DefinitionThis section has been translated automatically.
The name is borrowed from Latin (tinea = moth, woodworm).
Dermatophytes are able to break down keratin by splitting disulfide bridges, which explains their pronounced preference for substrates containing keratin. Even in case of tinea profunda with deep infestation of the hair follicles the pathogens do not penetrate into the dermis. By adding the respective body region, traditionally anchored terms like Eccema marginatum, Tinea inguinalis, Tinea barbae, Kerion Celsi, Tinea capitis profunda etc. become superfluous. The uniformity of the "tinea term" is endangered by designations like Tinea amiantacea for pityriasis amiantacea and Tinea versicolor for pityriasis versicolor.
The targeted treatment of tinea requires an exact diagnosis by detecting the pathogens in the native preparation and by culture.
PathogenThis section has been translated automatically.
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ClassificationThis section has been translated automatically.
The clinical picture of dermatophyte infection varies and is essentially defined by topography:
Occurrence/EpidemiologyThis section has been translated automatically.
Dermatophytes as pathogens of tinea are represented worldwide with different incidence and prevalence. The incidence of dermatomycoses depends mainly on local factors such as outside temperatures, skin perfusion and individual susceptibility. Thus, prevalences of tinea pedis in certain cohorts (e.g. soldiers) are between 10 and 15%.
Clinical featuresThis section has been translated automatically.
DiagnosisThis section has been translated automatically.
- infestation of hair follicles and/or nails
- Persistent hyper- or hypopigmentation
- Secondary bacterial overlaps
- Secondary contact allergy
- Surgical pretreatments (incisions)
- Pretreatment with corticosteroids
- Intertriginous maceration.
- See Table 1, see mycoses below.
General therapyThis section has been translated automatically.
External therapyThis section has been translated automatically.
External monotherapy is generally considered sufficient for the following types of dermatophytosis: non-inflammatory tinea corporis, tinea faciei, tinea manuum et pedum. The external antimycotics listed below are the most widely used, with comparable quality and effect:
- Imidazole derivatives: Clotrimazole (e.g. R055 R056, Canesten cream, Clotri OPT, Cutistad), Econazole (e.g. Epi-Pevaryl cream), Ketoconazole (e.g. Nizoral cream), Miconazole (e.g. R173, R172 Daktar solution, Vobamyk, Micotar), Bifonazol (e.g. Mycospor), Oxiconazol (e.g. Myfungar cream), Tioconazol (e.g. Mykontral), Fenticonazol (e.g. Lomexin)
- Allylamines: Naftifin (e.g. Exoderil cream), Terbinafin (e.g. Lamisil solution seems to have a certain superiority in the practical application compared to the imidazole preparations, as a one-time therapy - "Lamisil Once" - is effective for tinea pedis).
- Morpholine: Amorolfin (Loceryl cream)
- Ciclopiroxolamine (e.g. Batrafen cream)
- Sertaconazole nitrate (e.g. Zalain, Mykosert)
- Various: Tolnaftat (e.g. Tonoftal cream), colorants (e.g. eosin or methylrosanilinium chloride).
- Combination preparations with glucocorticoids, disinfectants or antibiotics. Although these combinations are appreciated as "antidepressants", they should only be used in exceptional cases. Glucocorticoid-containing monotherapeutics can be applied passagerly with inflammationally accentuated itchy dermatomycoses.
Internal therapyThis section has been translated automatically.
Indication for systemic therapy is given in the following diseases:
- Inflammatory accentuated dermatomycoses
- Hyperkeratotic tinea of the palms and soles of the feet
- Extensive tinea
- Tinea capitis
- Granulomatous or nodular tinea
- Immunocompromised patients
- Tinea unguium of several toes or fingers
- Therapy resistance or intolerance to external antimycotics.
The following preparations have found the widest distribution with comparable quality and effect: griseofulvin (e.g. Likuden M), itraconazole (e.g. Sempera), fluconazole (e.g. Diflucan), terbinafine (e.g. Lamisil).
