Tinea corporis is the term used to describe a fungal infection of the skin on the body, including the extremities, excluding the hands and feet. The infection is caused by filamentous fungi and is symptomatically accompanied by redness of the skin or pustules with severe itching. More than 30 species of filamentous fungi are known to cause tinea corporis in humans.
What is tinea corporis?
Tinea corporis is a fungal disease of the skin of the body, which includes the extremities excluding the hands and feet. Symptomatic features include localized redness of the skin or even pustules filled with tissue fluid or pus. Typically, the infected skin areas produce intense itching. Tinea corporis is one of the most common skin diseases, which can take a mild or acute course depending on the pathogen and the condition of the immune system. In many cases, there is a chronic infection with only mild symptoms. Skin fungi, also known as dermatophytes, live aerobically and heterotrophically, meaning that their metabolism depends on oxygen and organic matter for nutrition. A common characteristic of skin fungi is their ability to break down and metabolize keratin from dead skin cells. They possess the enzyme keratinase, which in principle is also capable of breaking down other proteins such as collagen and elastin. Dermatophytes, which can be infectious for humans, can be divided into anthropophilic, zoophilic and geophilic pathogens with regard to their “preferences”. While anthropophilic species specialize in infesting human skin, zoophilic species infect animals, including pets. However, zoophilic dermatophytes can also infect humans. The geophilic species are found almost everywhere in soil and are pathological to humans only in exceptional cases.
Causes
Tinea corporis is caused by pathogenic filamentous fungi, which are classified as cutaneous fungi or dermatophytes. More than 30 species of filamentous fungi are known to cause the typical fungal infections in human skin. Since pathogenic skin fungi or their spores are almost ubiquitous, an infection leading to the development of tinea corporis is favored by a weakened immune system. For example, diabetes mellitus, an immune system weakened by HIV or artificially suppressed by drugs to suppress rejection are increased risk factors. The disease can be transmitted through direct skin contact or contact with shared items such as towels or washcloths, as well as sanitary surfaces. Public sauna areas or swimming pools are also frequent sites of infection, as the skin fungi prefer warmth and moisture. Infections are therefore particularly persistent in areas of the body that are usually warm and moist, for example between the toes. Infection with zoophilic dermatophytes can also occur through direct physical contact with infected pets, for example with dogs, cats or hamsters.
Symptoms, complaints, and signs
Symptomatic of tinea corporis are initially small round spots on the skin with a diameter of one to two centimeters. Characteristic, but not obligatory, is marginal tenderness of the spots and itching, which can be severe. In deeper infections, additional symptoms of inflammation may develop. In the case of infections with anthropophilic dermatophytes adapted to humans, the symptoms that occur are usually weak, so that they often receive little attention and a chronic skin fungal disease can develop due to non-treatment. Deeper fungal infections can also be accompanied by painful inflammatory reactions. A special form is the so-called tinea corporis gladiatorum, also called mat burn, which predominantly affects martial artists who practice their sport on floor mats and can contract minor abrasions when throwing or falling on the mat, into which certain filamentous fungi penetrate and trigger mat burn.
Diagnosis and course of the disease
The typical symptoms, including itching, that seem to indicate tinea corporis may also have other causes, such as psoriasis, dry eczema, and others. To rule out a confusion of causes, a smear of the affected skin area is examined under the light microscope.If it becomes necessary to identify the exact type of filamentous fungus, a culture can be made with the swab of the skin on various culture media. However, the procedure may take several weeks. An examination using Wood’s light, also known as black light, can also provide information. The black light in the UV range of up to 365 nanometers wavelength causes skin areas infected with certain dermatophytes to glow green-yellowish. Genetic examination of fungal DNA to accurately identify the fungal species is also possible.
