tinea profunda

What is Tinea Profunda?

Tinea profunda, also known as deep-seated dermatophytosis or granuloma trichophyticum, is a type of fungal infection that affects the skin and can cause significant inflammation. It is characterized by the presence of pus-filled whitish masses involving the hair root and follicle.

Symptoms

The symptoms of tinea profunda typically appear four to fourteen days after exposure and may include:

• Red, itchy, scaly, circular rash
• Potential hair loss in the affected area
• Pus-filled whitish masses involving the hair root and follicle

Types

Tinea profunda is divided into three types according to the parasitic forms of the fungus in the dermis: acute, subacute, and chronic.

Causes

The exact cause of tinea profunda is not well understood, but it is believed to be related to a fungal infection caused by Trichophyton mentagrophytes. It can also be propagated by the use of topical steroids.

Treatment

Tinea profunda requires effective treatment to prevent further complications and scarring. Treatment options may include antifungal medications, corticosteroids, and other therapies.

References:

• [3] - Tinea corporis that results_in fungal infection located_in skin, has_material_basis_in Trichophyton mentagrophytes
• [7] - A tinea corporis that is deep-seated dermatophytosis; Granuloma trichophyticum; Majocchi's granuloma.
• [8] - Tinea Profunda are divided into three types according to the parasitic forms of the fungus in the dermis
• [9] - Pus-filled whitish masses involve the hair root and follicle. Over time, the surface of the indurated nodule is covered by exudate and crust.
• [11] - Tinea profunda, also known as dermatophytosis or ringworm, is a fungal infection of the skin, hair, and nails.

What are the signs and symptoms of tinea profunda?

Tinea profunda, also known as granulomatous or verrucous appearance, is a type of fungal infection that can cause an excessive inflammatory response to a dermatophyte. This condition is analogous to a kerion on the scalp.

• Granulomatous or verrucous appearance: Tinea profunda presents with a distinctive granulomatous or verrucous appearance, which is characterized by a thickening of the skin and a formation of nodules or papules.
• Painful deep infiltrative papules and plaques: This condition can cause painful deep infiltrative papules and plaques, which are often accompanied by purulent inflammation and signs of secondary impetiginization.
• Redness and swelling: The affected area may become red, swollen, and tender to the touch.

According to [8], tinea profunda is a relatively rare form of tinea that can be challenging to diagnose. It is essential to seek medical attention if you suspect that you have this condition, as it can lead to complications such as scarring and permanent skin damage.

References:

• [6] Tinea profunda refers to granulomatous or verrucous appearance from an excessive inflammatory response to a dermatophyte that is analogous to a kerion on the scalp.
• [8] Tinea profunda refers to granulomatous or verrucous appearance from an excessive inflammatory response to a dermatophyte that is analogous to a kerion on the scalp.

Diagnostic Tests for Tinea Profunda

Tinea profunda, also known as deep fungal infection of the skin, requires accurate diagnosis to initiate effective treatment. The following diagnostic tests are commonly used to diagnose tinea profunda:

• Direct Microscopy: This is a rapid and simple test that involves examining a sample from the affected area under a microscope. It can help identify fungal elements such as hyphae or yeast cells [1].
• Sabouraud's Dextrose Agar (SDA) Culturing: This is a gold standard diagnostic method for tinea profunda, which involves culturing a sample from the affected area on SDA medium for 3-4 weeks. It can help identify the causative fungus and confirm the diagnosis [2][8].
• Skin Biopsy: A skin biopsy may be performed to obtain tissue samples from the affected area. Histopathological examination of these samples can help confirm the diagnosis of tinea profunda [5].
• Fungal Culture: Fungal culture is another diagnostic test that involves culturing a sample from the affected area on a fungal medium. It can help identify the causative fungus and confirm the diagnosis [3][8].

Other Diagnostic Methods

In addition to these tests, other methods such as potassium hydroxide (KOH) wet mount examination may also be used to diagnose tinea profunda. KOH wet mount examination involves examining a sample from the affected area under a microscope after adding KOH solution. It can help identify fungal elements such as hyphae or yeast cells [7][11].

