Description, Causes and Risk Factors:
Alternative Name: Oriental ringworm, scaly ringworm, Tokelau ringworm.
Tinea imbricata is an unusual form of tinea corporis caused by the strictly anthropophilic dermatophyte Trichophyton concentricum (T. concentricum). The social consequences of T. concentricum infections in Melanesia and Polynesia merit special attention. Tinea imbricata is well established in many islands in the southern part of the Pacific Ocean. Tinea imbricata usually affects people living in primitive and isolated conditions.
Tinea imbricata is observed in all ages, from babies (six months old) to the elderly, and more frequently in farmers and land workers.
Transmission is usually by direct personal contact between family members sharing household items or from parent to child soon after birth. High humidity and warmth are likely environmental factors in the incidence of infection. Autosomal recessive inheritance has been implicated to play a role in the high susceptibility rates in some regions.
Some risk factors can be identified, such as humidity, poor hygiene, as well as genetic and immunological factors. Dietary influences, iron deficiency, and malnutrition have been cited as associated factors, but their precise role has not been determined.
Lesions begin as small, brown, pruritic macules and papules and progress to concentric rings of scales. The infection usually begins in childhood, and progresses slowly over time. Over 75% of those affected will have lesions covering 50% or more of their skin surface. The lesions are quite pruritic, and the pruritus is aggravated by heat. Areas of lichenification develop after chronic excoriation. As this infection is superficial, patients do not have accompanying constitutional symptoms.
The doctor will diagnose the condition by looking at the rash. The doctor may also scrape a few scales from the infected area and send it to the lab for examination under a microscope.
In some cases, the following tests may be done:
Skin lesion biopsy.
KOH (potassium hydroxide) test.
Most cases can be treated using an over-the-counter antifungal cream, gel or spray. There are lots of different kinds, so ask your dermatologist to help you choose the right one for you.
Usually, you apply antifungal creams, gels and sprays daily to the affected areas of skin for two weeks. The cream, gel or spray should be applied over the rash and to one inch of skin beyond the edge of the rash. Read the manufacturer's instructions first.
You may be advised to use the treatment for a further two weeks to reduce the risk of re-infection.
See your dermatologist if your symptoms do not improve after two weeks of treatment, as you may need to take antifungal tablets.
Research: Some patient responded to treatment with oral terbinafine 250 mg/day topical clotrimazole (1% ointment), topical miconazole (2% cream) two times daily and potassium permanganate for daily washing for four weeks.
Risk and benefits of medications should be discussed with your dermatologist before taking any medications.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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