Tinea or ring worm infection is fungal infection of the skin or nails. Patients often present with skin rash, plaques, itching and occasionally pustules. Circular redness around the edges is suggestive of ring worm infestation. In other areas patients may present with bald patches or thickened nails.
Medications (as per type and site of infection):
Tinea cruris, pedis or corporis –
- Cream Candid (Clotrimazole 1% w/w) to be applied locally twice a day for 2 weeks. Continue applying it for one more week after skin clears up.
- If no relief then, cream Fintop (Butenafine 1%) to be applied locally once a day for 2 weeks OR cream Terbest (Terbinafine 1%) to be applied locally once a day for 2 weeks.
- If no relief then, tab. Forcan 150 (Fluconazole 150 mg) 1 tablet once a week for 4 weeks.
Onychomycosis- fungal infection of nails
- Tab. Terbitotal (Terbinafine 250 mg) 1 tablet once a day (for fingernails continue for 6 weeks; for toenails continue for 12 weeks).
- Nailrox Nail Laquer (Ciclopirox 8% w/v) – apply once at bedtime to all affected nails and 5 mm of surrounding area for 7 days. After 7 days remove the previous coat and reapply as before.
Tinea barbae (over beard region) and Tinea capitis (over scalp)
- Tab. Forcan 150 (Fluconazole 150 mg) 1 tablet once a week for 4 weeks.
Tinea versicolor (overgrowth of the yeast on the skin characterized by hypopigmented scaly patches)
- Lotion Selsun (Selenium sulphide 2.5%) to be applied locally once a day for 7 days.
- Tab. Forcan 200 (Fluconazole 200 mg) – 2 tablets as a single dose.
General advice:
- Aactaril soap for regular shower.
- Maintain good general hygiene.
- Keep skin and skin folds clean and dry.
Investigations:
- Complete blood count to rule out systemic infection.
- Microscopy with Potassium hydroxide (KOH) mount on the slide with skin scrapings to look for fungi.
- Check blood sugar – for resistant or recurrent skin infections.
Referral:
Consider referral to dermatologist if patients fail to respond the treatments or present with additional complications.