Generality
Ringworm is a generic term referring to some cutaneous mycoses, fungal infections that normally affect the most superficial layers of the skin. Very common in our latitudes, ringworms are otherwise called dermatophytes, as they are caused by filamentous skin fungi that reproduce through spores (dermatophytes).
Causes and Symptoms
Dermatophyias (or ringworms) can be caused by three different kinds of dermatophytes: Trichophyton, Microsporum and Epidermophyton.
These filamentous mycetes feed on the keratin present in the horny layer of the epidermis and in the skin appendages, causing characteristic ring lesions, with sharp edges and centrifugal evolution; initially the macules appear as a sort of "pimple", which more or less quickly it widens in a centrifugal way, leaving progressively intact the skin in the center.This lesion is described with the Latin term "tinea", followed by the specification of the affected site.
Thus, for example, some of these dermatophytes can infect the scalp (ringworm of the head or tinea capitis), others the face (ringworm of the face or tinea faciei and beard ringworm), the trunk (tinea corporis), the hands (tinea manum ), the feet (tinea pedis or athlete's foot), the inguinal folds (tinea cruris) and nails (tinea unguium).
The variability of clinical manifestations is relevant and depends on the site affected, the fungal species involved and the patient's state of health.
Infection
On the epidemiological level, anthropophilic dermatophytes are distinguished, which exclusively affect the human species with possible interpersonal contagion, and zoophilic dermatophytes, which mainly affect animals but can be transmitted to man through contact with them.
Finally, we have the geophilic dermatophytes, whose reservoir is the soil; they represent only occasional pathogens for the human species.
Generally, therefore, the transmission of ringworm occurs by direct skin contact with sick people or infected animals, or indirectly through linen, clothing, professional tools, brushes, combs, etc.
Human-to-human infection is mediated by the contact of desquamated skin scales; as regards the athlete's foot, for example, a typical method of infection is the contact with showers, platforms, floors or other objects used by people affected by this dermatomycosis.
Diagnosis and therapy
For further information: Drugs for the treatment of Ringworm of the Hair - Drugs for the treatment of Ringworm of the Feet
The diagnosis, often already clinically evident, can be confirmed by taking biological material from suspicious areas, which is then examined under a microscope to identify the type of fungus involved. Only in this way, the specialist can program a specific antifungal therapy for the etiological agent, also taking into account the patient's immunological status, the type of area affected by the ringworm and the extent of clinical manifestations.
The therapy uses drugs called antifungals, used both for local application (creams, powders, lotions) and systemically; the latter is more indicated in extended forms, in chronic or long-standing infections. The drugs most used systemically are griseofulvin, itraconazole, fluconazole, terbinafine.
Treatment is usually quite lengthy, as complete resolution of the disease takes a couple of weeks.
Prevention
Gyms, swimming pools, saunas, changing rooms and hotel rooms are the main source of fungal infections. We therefore recommend:
- always use your own towel when using the gym equipment for mixed use;
- in the changing rooms and more generally in any community place (kindergartens, schools, barracks, beaches, etc.), avoid walking barefoot on rugs, carpets, grounds and various surfaces;
- avoid wearing tight clothing or synthetic fibers, especially in the hottest months. The humidity and the heat favor the engraftment of the ringworm;
- use breathable and light-colored footwear (breathable upper); let the shoes dry after use;
- regularly replace socks and wash them in hot water;
- use particular attention in the daily hygiene of the feet, taking care to dry the interdigital spaces well and to remove any macerated layers;
- use talc or antifungal powders on the skin folds, especially if you are obese, diabetic or suffer from sweating;
- always keep in mind that cattle and horses, but also and above all domestic animals - such as dogs, cats, hamsters, hamsters or rabbits - can be a source of transmission of some types of ringworm;
- avoid mixed use of strictly personal items, such as linen, clothing, towels and slippers;
- Particular attention will be paid in case of contagion. To avoid transmitting ringworm to other individuals, dermatophytosis patients should not use strictly personal items such as napkins, bidet wipes, linens, combs, files, or nail scissors in common with other family members or other people. In addition to strictly following the therapy prescribed by the doctor to eradicate ringworm, it is important to disinfect clothing and objects that have come into contact with the lesions, or wash them at high temperatures to kill the spores.