Complications
If left untreated, tinea corporis can cause a number of severe skin irritations. Severe pain, itching, and redness occur, which sufferers find extremely uncomfortable. Occasionally, bleeding occurs. In addition, painful blisters and pustules form in the course, which can become inflamed. In the further course, the fungal infection spreads to other regions of the body. The result is scales, papules and sometimes painful abscesses. Tinea corporis can also have long-term psychological effects. Sufferers often suffer from inferiority complexes and depressive moods. During treatment via antimycotics, side effects such as nausea, vomiting or headaches may occur. Fever and chills as well as kidney and liver damage may also occur in rare cases. In pregnant women and mothers during breastfeeding, the preparation may harm the child. In addition, allergies or intolerances may occur that require further treatment. Improperly applied home and natural remedies may also cause discomfort and possibly aggravate tinea corporis. It is therefore advisable to discuss the treatment of a fungal infection of the skin with the family doctor or a specialist beforehand.
When should you go to the doctor?
The affected person is in any case dependent on a medical examination and treatment in the case of tinea corporis. Only this can prevent further worsening of the symptoms, while further complications can also occur if the disease is not treated. Therefore, in the case of tinea corporis, a medical professional should be contacted at the first symptoms or complaints. Self-cure usually cannot occur with this disease. The doctor should be consulted in case of tinea corporis if the affected person suffers from severe itching on the skin. In most cases, the skin is covered with spots, and there may also be infection or inflammation on the skin itself. If these symptoms occur, the affected person must definitely consult a doctor. As a rule, tinea corporis also leads to a significant reduction in aesthetics, so that it can also lead to psychological upsets or depression. In this case, a psychologist should be consulted. The symptoms of tinea corporis are treated by a dermatologist.
Treatment and therapy
Basically, topical and systemic and a combination of both types of therapy are available for the treatment of tinea corporis. Topical therapy involves local control of the fungal infection with antifungal creams or ointments, tinctures, or powders. Most antifungal agents are aimed at inhibiting ergosterol, which is an important and necessary component of fungal cell membranes. If topical treatment does not achieve the goal because many body sites are affected, systemic treatment by oral intake of certain drugs containing antifungal agents is also possible. However, interactions with other drugs and possible side effects must be considered. In principle, therapies should be continued for three to four weeks after the symptoms have subsided to prevent the fungal infection from flaring up again (recurrence).
Prevention
The most important prevention for avoiding tinea corporis is to have an intact immune system. If the immune system cannot function optimally because of other diseases or because of artificial immunosuppression or because of unfavorable living conditions, typical sites of infection such as public baths and saunas should be entered only with bath slippers and thorough drying after showering. Breathable clothing is also preventive. Towels and textiles should be washed at 90 degrees to safely kill any fungi and spores.
Aftercare
In most cases, only limited or very few measures of direct aftercare are available to the affected person in the case of tinea corporis. For this reason, the affected person should see a doctor at an early stage to prevent the occurrence of other complications and complaints. It is also not possible for the disease to heal on its own, so a doctor should be consulted at the first signs and symptoms of the disease. Most sufferers are usually dependent on taking various medications to alleviate or limit the symptoms. Care should always be taken to ensure that the medication is taken regularly and in the correct dosage. If there are any uncertainties or questions, a doctor must always be consulted first. Likewise, the doctor should also be contacted if there are changes and complaints on the skin. The life expectancy of the affected person is usually not reduced. In some cases, contact with other patients of the disease may also be useful, as this will result in an exchange of information.
What you can do yourself
In addition to drug treatment, those affected can use other simple home remedies as a supportive measure: In the foremost place here is keeping the affected skin areas dry to prevent the spread of the fungus. In addition to a sufficient air supply for the skin, infected areas can be powdered with healing earth or baking powder. However, due to the additional care substances and oils contained, conventional cosmetic powders and baby powders are not recommended here. Apple cider vinegar has also been used for a long time as an old remedy for fungal infections. Affected persons can dab the affected areas several times a day with a cotton ball soaked in apple cider vinegar. Tea tree oil and Australian Manuka honey are used in a similar way. Like apple cider vinegar, these products are believed to have antifungal, or fungicidal, effects. However, all these agents should not be used if an antifungal ointment is applied to the skin at the same time. Again and again, moist warm compresses previously soaked in sage or chamomile decoction are recommended as home remedies. The extracts of sage and chamomile are said to have a disinfecting and fungicidal effect. However, since the dark, moist environment under the poultice provides ideal growth conditions for fungi, it is better to resort to other forms of self-therapy.
