Tinea corporis in Child
A severe antifungal-resistant tinea has emerged in South Asia from the rapid spread of a novel dermatophyte species: Trichophyton indotineae. Terbinafine-resistant T indotineae infections have been reported in Asia, Europe, Canada, and the United States, including one case in New York City with no history of recent international travel.
Disseminated tinea may be seen in patients with immunosuppression, diabetes, Cushing syndrome, and malignancy. Majocchi-like granulomas, deep ulcerated fungal infections, severe tinea capitis and corporis, and fungal nail involvement are characteristic of an inherited deficiency of CARD9 (caspase recruitment domain-containing protein 9), an inflammatory cascade-associated protein. The disorder is autosomal recessive and is most common in North African countries including Algeria, Morocco, and Tunisia. The infections usually begin in childhood and are caused by Trichophyton rubrum and Trichophyton violaceum. Lymphadenopathy, high IgE antibody levels, and eosinophilia are common, and the disorder can be fatal.
Tinea imbricata is a distinct form of tinea corporis caused by Trichophyton concentricum, which is prevalent in tropical locales such as Central and South America, the South Pacific, and Southeast Asia. This form has been reported in children as well.
Tinea indecisiva (tinea pseudoimbricata) is tinea corporis that mimics tinea imbricata. These cases are not caused by Trichophyton concentricum but rather by other Trichophyton or Microsporum species. There is usually underlying immunosuppression in patients with tinea indecisiva.
B35.4 – Tinea corporis
84849002 – Tinea corporis
Differential Diagnosis & Pitfalls
- Nummular dermatitis (round, scaly plaques)
- Granuloma annulare (ring-like lesions but nonscaly)
- Fixed drug eruption (round patches but nonscaly)
- Tinea versicolor (usually trunk and neck)
- Allergic contact dermatitis
- Irritant contact dermatitis
- Majocchi granuloma
- Lichen planus
- Lyme disease
- Erythrasma (in body folds)
- Pityriasis rosea
- Seborrheic dermatitis (the distribution of lesions is often a helpful clue in distinguishing this entity)
- Lichen simplex chronicus
- Ichthyosis vulgaris
- Small plaque parapsoriasis
- Pityriasis rubra pilaris
- Secondary syphilis
- Glucagonoma syndrome
- Erythema annulare centrifugum