Clinical Update: Tinea or dermatitis?

By Dr Ian McColl

WE ARE used to thinking of tinea infections of the skin presenting as an annular scaly rash and hence the name ringworm.

However, a more widespread tinea infection can present as a red scaly rash looking like a dermatitis or even psoriasis, often with a bit of itch associated with it.

How do you tell them apart? Dermatitis usually shows slight weeping of the skin with surface erosions, while psoriasis has a candlewax-like scale when it is lightly scratched.

The rash shown above is typical of tinea with a finer, slightly trailing scale and varying redness at the edges due to different levels of immune response to the fungus.

Take a 15 blade and scrape off the scale into a black card or a clean urine container and send for microscopic examination and culture.

Topical terbinafine cream is fungicidal but keep using for at least a week after the skin looks clear.

www.skinconsult.com.au

This article first appeared in Medical Observer on the 26th of August, 2015

WE ARE used to thinking of tinea infections of the skin presenting as an annular scaly rash and hence the...

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