Archive for July, 2009

Tinea Capitis Fungal Infection

A mold-like fungus called Tinea capitis is a fungal infection of the scalp. Tinea capitis fungal infection is widespread in some urban areas, particularly in children of Afro-Caribbean heritage, in North America, Central America, and South America.  It is common in parts of Africa and India. In Southeast Asia, the rate of infection has been reported to have decreased dramatically from fourteen percent to slightly over one percent in the last fifty years.  This said to be because of improved general sanitary conditions and improved personal hygiene practices in these areas. In northern Europe, occurrence of the disease is irregular at best.

In the United Kingdom and North America, T tonsurans is credited for more than ninety percent of cases of Tinea capitis fungal infection. In the non-urban areas, infrequent infections acquired from puppies and kittens are due to M canis, although this accounts for less than ten percent of cases in the United Kingdom. Occasional infection comes from other animal hosts like T verrucosum, from cattle, occur in more rural areas.

Tinea capitis can be persistent and very contagious. Tinea capitis is also called ringworm of the scalp.  Affecting children almost exclusively, this is a skin disorder that is caused by fungal organisms known as dermatophytes.  They cause scalp ringworm by outwardly contaminating certain kinds of tissue found in hair, skin, and nails. Tinea capitis is predominantly a disease of preadolescent children. It accounts for up to 92.5% of dermatophyte infections in children less than ten years of age. The disease is rare in adults, although occasionally, it has been found to affect the elderly. Tinea capitis occurrence is widespread in some urban areas in the United States.

Bald, patchy, areas where the hair has broken off from the scalp is just one of the symptoms of ringworm or Tinea capitis fungal infection.  Others are itching of the scalp, pus-filled lesions or sores on the scalp, round, scaly lesions on the scalp that may be inflamed, and small black dots on the scalp. This fungus is very contagious and easily passed from one person to another.  There is sometimes a problem with infection and re-infection within families, communities, and schools.

Tinea capitis symptoms to watch for are thickened, scaly, and sometimes boggy swellings, or expanded raised red rings. Common symptoms are severe itching of the scalp, dandruff, and bald patches where the fungus has rooted itself in the skin. Tinea capitis often presents identically to dandruff or seborrheic dermatitis.

Tinea Capitis Kerion

Tinea capitis otherwise known as scalp ringworm is a dermatophyte infection of the scalp. With certain dermatophyte infections like Tinea Capitis kerions are occasionally formed.  A kerion is a large, boggy, inflammatory scalp mass caused by a severe inflammatory reaction to the dermatophyte. A kerion may have pustules and crusting and can be mistaken for an abscess. A kerion may also cause scarring and hair loss.

Tinea capitis symptoms and signs vary by the area affected for example the skin, hair, nails etc.  Organism virulence and host susceptibility and hypersensitivity determine severity.  Most often, there is little or no inflammation; asymptomatic or mildly itching lesions with a scaling, slightly raised border fade and recur sporadically. Occasionally, inflammation is more severe and shows up as sudden vesicular or bullous disease. This is normally of the foot. It may also occur as an inflamed boggy lesion of the scalp called a kerion.

Tinea capitis causes the gradual appearance of round patches of dry scale, alopecia, or both. T. tonsurans infection causes what is called black dot ringworm.  With this infection the hair shafts break at the scalp surface.  M. audouinii infection causes patch ringworm.  The hair shafts break above the surface, leaving short stubs with this particular type of infection. Tinea capitis is less likely to appear as drawn out scaling, like dandruff, or in a spreading pustular patte

What is the most probable explanation for the higher occurrence of Tinea Capitis in the African-American population is that the higher prevalence is more likely due to infection and re-infection within families, communities, and schools. Ringworm of the scalp is most commonly caused by the fungus Trichophyton tonsurans.  Trichophyton tonsurans is the most common cause in the US, followed by Microsporum canis and M. audouinii. This fungus is easily passed from one person to another. It is also the cause of more than 90 out of every 100 cases of ringworm of the scalp found in both North and Central America.

Children are far more susceptible to the fungal infection and more likely than adults to develop a tinea capitis infection.  It is not unheard of that even after exposure to fungi causing ringworm adults do not develop an infection.   Adults can be carriers for ringworm, as well as children, but is less likely that the children carry the infection but show no symptoms.  Carriers can pass ringworm on to others but do not have symptoms of the disease.

