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11.17 Tinea (Athlete's Foot, ringworm)


Presentation

Patients usually seek emergency care for "athlete's foot," "jock itch," or "ringworm" when pruritis is severe or when secondary infection causes pain and swelling. Tinea pedis is usually seen as interdigital scaling, maceration, and fissuring between toes. At times tense vesicular lesions will be present instead. Tinea cruris is usually a moist, mildly erythematous eruption symmetrically affecting both groin and upper inner thigh. Tinea corporis appears most often on the hairless skin of children as dry erythematous lesions with sharp annular and arciform borders that are scaling or vesicular.

What to do:

What not to do:

Discussion

Tinea versicolor is asymptomatic, and its presentation to an acute care facility usually is incidental with some other problem. There is, however, no reason to ignore this fungal infection, which causes cosmetically unpleasant, irregular patches of varying pigmentation that tend to be lighter than the surrounding skin in the summer and darker than the surrounding skin in the winter. Prescribe a 25% sodium hyposulfite lotion (Tinver) bid for several weeks or a 2.5% selenium sulfide lotion (Selsun). Superficial scaling will resolve in a few days and the pigmentary changes will slowly clear over a period of several months.

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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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Craig Feied, MD
Mark Smith, MD
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