Tinea Corporis Clinical Presentation

Updated: Jul 09, 2018
  • Author: Jack L Lesher, Jr, MD; Chief Editor: Dirk M Elston, MD  more...
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Presentation

History

Symptoms, contact history, recent travel, and international residence are relevant clues in the history of a person with tinea corporis.

Infected patients may have variable symptoms. Patients can be asymptomatic. A pruritic, annular plaque is characteristic of a symptomatic infection. Patients occasionally can experience a burning sensation. HIV-positive or immunocompromised patients may develop severe pruritus or pain.

Tinea corporis may result from contact with infected humans, animals, or inanimate objects. The history may include occupational (eg, farm worker, zookeeper, laboratory worker, veterinarian), environmental (eg, gardening, contact with animals), or recreational (eg, contact sports, contact with sports facilities) exposure.

A few clinical variants are described, with distinct presentations.

Majocchi granuloma, typically caused by T rubrum, is a fungal infection in hair, hair follicles, and, often, the surrounding dermis, with an associated granulomatous reaction. Majocchi granuloma often occurs in females who shave their legs.

Tinea corporis gladiatorum is a dermatophyte infection spread by skin-to-skin contact between wrestlers. [2, 3]

Tinea imbricata is a form of tinea corporis found mainly in Southeast Asia, the South Pacific, Central America, and South America. It is caused by Trichophyton concentricum. [4]

Tinea incognito is tinea corporis with an altered, nonclassic presentation due to corticosteroid treatment. [5]

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Physical Examination

Tinea corporis can manifest in a variety of ways. Typically, the lesion begins as an erythematous, scaly plaque that may rapidly worsen and enlarge, as shown in the image below.

Large, erythematous, scaly plaque. Large, erythematous, scaly plaque.

Following central resolution, the lesion may become annular in shape, as is shown in the image below.

Annular plaque. Annular plaque.

As a result of the inflammation, scale, crust, papules, vesicles, and even bullae can develop, especially in the advancing border. [20]

Rarely, tinea corporis can present as purpuric macules, called tinea corporis purpurica. [21] One report describes 2 cases of tinea corporis purpurica resulting from self-inoculation with Trichophyton violaceum. [22]

Infections due to zoophilic or geophilic dermatophytes may produce a more intense inflammatory response than those caused by anthropophilic microbes.

HIV-infected or immunocompromised patients often have atypical presentations including deep abscesses or a disseminated skin infection.

Majocchi granuloma manifests as perifollicular, granulomatous nodules typically in a distinct location, which is the lower two thirds of the leg in females.

Tinea corporis gladiatorum often manifests on the head, neck, and arms, which is a distribution consistent with the areas of skin-to-skin contact in wrestling.

Tinea imbricata is recognized clinically by its distinct scaly plaques arranged in concentric rings.

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