Tinea faciei

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Tinea faciei
Other names: Ringworm of the face[1]
Mycose peau glabre - Dermatophytosis.jpg
Tinea faciei
SpecialtyDermatology, infectious diseases
SymptomsFace: Red patches, small raised bumps,[2] weeping, crusting, fragile hairs.[3]
ComplicationsTinea incognita[4]
CausesT. rubrum, T. mentagrophytes, T. tonsurans, M. gypseum, M.canis[5][1]
Diagnostic methodAppearance, skin scraping for microscopy and culture,[3] biopsy[2]
Differential diagnosisLupus erythematosus, impetigo, eczema, herpes zoster[4]
TreatmentAntifungals[3]
Medication
FrequencyUncommon[1]

Tinea faciei is a superficial fungal infection of the skin of the non-bearded part of the face.[6] It generally appears as a photosensitive, painless, red rash with small bumps and a raised edge appearing to grow outwards, usually over eyebrows or one side of the face.[2] It may feel wet or have some crusting, and overlying hairs may fall out easily.[3] There may be a mild itch or burning sensation.[6]

Tinea faciei can be caused by spread of fungal infections of the feet and nails, from pets such as cats and dogs, and from farm animals.[1] Causative organisms include T. rubrum, T. mentagrophytes, T. tonsurans, M. gypseum and M.canis.[5] Often misdiagnosed as an inflammatory condition, for which corticosteroids are applied, tinea faciei may be complicated by tinea incognita.[4]

Diagnosis is by the appearance of the rash and confirmed by taking a skin scraping for microscopy and culture,[3] or biopsy.[2] Differential diagnoses include lupus erythematosus, impetigo, eczema, herpes zoster,[4] seborrhoeic dermatitis, psoriasis, rosacea, actinic keratoses, perioral dermatitis and polymorphous light eruption.[1] Treatment is with topical antifungal medication; terbinafine, clotrimazole, miconazole and ketoconazole.[3] If the condition does not respond to topical treatment or is extensive, then oral terbinafine or itraconazole can be taken.[1]

The condition is uncommon.[1]

Signs and symptoms

It generally appears as a photosensitive painless red rash on the face, followed by patches of small, raised bumps.[2] It is considered distinct from fungal infection of the beard area.[3] The rash may weep or crust, and hairs may fall out easily. It is usually painless.[3]

Causes

It is usually caused by T. rubrum, T. mentagrophytes, M. gypseum, T. tonsurans.[5]

Diagnosis

Diagnosis is by the appearance of the rash and confirmed by taking a skin scraping for microscopy.[3]

Treatment

A & B. Tinea faciei before treatment C. 1 month of antifungal and anti-inflammatory treatment.

Treatment is usually with topical antifungal medication such as terbinafine cream twice daily for 2 weeks, or miconazole twice daily for 2-4 weeks.[3][2] Extensive infection may require treatment with oral terbinafine for 2 weeks.[3]

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 "Tinea faciei". dermnetnz.org. Archived from the original on 13 August 2021. Retrieved 18 September 2021.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "15. Diseases resulting from fungi and yeasts". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Edinburgh: Elsevier. p. 295. ISBN 978-0-323-54753-6. Archived from the original on 2021-08-29. Retrieved 2021-05-21.
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 "Tinea faciei (face) and barbae (beard)". www.pcds.org.uk. Archived from the original on 5 May 2020. Retrieved 21 May 2021.
  4. 4.0 4.1 4.2 4.3 Ginter-Hanselmayer, Gabriele; Nenoff, Pietro (2018). Presterl, Elisabeth (ed.). Clinically Relevant Mycoses: A Practical Approach. Springer. pp. 149–150. ISBN 978-3-319-92300-0. Archived from the original on 2021-09-22. Retrieved 2021-09-18.
  5. 5.0 5.1 5.2 Johnstone, Ronald B. (2017). "25. Mycoses and Algal infections". Weedon's Skin Pathology Essentials (2nd ed.). Elsevier. p. 441. ISBN 978-0-7020-6830-0. Archived from the original on 2021-05-25. Retrieved 2021-05-25.
  6. 6.0 6.1 Schachtel, April; DeNiro, Katherine L. (2021). "22. Superficial dermatophyte infections of the skin". In Jong, Elaine C.; Stevens, Dennis L. (eds.). Netter's Infectious Diseases (Second ed.). Philadelphia: Elsevier. pp. 101–102. ISBN 978-0-323-71159-3. Archived from the original on 2021-09-29. Retrieved 2021-09-29.

External links

Classification