Tinea Capitis Diagnosis

Tinea capitis symptoms on the scalp may or may not actually lead to a definite tinea capitis diagnosis.  It is sometimes hard to tell the source of the fungus or if it is an actual fungal infection.  This is a skin disorder that affects children almost exclusively. Tinea capitis is easily and frequently mistaken for other infections. Non-fungal conditions that resemble tinea infections include impetigo, Seborrhoeic dermatitis, Psoriasis, Discoid eczema, Lichen simplex, Contact allergic dermatitis and Pityriasis rosea. Suggestions for prevention include things like keeping the area clean.   Using a medicated shampoo, with ingredients like ketoconazole or selenium sulfide, may reduce the spread of infection.  It may be necessary for other family members and pets to be examined and treated.

There are options that can be explored to help with diagnosis.  Some are a skin lesion biopsy with microscopic examination can be done or culture or a Wood’s lamp test to confirm a fungal scalp infection.   The Wood’s lamp examination can be useful in evaluating the scope of infection, identifying areas for sampling and determining treatment response when the Tinea capitis diagnosis is positive. The examination can also be useful for looking at the contacts of an infected person.

Most dermatophytes do not fluoresce during examination but there are exceptions to this rule.  Two of those exceptions are zoophilic dermatophytes. Zoonotic means the disease can be passed from animals to humans.  Cats are more likely to be infected with Tinea capitis of all animals.  The skin changes in cats are very similar to those of affected people, but cats can carry the infection without exhibiting obvious signs just like infected humans.

Fungal organisms known as dermatophytes may cause scalp ringworm by infecting certain kinds of tissue found in hair, skin, and nails. It can be persistent as well  as contagious. Symptoms may consist of itching, scaly, and inflamed balding areas on the scalp. The specific pattern of fungal scalp ringworm depends on the infecting organisms.  Ringworm of the scalp or beard may look like dandruff with flakes of dead skin on the hair or beard. The infection can spread gradually and cover a large area.  Oral antifungal medications are required to treat the infection.  It is estimated that 3-8% of the population is affected by ringworm in the United States alone. Some people can carry the infection and pass it to others in the household. In other countries, statistics show an estimated 9.6% of people are affected to varying degrees, and nearly 40% can be carriers.

Tinea Corporis Contagious

The fungi transmitted primarily through contact with animals and is termed zoophile is usually responsible for Tinea corporis contagious infection. Most mammals have at least one type of fungus, and in most instances the animal and fungus coexist without the animal ever manifesting any symptoms of the fungus. This does not mean that the fungus cannot be transmitted to humans. Zoophile is the fungi category in which the infection is passed by animals.  There are two other categories of fungi that can cause infections of this type, geophile or fungi from soil sources and anthropophile, which are fungi from humans.

This highly contagious condition can be contracted by coming into direct contact with someone who is infected, or if contaminated items are touched. Because it is highly contagious the fungal infection can be passed from animal to person or person to person easily through contaminated items like clothing, shower or pool surfaces and toiletry items. The term tinea corporis is the medical term for ringworm, which refers to round or oval red scaly patches on the skin. Tinea corporis affects exposed areas but could also spread from other infected sites. Non-fungal conditions that resemble tinea corporis and could be mistaken for the infection include afflictions like impetigo, Seborrhoeic dermatitis, Psoriasis, Discoid eczema, Lichen simplex, Contact allergic dermatitis and Pityriasis rosea.

Ringworm or Tinea corporis infection forms a ring-shaped raised red rash in humans, but it is not the common appearance in animals.  Ringworm infections in animals can take on any form.  While ringworm can be passed from animals to humans, cats are the most likely of all animals to be infected and pass it on to human contacts.  The possible spread of Tinea corporis to humans can also come from other animals, including horses, camels, sheep and cattle.  Humans who have direct and repeated contact with animals have a much higher incidence of contracting the fungal infection this way.  They are also far more likely to contract a fungal infection or ringworm of the anthropophile variety from places like a school, playground, gym, or shower facilities.

