SKIN DISEASES

TINEA CAPITIS TINEA CORPORIS TINEA VERSICOLOR

TINEA CAPITIS

commonly known as ringworm of the scalp Causative agent : Dermatophyte fungal infection mainly of two genera Microsporum and Trichophyton.
Dermatophyte

DERMATOPHYTES
like to live on warm and moist area of the skin, such as places where there are skin folds. can also live on household items, such as clothing, towels and bedding.

EPIDEMIOLOGY
males are more susceptible as compared to females. children aged 3-7 years old are at the greater risk.

MODE OF TRANSMISSION
usually by direct contact with a human or animal source ( including dogs, cats and cattle) can also be transmitted by inanimate infected objects such as the back of the seats, combs, brushes, or hats.

INCUBATION PERIOD
it has an incubation period of 10-14 days.

SIGNS AND SYMPTOMS

Itching - The affected area of the scalp may itch due to the fungal infection. It worsens when the scalp is very dry and as the fungus spreads. Irritation - Individuals may also experience irritation in the affected area of the skin region. This may include a slight tingling or burning sensation with redness. It is usually provoked with excessive scratching. Lesions - The affected area of the scalp may show presence of circular pus filled lesions or sores (kerions). It may not be easily spotted as the typical red ring lesion of a fungal (ringworm) infection until the hair falls out. Rashes - Skin rashes are typically red with a raised border. The inner part of the rash may be red or white with crusting skin. These types of rashes may also appear in pets that have similar fungal infections which can be transmitted to humans.

SIGNS AND SYMPTOMS

Dots - The affected area of the scalp may sometimes also show presence of black dots. This occurs due to breaking of the hair at the roots. White balls attached to these remnants of the hair follicle may also be seen. Smooth skin - The affected area of the skin becomes smooth after the skin peels off. It may also be smoother than normal once the infection is treated and the skin heels. You may have a low-grade fever of around 37.78-38.3C or swollen lymph nodes in the neck.

Hair loss - is the most common complaint of tinea capitis patients as the fungi affects the scalp region, which results in loss of hair in the affected area.

PREVENTIONS
Wash your hands regularly. Shampoo your hair regularly. Don't share headgear, brushes, or combs. Wash towels, clothes, and any shared items used by an infected person to prevent spreading it to others in the household. Take your pets to the veterinarian for treatment if they develop skin rashes.

NURSING INTERVENTIONS
Administer prescribed medications, including griseofulvin, an antifungal agent. Topical agents do not provide an effective cure because the infection occurs within the hair shaft and below the surface of the scalp. Instruct the client and his family to use separate combs and brushes and to avoid exchanging hats and other headgear. Encourage the client that all family members and household pets must be examined, because familial infections are relatively common.

MEDICAL TREATMENT
The health care provider will prescribe a special medicine you take by mouth to treat ringworm in the scalp. Griseofulvin, terbinafine, and itraconazole are used to treat this condition You take the medicine for 4 - 8 weeks Keep the area clean. A medicated shampoo, such as one that contains ketoconazole or selenium sulfide, may slow or stop the spread of infection through the air. However, the shampoo alone cannot get rid of the ringworm. Other family members and pets should be examined and treated, if necessary. Other children in the home may want to use the shampoo 2 - 3 times a week for around 6 weeks.

MEDICAL TREATMENT
Adults only need to wash with the shampoo if they have signs of tinea capitis or ringworm. Once the shampoo has been started: Wash towels in warm, soapy water and dry each time they are used by someone who is infected Soak combs and brushes for 1 hour a day in a mixture of one-half bleach and one-half water. Do this for 3 days. No one in the home should share combs, hairbrushes, hats, towels, pillowcases, or helmets with other people.

TINEA CORPORIS

commonly known as ringworm of the body Causative agent : Dermatophyte fungal infection mainly of two genera Microsporum and Trichophyton.

EPIDEMIOLOGY
Sex: Males are infected more than females. .Age: Tinea corporis affects persons of all age groups, but prevalence is highest in preadolescents (10-13 yrs. old).

MODE OF TRANSMISSION
Exposure to contaminated soil Exposure to infected animals or people (cattle, kittens, puppies, guinea pigs, mice and horses)

INCUBATION PERIOD
has an incubation period of between 1 to 3 weeks.

SIGNS AND SYMPTOMS

Itching Rashes that begins as a small area of red, raised spots and pimples. The rash slowly becomes ring-shaped, with a red-colored, raised border and a clearer center. The border may look scaly. The rash may occur on the arms, legs, face, or other exposed body areas.

