Tinea corporis, cruris, or pedis is also known as Ringworm, Jock itch, and Athlete's foot. Tinea cruris and pedis are usually caused by the fungi T. rubrum, T. mentagrophytes, or E. floccosum. Tinea infections are acquired from people, fomites, and animals (M. canis and T. mentagrophytes).
CASES/YEAR
600,300 (US); 12,006,000 (Global)
AGENT TYPE
Fungi (Dermatophytes)
OTHER NAMES
Ringworm; Jock itch; Athlete's foot; Skin infection (Trichophyton, Microsporum, or Epidermophyton); Tinea cruris and pedis (usually T. rubrum, T. mentagrophytes, or E. floccosum);
INCUBATION
Usually 4-10 days for tinea corporis and cruris; unknown for tinea pedis; [CCDM, p. 231-2]
INITIAL SYMPTOMS
"The archetypal lesion of dermatophytosis is an annular scaling patch with a raised margin showing a variable degree of inflammation; the center is usually less inflamed than the edge." [PPID, p. 3203]
PRECAUTIONS
Standard; "Rare episodes of person-to-person transmission." [CDC 2007 Guideline for Isolation Precautions] "While under treatment, infected persons should be excluded from swimming pools and activities likely to lead to exposure of others." [CCDM, p. 231]
COMMENTS
"Tinea corporis can occur at any age, although in temperate countries it is most often seen in children and is associated with zoophilic infections." T. rubrum can infect the lower legs (mainly women) causing a nodular folliculitis that mimics erythema nodosum. [PPID, p. 3204] Tinea infections are acquired from people, fomites, and animals (M. canis and T. mentagrophytes). Tinea cruris is an infection or the groin or perineal/perianal area that affects mainly adolescent or adult males. The three types of tinea pedis infections are interdigital web space, acute vesicular (usually at the instep), and moccasin. Infection of the palmar surface, often caused by T rubrum, may present as dermatitis of one hand. Unusual types of tinea corporis are verrucous lesions (immunocompromised hosts) and borders of lesions that coalesce into a serpiginous pattern. [ID, p. 1165-9] The "id" reaction to tinea pedis is the appearance of pruritic vesicles on the fingers and palms. [ABX Guide: Tinea pedis] Tinea corporis in AIDS patients can present as fluctuant ulcerative nodules mainly on the extremities. [Cohen, 3rd Ed, p. 997] Tinea cruris often occurs with tinea pedis. Vesicles are characteristic of zoophilic dermatophytes (T. mentagrophytes var. mentagrophytes and T. verrucosum). Deep-seated Trichophyton infections can cause erythema nodosum. [Guerrant, p. 951] Unlike inguinal candidiasis, tinea cruris does not have satellite pustules outside the lesion margins. [CCDM, p. 230]
DIAGNOSTIC
KOH prep of scrapings using #15 blade at the active border: septated hyphae; Culture is more sensitive, but less practical--growth takes 1-4 weeks; [ABX Guide]
SIGNS & SYMPTOMS
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S cellulitis or rash, circinate
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S papules or plaques
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S pustule
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S rash on palms
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S skin blister or vesicles
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S skin or subcutaneous nodule
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S ulcer of skin
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S warty growth of the skin
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S skin lesion, linear or serpiginous
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*erythema nodosum
ENTRY
Skin or Mucous Membranes (Includes Conjunctiva)
RESERVOIR
Cattle, Goats and Sheep, Cats, Dogs, Horses, Human
RISK FACTORS
- Handle domestic animals
- Touch infected farm animals
REFERENCES FOR CASES/YEAR
1. (US) !/20 X global cases/yr;
2. (Global) Tinea corporis, cruris, and pedis were 69% of dermatomycoses cases in Japan in 2006; Using incidence results from study in New Zealand in 2003 showing 2900 cases of dermatomycoses per million; 0.69 X 2900 = 2001 cases per million; 2001 X 300 million = 600,300 cases/year (US); 2001 X 6000 million = 12,006,000 cases per year (worldwide); [PMID 23149353 & 14616492]