Ringworm

views updated

Ringworm

Introduction

Disease History, Characteristics, and Transmission

Scope and Distribution

Treatment and Prevention

Impacts and Issues

BIBLIOGRAPHY

Introduction

Ringworm, also known medically as Tinea and dermatophytosis, is a group of contagious, very common cutaneous (skin) infections, which can also involve the scalp, hair, or nails. It is caused by various moldlike fungi called dermatophytes, which live on dead tissues of the body. Because many different fungi species cause ringworm, an infection with one species will not make a person immune to infection from other species.

Moist areas of the body such as the groin, between the toes, and in the armpits are generally infected the most frequently. The infected area often looks inflamed and feels itchy. These symptoms are caused by sensitivity to the fungus or by a secondary bacterial infection. Ringworm, in its most serious forms, causes an acute infection with blisters on the feet or lesions on the scalp.

Disease History, Characteristics, and Transmission

The most common symptom of ringworm is flat, nearly round lesions. They may be dry and scaly, or moist and crusty. Eventually, they turn red and become extended, itchy bumps with edges that blister and secrete fluid. As the infection continues, the color sometimes becomes nearly clear in the center and redder on the outside. This pattern causes the patch to look ringlike in appearance, which gives ringworm its common name.

The incubation period is generally not known. However, ringworm of the scalp (tinea capitis) usually appears 10–14 days after contact and ringworm of the body (tinea corporis) usually appears in 4–10 days.

Ringworm infection is most often spread during human-skin-to-human-skin contact. It becomes contagious to another person even before the infection is evident on the first person. Ringworm is sometimes spread when humans touch infected cats and dogs; when humans care for other domestic animals such as cows and pigs; and when humans touch contaminated clothes, towels, hairbrushes, combs, headgear (such as hats), or other infected objects.

The most contagious form—ringworm of the scalp—is seen primarily in children. Symptoms include growing pimples, itching of scalp, and breaking off of hair. The scalp may temporarily become bald in patches.

Ringworm can also occur on the arms, legs, and trunk. It causes raised, round patches on the skin. The inner parts heal first, while the outer parts further spread the infection. When ringworm infection reaches other areas of the body, such as the armpit and groin, the shape often changes to resemble butterfly wings or it may be completely irregular in shape. The condition is called tinea cruris, or jock itch, when it affects the groin area.

The fingernails and toenails may also be infected. This condition is called tinea unguium. When this happens, the nails become yellowish, thickened, and deformed. They may crumble and fall off. When the infection spreads to the feet, ringworm is often called athlete's foot (tinea pedis). When ringworm affects facial hair it is called tinea barbae; when it affects the face, tinea faciei;andwhenit affects hands and palms, tinea manuum.

WORDS TO KNOW

CUTANEOUS: Pertaining to the skin.

DERMATOPHYTE: A dermatophyte is a parasitic fungus which feeds off keratin, a protein which is abundant in skin, nails and hair and therefore often causes infection of these body parts

TOPICAL: Any medication that is applied directly to particular part of the body's surface is termed topical; for example, a topical ointment.

IN CONTEXT: CULTURAL CONNECTIONS

Ringworm-causing fungi affect various parts of the body and give rise to alternative names and conditions. In the scalp ring worm is known as tinea capitis, on the body, ringworm is known as tinea corporis). In the groin region ringworm is known as tinea cruris, more commonly called “jock itch,” and on the feet ringworm is known as tinea pedis, more commonly known as athlete's foot.

Over one million children (about 0.3% of the 2006 population) are infected with scalp ringworm annually in the United States. It is a highly contagious, and the number of children infected each year is increasing. Ringworm of the scalp represents over 90% of all skin fungal infections in U.S. children aged ten years or younger. About 7% of the U.S. population suffers from ringworm of the scalp. It is most frequently caught in overcrowded conditions such as medical facilities, nursing homes, and educational institutions. Elderly people and people with weak immune systems are at increased risk for acquiring ringworm because of their susceptibility to infections.

Jock itch and athlete's foot are important economically because they are targets of several commercial products and generate millions of dollars in advertising revenues spent to market the over-the-counter products designed to fight the fungal infections.

Scope and Distribution

Ringworm can occur almost anywhere in the world. Because the fungi that cause tinea cruris and tinea pedis thrive in moist and humid areas, they occur most frequently in the tropical and subtropical areas of the world.

Treatment and Prevention

Doctors often identify ringworm visually. If not recognizable, it is often diagnosed by scraping off or plucking some material from the infected area. The sample is examined under a microscope to confirm the presence of fungal growth. Ringworm of the scalp is diagnosed with an ultraviolet light under which the fungus appears to be a bright, yellowish green color.

Ringworm treatment includes topical antifungal medications. Common antifungal creams, lotions, or powders that contain miconazole, econazole, or clotrimazole are often used either by prescription or over-the-counter.

Infected children are sometimes isolated from others, especially other children, to prevent further spreading of the infection. Griseofulvin is commonly used to treat animals and humans. It usually eliminates the infection, but side effects can be pronounced. Undecylenic acid is sometimes used as a fungicide. Antibiotics may be necessary to cure bacterial infections.

According to the Mayo Clinic, although ringworm is unpleasant, it is not serious except for people with weak immune systems. Ringworm usually resolves itself without a visit to the doctor within four weeks. Bed linens and pajamas should be washed daily. A person should seek medical treatment if the infection becomes severe or persistent. Antifungal drugs, including fluconazole, itraconazole, ketoconazole, and terbinafine, are sometimes taken by mouth for persistent infections.

The National Institutes of Health recommends a variety of measures to prevent ringworm including:

Shampoo hair regularly, especially after it is cut.
Wear shoes in shower stalls, gym locker rooms, pools, and other moist areas.
Keep skin and feet clean and dry.
Do not share personal care items or items of apparel, such as towels, hairbrushes, shoes, or hats.
Avoid touching pets or other domestic animals that have bald spots.

Impacts and Issues

Anyone can get ringworm. Children are more susceptible to certain types of ringworm fungi, while other types occur equally in all age groups. Children become more susceptible to ringworm when they are malnourished, live in a warm climate, practice poor hygiene, come into contact other children or pets with ringworm, or have weak immune systems due to medicines or disease. Complications of ringworm include spreading the infection to other areas than the initial site; bacterial skin infections; skin irritations, such as contact dermatitis; and side effects from drugs used for treatment.