance of rash following itching on the upper back was disappeared. Itching is felt everytime not induced with environment temperature, but itching is increasing at the time of using pads and when the groin area is moist.  

Case Report

History of previous illness:The patient had the same complaint before since two month ago. Patient were also informed having a history of diabetic since twelve year ago.

History of Family disease:None of his family had this kind of disease.

History of Treatment:Since the patient have complaint he was getting treatment from a doctor and take medication with diagnosis seborrhoic dermatitis on Descember, 3th 2013 and tinea manum on September, 13th 2013 but not healed.

Case Report

Status of Dermatology

On facial and palmars dextra and sinistra region, found erithematous patch and hypopigmentation with

circumpscripta boundary , irreguler and polycyclic edges. There are papules and scales on edge of

lesions, multiple lesions, plaque size, cental healings, disseminated

arrangement and generalized distribution

Clinical Test

Microscopic Examination of skin scrapins with 10% potassium hydroxide (KOH) showed long

septate and branching hyphae

1. Tinea facialis2. Seborrheic dermatitis3. Cutaneus candidiasis4. Granulloma anulare5. Morbus Hansen

DiagnosisTinea facialis

Differential diagnososis

Systemic Medication:1. Ketokenazole 200 mg tab once daily for 2 to 3 weeks

 Topical Medication :

1. Ketokenazole salp once daily at night for 2 to 4 weeks2. Myconazole cream once daily in the morning for 2 to 4 weeks.

Management

1.Taking medicine regularly2. Do not scratch the rash to prevent the secondary infection3. Change chlotes when the body is sweating4. Wearing loose clothing and materials that easily absorb

sweat5. Dry off after a shower and sweating

Education

Quo ad vitam : dubia ad bonamQuo ad functionam : dubia ad bonamQuo ad sanactionam : dubia ad bonam

Prognosis

DIscussion

Fungal infection

Superficial

Subcutaneus

Systemik

Dermatophytosis/ Tinea (Ringworm)

Atacchments keratin and use as source of nutriens

to colonize

Stratum corneum of epidermis, hair,nails and

horny tissues or animal

Nonhairy, glabrous skin

Tinea Facialis

Discussion

Dermathopytes

Genera

Geophilic

Epidermophyton: skin,nail

Trichophyton: skin, nail, hair

Microsporum: skin, hair

Habitat and pettern of infection

Anthropophilic

Zoophilic

Skin Disease Location of lesions Clinical Features Fungi Most Frequently Responsible

Tinea corporis (ringworm)

Nonhairy, smooth skin.

Circular patches with advancing red, vesiculated border and central scaling. Pruritic.

T. rubrum, E.floccosum

Tinea pedis (athlete`s foot)

Interdigitalis spaces on feet of persons wearing shoes.

Acute: itching, red vesicular. Chroni: itching, scaling, fissures

T. rubrum, T. mentagrophytes, E.floccosum

Tinea cruris (jork itch)

Groin. Eritematous scaling lesion in intertridiginous area. Pruritic.

T. rubrum, T. mentagrophytes, E.floccosum

Tinea capitis Scalp hair. Endothrix: fungus inside hair shaft. Ectothrix: fungus on surface of hair.

Circular bald patches with short hair stubs or broken hair within hair follicles. Kerion rare. Microsporum-infected hairs fluoresce.

T. mentagrophytes, M.canis

Clinical features of dermatophytes infection

Skin Disease Location of lesions Clinical Features Fungi Most Frequently Responsible

Tinea barbae Beard hair. Edematous, erythematous lesion. T.mentagrophytes

Tinea Unguium (onycho-mycosis)

Nail. Nails thickened or crumbling distally;discolored;lusterless. Usually associated with tinea pedis.

T. rubrum, T. mentagrophytes, E.floccosum

Dermatophytid (id reaction)

Usually sides and flexor aspects fingers. Palm. Anysite on body.

Pruritic vesicular to bullous lesions. Most commonly associated with tinea pedis.

No fungi present in lesion. May become secondarily infected with bacteria.

Clinical features of dermatophytes infection

Topical treatment

• Allyfamines • Imidazoles • Tolnaffate • Butenafine • Ciclopirox

Systemic treatment

• Adults:• Fluconazol 150 mg/week• Itraconazole 100 mg/day• Terbinafin 250 mg/day• Griseovulvin 500 mg/day

• Children:• Griseovulvin 10-20 mg/kg/day• Itraconazole 5 mg/kg/day• Terbinafrin 3-6 mg/kg/day

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