Which physical findings are characteristic of tinea infections?

Updated: Apr 27, 2021
  • Author: Mityanand Ramnarine, MD, FACEP; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

At physical examination, the various types of tinea may have different findings, as follows:

  • Tinea capitis: The clinical appearance of fungal infection of the scalp varies depending on the type of hair invasion. Patients typically present with scaling of the scalp or circumscribed alopecia with broken hair at the scalp.

  • Tinea corporis: Infection is usually on the exposed skin of the trunk and extremities. It is characterized by annular scaly plaques with raised edges, pustules, and vesicles. It can also have geometric patterns. This is usually tinea imbricata (T concentricum). Tinea corporis gladiatorum is seen on the head, neck, and arms, in a distribution consistent with the areas of skin-to-skin contact in wrestling.

  • Tinea pedis: This is a fungal infection of the toe webs and plantar surface and often affects only one foot. Toe-web scaling, fissuring, and maceration; scaling of soles and lateral surfaces; erythema; vesicles; pustules; and bullae may be present.

  • Tinea manuum: This is a fungal infection of the palms and finger webs that usually occurs in association with tinea pedis. Similarly, often only one hand is involved. Scaling and erythema may be present.

  • Tinea cruris: It is a dermatophytic infection of the groin and pubic region. It is characterized by erythematous lesions with central clearing and raised borders. Tinea cruris often co-occurs with tinea pedis or tinea unguium.

  • Tinea barbae: The beard and neck area are affected. Erythema, scaling, and pustules are present.

  • Tinea unguium: Tinea unguium is also called onychomycosis. This is an infection of the nail. It is characterized by onycholysis (nail plate separation from nail bed) and thickened, discolored (white, yellow, brown, black), broken, and dystrophic nails.

  • Tinea incognito: This is a common difficult diagnosis to make without history. It is often present as a result of prior treatment with hydrocortisone, causing atypical appearance. [6]

  • Autoeczematization reactions: (also known as id reactions) are secondary dermatitic eruptions that occur in association with primary, often inflammatory, skin disorders. It is secondary to a tinea infection at another site. It is due to cell-mediated immunity and resolves with treatment of tinea.


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