Operative therapieThis section has been translated automatically.
ProphylaxisThis section has been translated automatically.
NaturopathyThis section has been translated automatically.
TablesThis section has been translated automatically.
Diagnostic criteria for tinea
Chronic liver diseases
Chronic kidney diseases
Endocrinological diseases (e.g. diabetes mellitus)
Peripheral circulatory disorders (Tinea unguium)
External pre-therapies (especially pre-treatment with glucocorticoids)
other skin diseases
especially atopy or contact sensitization
Lifeguard or similar
Sports activities with use of common cleaning areas in showers or sauna
General physical examination
Localization of the skin changes
Extent of the lesions
Type of lesion
Non-inflammatory, scaling, chronic
Acute or subacute, eczematous, itching
Follicular papules or nodules (abscess)
Vesicular or bullous (Id reaction)
Pustular, similar to pyoderma
Note(s)This section has been translated automatically.
- Taking of the smear: The taking of the smear is to be carried out according to the No. 298 GOÄ (also several times, in case of taking of different smears). Body parts and separate preparation). In the case of complex nail collection, the No. 743 GOÄ (analogous) can be applied.
- Microscopy: In case of microscopic fungus detection with addition of potassium hydroxide solution, No. 4711 GOÄ can be used. Simple staining with methylene blue is accounted for with No. 3509 GOÄ (per preparation).
- Culture: A Sabouraud agar (simple culture medium) is charged with No. 4715 GOÄ up to 5 times from the same medium. If special culture media (complex culture medium) are used, the number 4716 GOÄ or the No. 4717 (differentiation medium) must be used.
- Light microscopic examination of cultivated fungi: No. 4722 GOÄ.
LiteratureThis section has been translated automatically.
- Brasch J (1990) Pathogen and pathogenesis of dermatophytosis. Dermatologist 41: 9-15
- Drake LA et al (1996) Guidelines of care for superficial mycotic infection of the skin: Tinea corporis, tinea cruris, tinea faciei, tinea manuum tinea pedis. J Am Acad Dermatol 34: 282-286
- Effendy I (2003) Nail changes during childhood. dermatologist 54: 41-44
- Gupta AK et al (2003) Superficial fungal infections: an update on pityriasis versicolor, seborrheic dermatitis, tinea capitis, and onychomycosis. Clin Dermatol 21: 417-425
- Ilkit M et al (2014) Tinea pedis: the etiology and global epidemiology of
acommon fungal infection. Crit Rev Microbiol 41:374-388
- Leibovici V et al (2014) Prevalence of tinea pedis in psoriasis, compared to atopic dermatitis andnormal
controls--a prospective study. Mycoses 57:754-758
- Nenoff P et al (2014) Mycology - An Update Part 2: Dermatomycoses: Clinical picture and diagnostics. YYG 12: 749-778
- Seebacher C (2003) The change of dermatophyte spectrum in dermatomycoses. Mycoses 46(Suppl1): 42-46
- Seebacher C et al (2006) Tinea capitis. J Dtsch Dermatol Ges 4: 1085-1091
Incoming links (62)Acrocyanosis; Benhamiae trichophyton; Bowen's disease; Clotrimazole ointment hydrophilic 2% (nrf 11.50.); Clotrimazole solution hydrophile 1% (nrf 11.40.); Demodex folliculitis; Dermatitis; Dermatomycoses; Dermatophyte infections; Dermatophytosis; ... Show all
Outgoing links (65)Acute paronychia; Amorolfin; Antibiotics; Antimycotics; Candida paronychia; Chronic mucocutaneous candidiasis; Ciclopirox; Clotrimazole; Clotrimazole ointment hydrophilic 2% (nrf 11.50.); Clotrimazole solution hydrophile 1% (nrf 11.40.); ... Show all
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