Description, Causes and Risk Factors:
Alternative Name: Favus, crusted ringworm, honeycomb ringworm.
A severe, unremitting type of chronic ringworm of the scalp and nails, with scarring and formation of crusts called scutula, caused by three dissimilar dermatophytes, Trichophyton schoenleinii (most commonly), T. violaceum, and Microsporum gypseum. It occurs more frequently in the Mediterranean countries, southeastern Europe, southern Asia, and northern Africa.
Tinea favosa is a chronic fungal infection of the scalp, glabrous skin, and/or nails caused by Trichophyton schoenleinii. Occasionally Trichophyton violaceum or Microsporum gypseum may cause similar lesions. Although tinea favosa occurred worldwide in the past, due to the great improvement in socio-economic conditions it is now limited to some endemic regions. It can still be found in areas where the population suffers from poor hygiene and malnutrition. Tinea favosa has been observed worldwide, including Southern and Northern Africa, Pakistan, the United Kingdom, Australia, South America, the Middle East, and Poland.
The eruption takes the shape of large flattened pustules, which have an irregular edge, and are surrounded by inflammation. Sometimes they appear first behind the ears, and at other times upon the face, spreading thence to the scalp. The face is usually involved to some extent wherever the eruption may originally show itself. Tinea favosa is mostly confined among children. In the outset of the disease the pustules on the scalp are generally distinct: -- on the face they rise in irregular clusters. When broken they discharge a viscid matter and run together, gradually forming sores of a vicious character. These sores are covered by yellowish-greenish scabs which present a revolting appearance.
Itchiness in the red area.
Scaling of the ring or patch.
Slightly raised border.
Often redder around the outside with normal skin tone in the centre.
Centre of the ring looks normal (tendency to clear centrally).
Pink to red patch or ring with slight inflammation.
Differential Diagnosis: Psoriasis, alopecia areata, seborrheic dermatitis, pityriasis rosea, drug eruptions, eczema, skin lupus.
From eczema by the condition of the affected hair, the atrophic and scar-like areas, the odor, and the history. From ringworm by the crusting and the atrophy. In this latter disease there is usually but slight scaliness, and rarely any scarring.
Finally, if necessary, a microscopic examination of the crusts may be made.A portion of the crust is moistened with liquor potass
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