Spongiotic Dermatitis - Tinea

• The most likely diagnosis is?

a) Nummular dermatitis

b) Psoriasis

c) Contact Dermatitis

d) Berloqu dermatitis

e) Tinea Corporis

Question

Spongiotic Dermatitis - Tinea

Tinea (ringworm) is a dermatophyte infection of the skin

Fungal Infection of body/scalp can occur at any age and is more common in warmer climates

Spongiotic Dermatitis - Tinea

There is a broad manifestation of lesion size and location

This variability is explained by differences in host immunity and species of fungus

Spongiotic Dermatitis - Tinea

In classic ringworm, lesions begin as flat, scaly spots that then develop a raised border extending out in all directions.

The central area may become brown or clear, and has less scale than the advancing border

The vesiculobullous reaction pattern - dermatophyte The prototypical lesion of tinea

corporis is an annular scaly patch that may occur singularly or in multiple forms

Frequently polycyclic rings occur. Additional features are

involvement of the hair follicle with a fungal folliculitis or inflammation with pustules, vesicles, and crusting.

Spongiotic Dermatitis - Tinea

• Clinically, dermatophyte infections are classified by body region.

Spongiotic Dermatitis - Tinea

Tinea Faciale

Tinea corporis

Tinea cruris

Tinea Capitis

Tinea Manum

The vesiculobullous reaction patthern - dermatophytosis

The vesiculobullous reaction pattern - dermatophyte

• Dermatophytes are classified in several ways. The ringworm fungi belong to three genera: Microsporum, Trichophyton, and Epidermophyton.

• The anthropophilic dermatophytes grow only on human skin, hair or nails

• Zoophilic varieties originate from animals, but may infect human.

• Geophilic dermatophytes live in soil but may infect humans.

• KOH prep reveals hyphae

The vesiculobullous reaction pattern -dermatophytosis

• The dermatophytes include a group of fungi (ringworm) that under most conditions have the ability to infect and survive only on dead keratin, that is, the top layer of the skin , the hair, and the nails

• They cannot survive on mucosal surfaces such as the mouth or vagina where the keratin layer does not form

• Treatment is antifungal creams for tinea corporis• Oral antifungals for tinea capitis and tinea unguium

• This dermatitis best represents

a) Vitiligo

b) Post inflammatory hypopigmentation

c) Psoriasis

d) Albinism

e) Tinea Versicolor

Question

Tinea Versicolor• Caused by the yeast Malassezia

furfur • It manifests clinically as white or

light brown macules that may be discrete or confluent, on the trunk especially.

• Usually asymptomatic • May cause some itching• Chest and back are usual

location

Tinea Versicolor

• Versicolor means multiple colors• The patches may be

hyperpigmented

Tinea Versicolor

Tinea Versicolor

Tinea Versicolor

• Scales scraped from lesions and placed in KOH may be scrutinized by conventional microscopy

• Short, blunt hyphae and small spores (Spaghetti and meat balls)

Tinea Versicolor

• Woods light exam helps to evaluate the extent of the disease

Tinea Versicolor - Therapy

• For localized disease, administration of topical antimycotics, such as azoles, or selenium sulfide in a shampoo eliminates the causative organisms.

• For widespread lesions, oral ketoconazole, itraconazole, or fluconazole is curative