This article needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (December 2008)

Ringworm
Classification and external resources
Ringworm on the arm
ICD-10	B35.4
ICD-9	110.9
DiseasesDB	17492
eMedicine	emerg/592
MeSH	D014005

Ringworm is a fungal infection of the skin in humans and domestic animals such as sheep and cattle. Fungi are organisms that survive by eating plant or animal material. Those that cause parasitic infection (dermatophytes) feed on keratin, the material found in the outer layer of skin, hair, and nails. These fungi thrive best on skin that is warm and moist.

This condition has been prevalent since before 1906, at which time ringworm was treated with compounds of mercury. Hairy areas of skin were considered too difficult to treat, so the scalp was treated with x-rays and followed up with antiparasitic medication ^[1].

It is estimated that in current times, up to twenty percent of the population is infected by ringworm or one of the other dermatophytoses. It is especially common among people who play sports, wrestling in particular; wrestlers with ringworm may be disqualified. ^[2]

Misdiagnosis and treatment of ringworm with a topical steroid can result in tinea incognito, a condition where ringworm fungus will grow without typical features like a distinctive raised border.

[edit] Prevention

Fungi thrive in moist, warm areas, such as locker rooms, tanning beds, swimming pools and in skin folds. The fungi may be present without any symptoms.

Advice often given to prevent ringworm includes:

• Avoidance of sharing clothing, sports equipment, towels, or sheets.
• Washing clothes in hot water with fungicidal soap after suspected exposure to ringworm.
• Avoidance of walking barefoot, wearing of appropriate protective shoes to the beach and flip-flops (thongs) in locker rooms.^[3][4][5][5]
• After being exposed to places where the potential of being infected is great ^[6], one should wash with an antibacterial and anti-fungal soap or one that contains tea tree oil, which contains terpinen-4-ol.^[7][8]
• Avoid touching pets with bald spots as they are often carriers of the fungus.
• Avoid showering at night which causes the scalp to become moist. And then waking up in the morning, the scalp could be dry and flaky.^{[citation needed]}

[edit] Diagnosis in pets

To determine if your pet has ringworm, it can be as simple as observing the circular bare patches on the skin. But, to truly know if it is ringworm, your vet can do 1 of 3 tests.

Woods Test- This is simply a black light with a magnifying lens. About 50% of the ringworm fungus will show up as fluorescent under the black light.

Microscopic test- Your vet will take a hair from around the infected area and place it in a special solution and view it under the microscope. This is effective for about 40%-70% of the infections.

Culture Test- The most effective, yet longest, way to determine if there is ringworm in your pet is to have a vet collect scales from the area and have it cultured.^[9]

[edit] Treatment

Antifungal treatments include topical agents such as Miconazole, Terbinafine, Clotrimazole, Ketoconazole, or Tolnaftate applied twice daily until symptoms resolve (usually within two weeks), however if constantly touched it can leave a dark patch of skin where it had been. In more severe cases or where there is scalp ringworm, systemic treatment with oral medications may be given.

Most treatments should be continued for up to 14 days after the disease ceases to produce any visible symptoms. If the antifungal treatment is prematurely stopped, the infection is very likely to reappear, in which case it may also be more difficult to overcome. Thus, it is very important to use the appropriate treatment in the first place and respect the doctor's or pharmacist's instructions in order to obtain the best results and minimize the risks of relapse.

When confronted with ringworm, it is very important to maintain proper hygiene and take a set of precautions in order to prevent the infection from spreading to other places on the body (the lesions should be covered with band-aid or a soft, sterile cloth). For instance, ringworm of the foot can spread to the toenails over the course of a few weeks if neglected, causing difficult to treat nail infections called tinea unguium. Similarly, common forms of ringworm of the body may become less responsive to regular treatments if they spread to body areas such as armpits, hands, palms or crotch. By maintaining proper hygiene and avoiding the exposure of the affected regions of the body over the entire course of treatment, you will also minimize the chances of contaminating other persons.^[10]

[edit] See also

• Folliculitis
• Pityriasis rosea

[edit] Notes

[edit] External links

• Tinea photo library at Dermnet