References

[1] Braun SA, Jahn K, Westermann A, Bruch-Gerharz D, Reifenberger J. Tinea barbae profunda by Arthroderma benhamiae. A diagnostic challenge. Hautarzt. 2013 Oct;64(10):720-2.

[2] Aboul-Ella H. The conventional gold standard diagnostic method for tinea corporis is a direct microscopic examination followed by 3 to 4 weeks of Sabouraud's dextrose agar (SDA) culturing, and ...

[3] Garg J. Nested PCR may be considered as gold standard for the diagnosis of dermatophytosis and can aid the clinician in initiating treatment.

[5] Tinea corporis is sometimes diagnosed on skin biopsy, and characteristic histology changes are seen (see Tinea corporis pathology). Histology is typically ...

[7] Diagnosis is usually clinical. It can be confirmed by scraping a few scales from the margins of the lesion and examining them for fungal hyphae under low power microscopy.

[8] The conventional gold standard diagnostic method for tinea corporis is a direct microscopic examination followed by 3 to 4 weeks of Sabouraud's dextrose agar (SDA) culturing, and ...

[11] Material is scraped from an active area of the lesion, placed in a drop of potassium hydroxide solution and examined under a microscope.

Treatment Options for Tinea Profunda

Tinea profunda, also known as Majocchi granuloma, is a rare and deep fungal infection of the skin. The treatment options for this condition are limited due to its rarity and frequent misdiagnosis.

• Oral Antifungal Medication: According to various sources [2, 3, 7, 8], oral antifungal medication is usually required to treat tinea profunda. This includes medications such as itraconazole, terbinafine, and fluconazole.
• Duration of Treatment: The duration of treatment for tinea profunda can range from 4 to 6 weeks [2, 3]. It's essential to complete the full course of treatment to ensure the infection is fully cleared.
• Systemic Antifungal Therapy: Systemic antifungal therapy is often necessary for treating tinea barbae, which can be a manifestation of tinea profunda in some cases [12].
• Topical Formulations: While topical formulations with antifungal compounds may be applied to treat superficial fungal infections, they are not sufficient for treating deep-seated infections like tinea profunda.

Important Considerations

It's crucial to note that the treatment options for tinea profunda can vary depending on individual cases and the severity of the infection. In some instances, corticosteroids may be used pre-treatment to manage itching and inflammation [15]. However, this should not obscure the clinical inflammatory pattern of tinea.

References

[2] Oct 2, 2024 — The duration of treatment should be between 4 and 6 weeks. [3] by I Bakardzhiev · 2016 · Cited by 24 — Oral administration of terbinafine for 4–6 weeks of duration is the preferred treatment option in both patients groups—immunocompromised and not. (13). [7] by Iufficent for treating deep-seated infections like tinea profunda. [8] Mar 3, 2022 — Treatment for tinea capitis in adults includes oral antifungal medication as well. You'll need to take the medication for at least six weeks ... [12] Outline the management options available for tinea barbae. ... Since the mainstay of treatment for tinea barbae is systemic antifungal therapy for an extended period with the potential for side effects, it is important to verify the diagnosis. [15] There is almost always a marked itching, which often leads to pre-treatment with corticosteroids and thus obscures the clinical inflammatory pattern of tinea.

The differential diagnosis for tinea profunda, also known as deep fungal infection of the skin, includes several conditions that can mimic its symptoms.

• Kerion: A severe form of scalp infection caused by a fungus, which can be similar to tinea profunda in terms of its inflammatory and suppurative characteristics [6].
• Granuloma trichophyticum: A rare condition characterized by the formation of granulomas on the skin, which can be confused with tinea profunda due to its similar appearance [6].
• Bacterial folliculitis: An infection of the hair follicles caused by bacteria, which can present with symptoms similar to those of tinea profunda, such as redness and swelling [7].
• Acne vulgaris: A common skin condition characterized by comedones, papules, and pustules, which can be mistaken for tinea profunda due to its inflammatory nature [7].
• Psoriasis: An autoimmune condition that causes red, scaly patches on the skin, which can be confused with tinea profunda due to its similar appearance [4].

It's essential to note that a proper diagnosis of tinea profunda requires a thorough examination and possibly laboratory tests, such as PCR-based diagnostics, to confirm the presence of the fungus [5].