Children seem to be the most vulnerable to Tinea corporis skin infection and can easily pass it around to other children. This does not mean that adults are not immune and they can also become infected. The best way to prevent Tinea corporis infections is by keeping the skin clean and dry, changing socks and underwear each day, and wearing some type of shower shoe or sandal when in public showers or locker rooms.

Jock Itch Tinea Cruris

Jock itch, Tinea cruris, Tinea of the groin are all phrases referring what is commonly called “jock itch”  Affecting people around the world, Jock itch is just one of superficial fungal infections of the skin, known as dermatophytes. These are some of the most common self-treatable trivial medical conditions. As opposed to more serious fungal conditions, such as candidiasis or sporotrichosis, dermatophytes are limited to the upper layer of skin.  Living there undetected they feed on the dead skin cells called keratin.  Unlike yeast infections, tinea cruris generally does not involve the scrotum or the penis.  It is very common and affects men more often than women and rarely affects children.

As many as one in five Americans have a dermatophyte infection at any particular time. The most common dermatophytic infection in the United States is athlete’s foot or tinea pedis. Tinea corporis and tinea cruris are also quite common. In a large part Tinea Cruris begins as Tinea Pedis and is spread to the groin area unsuspectingly. Keeping feet clean and dry, not sharing socks or contaminated articles and wearing shower shoes goes a long way to keeping Athlete’s Foot from spreading to the genitial area.   Most experts will recommend boiling the underclothing or contaminated garments thoroughly to minimize the possibility of re-infection.

Humidity and moisture play contributing roles in the contraction of any fungal infection. The way the infection spreads is similar to the growth patterns that are seen in molds, mildew, and similar plant species.  Jock itch usually begins with mild sporadic itching in the groin. The itching can get progressively worse and become quite unbearable. The itching rash is usually found on both sides of the groin and affects the skin folds, the inner thighs and genitals. Direct skin contact raises the chances of contracting a fungal infection. Humans are far more likely to contract a fungal infection or ringworm from places like a school, playground, gym, or shower facilities.

Tinea of the groin, Jock itch or Tinea cruris tends to have a reddish-brown color and to extend from the folds of the groin down onto one or both thighs. Other conditions that can be confused with Tinea cruris include yeast infections, psoriasis, and intertrigo, a chafing rash which results from the skin rubbing against the skin. Persons with atopic dermatitis, which is a persistent inherited skin affliction characterized by itchy, inflamed rashes on the skin may also be more susceptible to contracting jock itch.

Griseofulvin Tinea Capitis

Tinea capitis, or ringworm of the scalp, is the most common dermatophyte infection among children.  This is a problem worldwide but approximately 3 to 8 percent of American children are affected, and up to one third of in-house contacts are asymptomatic carriers, meaning they show no outward signs of the infection. Tinea infections are usually spread by humans but may also be passed to humans from animals. Adolescent and adult infections are uncommon.

The three primary dermatophytes most commonly seen are Trichophyton tonsurans, Microsporum audouinii and Microsporum canis. Anti-fungal medications, taken by mouth, are used to treat the infection. There are several different options that are often used to treat this condition.  Griseofulvin has long been the standard therapy for tinea capitis.  It is currently the only antifungal agent labeled by the U.S. Food and Drug Administration for this condition. Griseofulvin is an antibiotic derived from a species of Penicillium.

Griseofulvin acts systemically to inhibit the growth of Trichophyton, Microsporum, and Epidermophyton genera of fungi. With the use of an anti-fungal like griseofulvin Tinea Capitis can be treated effectively.  Fungistatic amounts are deposited in the keratin, which is gradually exfoliated and replaced by non-infected tissue.  Griseofulvin absorption from the gastrointestinal tract varies considerably from one individual to the next. This is mainly because of insolubility of the drug in the upper G.I. tract. The peak serum level found in fasting adults given 0.5 gm occurs at about four hours and ranges between 0.5 and 2.0 mcg/mL.

As previously mentioned some individuals do not absorb at the same rate as others and tend to attain lower blood levels at all times. This may explain why some patients respond better to this type of treatment than others. Better blood levels can probably be attained in most patients if Griseofulvin is taken after ingesting a meal with a high fat content.

