By Gary M. White, MD
Tinea corporis (aka ringworm) is a fungal infection of the skin, usually on the trunk or extremities, by a dermatophyte.
A red, annular scaly lesion or lesions is seen. The border is often said to be "active", meaning it is more red, inflammatory, raised, etc. Larger plaques or areas may occur, emanating from the gluteal cleft, web spaces or occurring anywhere. At times, the body's immune response is so exuberant that only an inflammatory plaque is seen (see tinea, inflammatory).
See annular, red, scaly lesions.
For limited disease, a topical antifungal medication is indicated. For more widespread disease, an oral antifungal (e.g., terbinafine) should be given. Patients who get tinea corporis often have recurrences. In order to minimize these, any tinea infection of the nails should be eliminated (see onychomycosis) and tinea of the feet suppressed (see tinea pedis).
Oral ketoconazole should not be used due to the risk of fulminant hepatitis.
The dorsal hand and wrist rash is less obvious. The ventral wrist has the characteristic active edge.
Tinea often "emanates" from the gluteal cleft.
Watch for the tinea creeping up the leg.
Cases with greater inflammation.
Tinea corporis on the thigh.
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