PREVENTIONS
Washing hands after handling animals, soil, and plants. Avoiding touching characteristic lesions on other people. Wearing loose-fitting clothing. Practicing good hygiene when participation in sports involves physical contact with other people. Wash all towels in warm, soapy water and then dry them. Use a new towel and washcloth every time. Clean sinks, bathtubs, and bathroom floors well after using. Wear clean clothes every day and do not share clothes

NURSING INTERVENTIONS
Administer prescribed medications, which may include topical antifungalmedication. Instruct the client to use a clean towel and washcloth daily. Instruct the client to thoroughly dry all skin areas and skin folds that retain moisture. Encourage the client to wear clean cotton clothing next to the skin. Instruct the client to be careful around pets and pet objects.

MEDICAL TREATMENT
Consult your doctor or dermatologist as soon as possible. If the rash is accompanied by redness, swelling, drainage, or fever, seek immediate medical attention. Mild conditions: topical antifungal creams, Severe conditions; griseofulvin or terbinafine. In severe cases, where the infection has spread deeper into the skin or into hair follicles, an oral prescription medication may be prescribed. These include itraconazole (Sporanox), fluconazole (Diflucan), ketoconazole (Nizoral), and terbinafine (Lamisil).

TINEA VERSICOLOR (Pityriasis Versicolor)

Causative organisms: caused by yeast called Malassezia furfur that normally lives on the skin of most adults without causing problems. Malassezia furfur

Malassezia furfur
Malassezia is a lipid-dependent, dimorphic fungus that is a component of normal skin flora. Transformation of Malassezia from yeast cells to a pathogenic mycelial form is associated with the development of clinical disease. External factors suspected of contributing to this conversion include exposure to hot and humid weather, hyperhidrosis, and the use of topical skin oils.

EPIDEMIOLOGY
Race: Although the alteration in skin pigmentation is more apparent in darker-skinned individuals, the incidence of tinea versicolor appears to be the same in all races. Sex: Several studies have addressed the frequency of tinea versicolor based on sex, and no dominance of either sex is apparent. Age: In the United States, tinea versicolor is most common in persons aged 15-24 years, when the sebaceous glands are more active. The occurrence of tinea versicolor before puberty or after age 65 years is uncommon. In more tropical countries, age frequency varies; most cases involve people aged 10-19 years who live in warmer, humid countries, such as Liberia and India. Highest incidence is found in tropical climates.

MODE OF TRANSMISSION
Not contagious but here are some of the predisposing factors: Removal of the adrenal gland Cushing's disease Pregnancy Malnutrition Burns Steroid therapy Suppressed immune system Oral contraceptives Excess heat Excess humidity Can be spread through: skin-to-skin contact or by coming in contact with contaminated articles such as towels, clothing or bedding.

INCUBATION PERIOD
Because yeast normally dwells on the skin in minute amounts, the incubation period is unknown. The timeframe can range from weeks to months, and the disease typically begins during or just after the warmest months of the year.

SIGNS AND SYMPTOMS

First sign of tinea versicolor is often spots on the skin. The spots are lighter (sometimes darker) than the surrounding skin. The color of the spots can be white, pink, salmon, red, tan, or brown. The spots can appear anywhere on the body. Spots can be dry and scaly. Skin may itch where the spots appear. Spots become more noticeable as the skin tans. The yeast prevents the skin from tanning. Spots grow slowly. As the yeast grows, the spots can combine and form patches of lighter (or darker) skin. The spots may disappear when the temperature drops and return in the spring or summer when the air gets warm and humid.

PREVENTIONS
Avoid close contact with those who have tinea versicolor. Keep your skin clean and dry: Bathe after physical exertion and sweating. Good personal hygiene Wash personal items regularly: Bedding Clothes Linens Do not share personal care items: Towels Razors Wash your hands frequently.

NURSING INTERVENTIONS
Advice not to avoid too much exposure to heat. Advice to give importance in personal hygiene especially in taking a bath. Advice to give importance in hand washing. Advice not to share personal things to others.

MEDICAL TREATMENT
Topical anti-fungals. These products are applied directly to your skin and may be in the form of lotions, shampoos, creams, or soaps. They keep the growth of the yeast under control Anti-fungal pills. These may be used to treat more serious or recurrent cases of tinea versicolor. Medicine applied to the skin: This is the most common treatment. There are anti-fungal shampoos, soaps, creams, and lotions that can keep the yeast under control.

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