Some of the symptoms of tinea capitis or scalp ringworm to watch for are bald patched areas, where hair that has broken off from the scalp, itching of the scalp, pus-filled lesions or sores on the scalp, round, scaly lesions on the scalp that may be inflamed, and small black dots on the scalp. Tinea capitis may be extremely persistent, and it may return after treatment. It has been found that in many cases it goes away on its own as a person reaches puberty.  Good general hygiene is a key factor to prevent and treat tinea infections.

Tinea Corporis Emedicine

In discussions of infections such as Tinea Pedis and Tinea corporis Emedicine states that these fungal infections occurs worldwide. Tinea pedis is the most common type in the United States and in the rest of the world. According to Emedicine Tinea capitis, which is ringworm of the head, is the most common dermatophyte infection of childhood.  Tinea corporis on the other hand is present in all ages, although it is seen more frequently in adolescents and pregnant females.  Onychomycosis is a common problem, especially in adults. In a survey in the United States, the occurrence of onychomycosis was approximately 3% in males and 1.4% in females. Emedicine goes on to state that in a sample of North American children, 0.44% had onychomycosis.

Fungal infection concerns all races, but the frequency of organisms differs by country.  Both sexes are touched by fungal infection. Though in some cases like Tinea cruris the infection is much more commonly found in males.  This is because of the male anatomy is prone to and allows moisture to accumulate in the crural folds. Fungal infection can also affect all ages. Tinea capitis mainly is found in children but adults are not immune

Tinea cruris, tinea pedis, and onychomycosis predominantly affect the adult population. Dermatophytoses may be acquired from different sources, such as people, animals, or soil.   Infected humans are the most common source of tinea corporis in the United States. Contact with contaminated household pets, farm animals, and contact with infected hair brushes, towels, etc. can spread infection.  T verrucosum causes 98% of dermatophyte infections in cattle and is showing increasing prevalence of infection in human contacts. T mentagrophytes is spread by rabbits, guinea pigs, and small rodents.

Tinea corporis may result from contact with infected humans, animals, or inanimate objects. Persons such as farm workers, zookeepers, laboratory workers and veterinarians have a higher exposure rate to possible infection from animals. Gardening or contact with animals provides opportunities for infection as well as contact sports and sports facilities exposure.

Tinea corporis can manifest in a variety of ways.   Infection signs are typically noticed on the exposed skin of the trunk and extremities.  Tinea Corporis is characterized by annular scaly plaques with raised edges, pustules, and vesicles. This is usually tinea imbricata (Trichophyton concentricum).Tinea corporis gladiatorum is seen on the head, neck, and arms, in a pattern consistent with the areas of skin-to-skin contact often seen in contact sports such as wrestling.

Tinea Corporis Tinea Cruris

Tinea corporis is the name given to a fungus infection of the skin also called “ringworm of the body”.  This condition often has an impact on children and adults who live in warm, damp environments like tropical climates. The typical appearance of this infection is a circular plaque with a well outlined border. Since tinea corporis can be contagious and it can spread rapidly among children and in settings like day-care centers and schools.  It may be passed from person to person, from contact with an infected animal, most often a cat, or from exposure to fungus in the soil. Itchy red scaly patches come up anywhere skin contact has been made. They often develop into a ring-like formation.

Tinea Corporis, Tinea cruris and other tinea infections of this type can usually be cleared up with topical creams.  If the infection was spread by an animal, even if it shows no signs of a skin infection treatment will need to be administered to the animal also.  Tinea corporis is a superficial dermatophyte infection.  Ringworm is the more common term used for Tinea corporis infection with is caused by dermatophytes.  Dermatophyte infections can be distinguished by either inflammatory or non-inflammatory lesions on the skin.  Tinea corporis looks like a rash that forms one-half to one-inch, ring-shaped, pink or red patches with a clear center. A slightly itchy rash may accompany the other symptoms.

Jock itch or Tinea cruris appears around the groin area but not normally on the penis and develops into a red, ring-like rash. Jock itch can be unbearably itchy and form small, painful blisters. This type of ringworm can cause itching or a burning sensation in areas of the groin, thigh skin folds, or anus.  It may also affect the inner thighs and genital areas. The itchy red patches will spread in the warm moist areas of the body. Variations of red, tan, or brown coloration may appear in the infected areas.  Flaking, rippling, peeling, or cracking skin will also be present. Unlike yeast infections, tinea cruris generally does not involve the scrotum or the penis.  It is very common and affects men more often than women and rarely affects children.

