TINEA CORPORIS

Nurotus Saniyah G9911112115

Pembimbing: Dr. Nugrohoaji Dharmawan, SpKK, M.Kes

SYNONIMS

Tinea circinata Tinea glabrosa Schrende Fletche Herpes circine trichophytique Ringworm of the body Kurap

DEFINITION

Tinea corporis

All dermatophytosis of glaborous skin (facial, body, upper and lower extremity)

Dermatophytosisdisease caused by dermatophyte

A group of taxonomically related fungi that has ability to form molecular attachments to keratin and use it as a source of nutrients allow s them to colonize keratinized tissues, including the stratum corneum of epidermis, hair, and nails.

EPIDEMIOLOGY

• All age• Man:Woman = 1:1• Usually occurred in areas with high humidity• Depends on body and environment hygiene

ETIOLOGY

Dermatophytes

Tricophyton

Epidermophyton

Mycrosporum

Tinea CorporisT. rubrum, T.

mentagrophytes, M. canis, T. tonsurans

PATHOGENESIS

3 main steps

adherence

penetration

Development of a host respons

Adherence Dermatophytes must overcome several obstacles (UV light, variation of temperature and moisture, and competition from normal flora) in order to adhere to keratinized tissue

Penetration Secretion of keratinase enzyme by dermatophytes that will invate stratum korneum and keratin to provides a source of nutrition for the dermatophytes

Development of host response

To create clinical symptoms, the dermatophytes must overcome non spesifik and spesifik immune of the host

SIGN AND SYMPTOMS

Many variants The classic presentation : annular lesion with

scale across the entire erythematous border, some lesions are often confluented.

Lesion: Erythematous with skuama, centra healing

Erosion and crusta sometimes appear caused by scratching of the skin

Itchy, especially when the patient is sweating

LABORATORY STUDIES

Skin scraping with KOH 10-20% hyphae or fungi’s spore

DIAGNOSIS

From the clinical manifestation Add the laboratories finding

DIFFERENTIAL DIAGNOSIS

Dermatitis seborroik Psoriasis Morbus Hansen Pitiriasis Rosea Dermatitis Numularis Candidiasis Neurodermatitis Circumscripta

TREATMENT : NON MEDIKAMENTOSA

Education for increase body and environment hygiene

Recommend for avoiding tight and non sweat absorbable clothing

TREATMENT : MEDIKAMENTOSA

Derivat imidazole (mikonazole, klotrimazole, tiokonazole, ketokonazole)

Derivat alilamin (terbinafin, naftitin HCl)

Griseofulvin1st line Itrakonazol

Broad Fungisid Ketokonazole

Fungistatic Flukonazole

Non hepatotoxic

Topical Systemic

PROGNOSIS

With proper treatment Commonly are good Important to prevent re-infection

CASE REPORT

Name : Mrs. M Age : 56 years old Sex : woman Address : Griyan RT 2/1

baturan Colomadu, Karanganyar

Date of inspection : 29 May 2012 Number of MR : 01121232

CHIEF OF COMPLAIN Feeling itch in the upper arm and back

Approximately 1 year before goes to hospital, the patient complain some lesions at upper arm, then she lubricates some aloe vera to the lesions. After that the lesion become itchy and spread to the back. Previously, patient checked up at the puskesmas for 6 times. She got mikonazole zalf, after that the complain reduced but not totally healed.

HISTORY OF DISEASE

HISTORY OF PREVIOUS DISEASE

History of similar disease : (-)History of food allergy : (-)History of drug allergy : (-)History of hypertension : (-)History of DM : (-)History of atopic : (+)

HISTORY OF FAMILY DISEASEHistory of similar disease : (-)History of food allergy : (-)History of drug allergy : (-)

HISTORY OF HABIT

The patient usually take a bath 2 times for a day with the soap and using different towel with other family. The patient often scratch her skin when she feels itch.

PHYSICAL EXAMINATION

A. Generalis status Generally : good, compos mentis,

sufficient nutrient impressive Head : normally Face : normally Neck : normally Back : look at dermatology status Axilla : look at dermatology status Thorax : normally Abdomen : normally Gluteus : normally Upper extremity : look at dermatology status Lower extremity : normally

DERMATOLOGY STATUS

Regio upper extremity, axilla, and thorax posterior (back): some macula erythematous lesions with skuama and centra healing.

SKIN SCRAPING WITH KOH LONG HYPHAE

DIFFERENTIAL DIAGNOSIS

Tinea corporis Psoriasis vulgaris Pitiriasis rosea

DIAGNOSIS

Tinea corporis

TREATMENTNon medikamentosao keep the hygiene of body, clothes, and

environmento Keep the lesion area away from sweat and high

humidity conditiono Use different towel with other familieso Not scratch the skin

Medikamentosao Ketokonazole 2x200 mg (for 14 days)o Cetirizin 1x10 mg (for 7 days, if the patient feels

itch)o Miconazole cream gr 50

PROGNOSE

Ad vitam : good ad sanam : good Ad functional : good Ad cosmeticum : good