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Tinea Corporis or Tinea Circinata

For further information, see CMDT Part 6-16: Fungal Infections of the Skin

Key Features

Essentials of Diagnosis

  • Ring-shaped lesions with an advancing scaly border and central clearing or scaly patches with a distinct border

  • Microscopic examination of scrapings or culture confirms the diagnosis

General Considerations

  • The lesions are often on exposed areas of the body such as the face and arms

  • History of exposure to an infected pet (who may have scaly rash or patches of alopecia) may occasionally be obtained, usually indicating Microsporum infection

  • Trichophyton rubrum is the most common pathogen, usually representing extension onto the trunk or extremities of tinea cruris, pedis, or manuum

Clinical Findings

Symptoms and Signs

  • Itching may be present

  • In classic lesions, rings of erythema have an advancing scaly border and central clearing

Differential Diagnosis

  • Psoriasis

  • Systemic lupus erythematosus

  • Secondary syphilis

  • Granuloma annulare

  • Pityriasis rosea

Diagnosis

Diagnostic Procedures

  • The diagnosis should be confirmed by KOH preparation and culture

Treatment

Medications

Table 6–2.Useful topical dermatologic therapeutic agents.1
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Table 6–2. Useful topical dermatologic therapeutic agents.1
Agent Formulations, Strengths, and Prices2 Frequency of Application Potency Class Common Indications Comments
Corticosteroids (Listed in Order of Increasing Potency)
Hydrocortisone acetate

Cream 1%: $3.99/30 g

Ointment 1%: $1.58/28 g

Solution 1%: $7.34/44 mL

 Twice daily Low

Seborrheic dermatitis

Pruritus ani

Intertrigo

Not the same as valerate or hydrocortisone butyrate

Not for poison oak OTC lotion (Aquanil HC), OTC solution (Scalpicin)
 

Cream 2.5%: $9.66/28 g

Ointment 2.5%: $11.00/28 g

     As for 1% hydrocortisone

Perhaps better for pruritus ani

Not clearly better than 1%

More expensive

Not OTC
Alclometasone dipropionate (Aclovate)

Cream 0.05%: $48.08/15 g

Ointment 0.05%: $20.00/15 g

 Twice daily Low As for hydrocortisone

More efficacious than hydrocortisone

Perhaps causes less atrophy
Desonide

Cream 0.05%: $21.60/15 g

Ointment 0.05%: $23.21/15 g

Lotion 0.05%: $296.09/59 mL

 Twice daily Low

As for hydrocortisone

For lesions on face or body folds resistant to hydrocortisone

More efficacious than hydrocortisone

Can cause rosacea or atrophy

Not fluorinated
Clocortolone (Cloderm) Cream 0.1%: $322.47/45 g Three times daily Medium

Contact dermatitis

Atopic dermatitis

 Does not cross-react with other corticosteroids chemically and can be used in patients allergic to other corticosteroids
Prednicarbate (Dermatop)

Emollient cream 0.1%: $137.10/60 g

Ointment 0.1%: $30.00/15 g

 Twice daily Medium As for triamcinolone

May cause less atrophy

No generic formulations

Preservative-free
Triamcinolone acetonide

Cream 0.1%: $3.60/15 g

Ointment 0.1%: $5.57/15 g

Lotion 0.1%: $42.42/60 mL

 Twice daily Medium

Eczema on extensor areas

Used for psoriasis with tar

Seborrheic dermatitis and psoriasis ...

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