Tinea corporis on the other hand occurs in both men and women. Women of childbearing age are more likely to develop tinea corporis as a result of their greater frequency of contact with infected children. Dermatophyte infections can be a nuisance but normally do not present any serious or life threatening repercussions.

Ringworm Scalp Tinea Capitis

When dealing with skin infections such as ringworm scalp (tinea capitis) and feet (tinea pedis) are the more common areas affected by this type of infection.  Ringworm of the scalp is a very common fungal infection but it can be treated and kept from spreading to others. Fungal organisms known as dermatophytes can cause scalp ringworm by on the surface infecting certain kinds of tissue found in hair, skin, and nails. This forms the crusty, scaly patches related with scalp ringworm. Scalp ringworm (Tinea capitis) is a very widespread and extremely common fungal infection predominately seen in children the world round. Children from four to fourteen years are the most likely to develop tinea capitis symptoms, although it can occasionally appear in adults.

Ringworm of the scalp (tinea capitis) is also one of the more common causes of hair loss. On some occasions it may be quite easy to recognize the infection because of the scalp symptoms which can include a red circular lesion, hair loss, and a scaly border that may be itchy. Scalp ringworm signs and symptoms can often be more subtle though, with no apparent signs of scaling or itching, and broken hairs instead of hair loss which is called black dot tinea capitis. Some of the symptoms of tinea capitis or scalp ringworm to watch for are bald patched areas, where hair that has broken off from the scalp, itching of the scalp, pus-filled lesions or sores on the scalp, round, scaly lesions on the scalp that may be inflamed, and small black dots on the scalp.
Areas that are frequently moist from perspiration, skin folds that stay damp are ripe for a fungal infection attack. The fungi that cause ringworm tend to grow and thrive in warm moist areas of the body.  The feet, the groin and the scalp are good examples of the areas most affected.  You may experience bald patches where hair would normally grow on the scalp.  The fungus lives on the dead tissue of the skin and leaves a lesion.  Ringworm can only live on the dead layer of keratin protein on top of the skin. It has been found that in many cases as a person reaches puberty it goes away on its own.  Good hygiene is a key factor to generally prevent and treat tinea infection of the skin because it may be aggravatingly persistent, and come back again after treatment.

Ovide head Lice Treatment
Where head lice are concerned there are several different methods of treating them, among these being the very odd methods of smothering the creatures with substances that are found in the average kitchen through washing the hair regularly in a natural herbal shampoo, right down the basic and essential practice of combing the hair with a special head lice comb, something that should be carried out in conjunction with any other chosen method.
However, despite the availability of prescription insecticide shampoos, designed to kill the creatures and reportedly very effective, many people are wary of using these items, and choose not to do so. They fear the consequences of smothering their child’s head in what is effectively a poison, and of the apparent possible side effects these substances can have.
Ovide head lice treatment is one of these popular prescription only lotions, so let’s have a closer look at what it is, what it does, and whether or not there is anything to be concerned about.
The first thing to understand is the Ovide is a trade mark, a brand name for a particular head lice treatment, and it contains an insecticide called Malathion. Malathion is present in only minute quantities in the product – one half of a percent, in fact – yet this is said to be enough to kill the head lice while being harmless to the patient. However, it is not for use on those under six years of age, and does come with some possible side effects.
Side effects are minor, and include an increase in dandruff and irritation to the scalp; furthermore, the substance can be dangerous to the eyes, and as Ovide is an alcohol based product it is flammable.
The plus side is that it is thoroughly tested and is safe when used in conjunction with the directions given, and as it is available only on prescription cannot be given for anything other than serious head lice infestations.
There are many reports that some insecticides have become useless as the head lice have developed immunity to them, although this is not a reported problem with Malathion based lotions such as Ovide. It remains popular and widely prescribed, and is certified safe.
The choice as to whether to use an insecticide or a natural product remains with the individual, with the advantages of scientific testing and known success being for the former, and the knowledge of complete safety for the latter; it’s a choice only you can make.