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Tinea corporis in Child
See also in: Cellulitis DDx
Other Resources UpToDate PubMed

Tinea corporis in Child

See also in: Cellulitis DDx
Contributors: Vivian Wong MD, PhD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Tinea corporis is a localized inflammatory skin condition due to fungal colonization of the superficial epidermis. The most commonly implicated species is Trichophyton. Fungal organisms are transmitted to children by direct contact with those infected or through fomites. Majocchi granuloma is caused by organisms invading the hair follicle or shaft of hairs on skin other than the scalp with a secondary granulomatous perifolliculitis. Varying location presentations include tinea capitis (scalp), tinea faciei (face), tinea pedis (feet), tinea manuum (hands), and tinea cruris (crural folds).

A severe antifungal-resistant tinea has emerged in South Asia from the rapid spread of a novel dermatophyte species: Trichophyton indotineae. Terbinafine-resistant T indotineae infections have been reported in Asia, Europe, Canada, and the United States, including one case in New York City with no history of recent international travel.

Disseminated tinea may be seen in patients with immunosuppression, diabetes, Cushing syndrome, and malignancy. Majocchi-like granulomas, deep ulcerated fungal infections, severe tinea capitis and corporis, and fungal nail involvement are characteristic of an inherited deficiency of CARD9 (caspase recruitment domain-containing protein 9), an inflammatory cascade-associated protein. The disorder is autosomal recessive and is most common in North African countries including Algeria, Morocco, and Tunisia. The infections usually begin in childhood and are caused by Trichophyton rubrum and Trichophyton violaceum. Lymphadenopathy, high IgE antibody levels, and eosinophilia are common, and the disorder can be fatal.

Tinea imbricata is a distinct form of tinea corporis caused by Trichophyton concentricum, which is prevalent in tropical locales such as Central and South America, the South Pacific, and Southeast Asia. This form has been reported in children as well.

Tinea indecisiva (tinea pseudoimbricata) is tinea corporis that mimics tinea imbricata. These cases are not caused by Trichophyton concentricum but rather by other Trichophyton or Microsporum species. There is usually underlying immunosuppression in patients with tinea indecisiva.

Codes

ICD10CM:
B35.4 – Tinea corporis

SNOMEDCT:
84849002 – Tinea corporis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Nummular dermatitis (round, scaly plaques)
  • Granuloma annulare (ring-like lesions but nonscaly)
  • Fixed drug eruption (round patches but nonscaly)
  • Tinea versicolor (usually trunk and neck)
  • Allergic contact dermatitis
  • Irritant contact dermatitis
  • Majocchi granuloma
  • Psoriasis
  • Lichen planus
  • Lyme disease
  • Erythrasma (in body folds)
  • Pityriasis rosea
  • Intertrigo
  • Seborrheic dermatitis (the distribution of lesions is often a helpful clue in distinguishing this entity)
  • Lichen simplex chronicus
  • Ichthyosis vulgaris
  • Scabies
  • Small plaque parapsoriasis
  • Juvenile pityriasis rubra pilaris
  • Secondary syphilis
  • Glucagonoma syndrome
  • Bullous impetigo
  • Erythema annulare centrifugum

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:11/08/2016
Last Updated:05/24/2023
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Tinea corporis in Child
See also in: Cellulitis DDx
A medical illustration showing key findings of Tinea corporis : Erythema, Fine scaly plaque, Round configuration
Clinical image of Tinea corporis - imageId=406479. Click to open in gallery.  caption: 'Post-inflammatory annular hyperpigmentation at site of treated tinea on an extremity.'
Post-inflammatory annular hyperpigmentation at site of treated tinea on an extremity.
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