Tinea corporis: an updated review

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Background: Tinea corporis is a common fungal infection that mimics many other annular lesions. Physicians must familiarize themselves with this condition and its treatment.

Objective: This article aimed to provide a narrative updated review on the evaluation, diagnosis, and treatment of tinea corporis.

Methods: A PubMed search was performed with Clinical Queries using the key term ‘tinea corporis.’ The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies, and reviews. The search was restricted to the English language. The information retrieved from the mentioned search was used in the compilation of the present article.

Results: Tinea corporis typically presents as a well-demarcated, sharply circumscribed, oval or circular, mildly erythematous, scaly patch or plaque with a raised leading edge. Mild pruritus is common. The diagnosis is often clinical but can be difficult with prior use of medications, such as calcineurin inhibitors or corticosteroids. Dermoscopy is a useful and non-invasive diagnostic tool. If necessary, the diagnosis can be confirmed by microscopic examination of potassium hydroxide wetmount preparations of skin scrapings from the active border of the lesion. Fungal culture is the gold standard to diagnose dermatophytosis especially if the diagnosis is in doubt and results of other tests are inconclusive or the infection is widespread, severe, or resistant to treatment. The standard treatment of tinea corporis is with topical antifungals. Systemic antifungal treatment is indicated if the lesion is multiple, extensive, deep, recurrent, chronic, or unresponsive to topical antifungal treatment, or if the patient is immunodeficient.

Conclusion: The diagnosis of tinea corporis is usually clinical and should pose no problem to the physician provided the lesion is typical. However, many clinical variants of tinea corporis exist, rendering the diagnosis difficult especially with prior use of medications, such as calcineurin inhibitors or corticosteroids. As such, physicians must be familiar with this condition so that an accurate diagnosis can be made and appropriate treatment initiated.

Keywords: butenafine, dermatophytosis, fluconazole, itraconazole, naftifine, ringworm, terbinafine.

Citation: Leung AKC, Lam JM, Leong KF, Hon KL. Tinea corporis: an updated review. Drugs in Context 2020; 9: 2020-5-6. DOI: 10.7573/dic.2020-5-6

Contributions: Professor Alexander KC Leung was involved in the conceptualization of the manuscript. He wrote the first draft of the paper and oversaw the manuscript creation. All the authors contributed to drafting and revising the manuscript and approved the final version submitted for publication. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: Professor Alexander KC Leung and Professor Kam Lun Hon are associate editors of Drugs in Context and confirm no other conflicts of interest. All other authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2020/07/dic.2020-5-6-COI.pdf

Acknowledgements: None.

Funding declaration: Professor Alexander KC Leung, Dr Joseph Lam, Dr Kin Fon Leong, and Professor Kam Lun Hon disclose no relevant funding associated with the preparation of this article.

Copyright: Copyright © 2020 Leung AKC, Lam JM, Leong KF, Hon KL. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2020 Leung AKC, Lam JM, Leong KF, Hon KL. https://doi.org/10.7573/dic.2020-5-6. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/tinea-corporis:-an-updated-review

Correspondence: Alexander KC Leung, The University of Calgary, Alberta Children’s Hospital, #200, 233 – 16th Avenue NW, Calgary, Alberta, Canada T2M 0H5. aleung@ucalgary.ca

Provenance: Invited; externally peer reviewed.

Submitted: 13 May 2020; Peer review comments to author: 8 June 2020; Revised manuscript received: 18 June 2020; Accepted: 25 June 2020; Publication date: 20 July 2020.

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