Ringworm in humans
Ringworm is a disease of the skin, nails and hair of a person, which is provoked by pathogenic fungi and is highly contagious. This type of fungal infection is well studied in medicine, it can be called trichophytosis or microsporia, as it is caused by two types of mycotic organisms: Microsporum and Trichophyton. Terms such as dermatophytosis, dermatophytosis, dermatomycosis are also synonymous with ringworm.
Microsporia is a highly contagious infection; children are at increased risk. Moreover, boys are five times more likely to become infected with ringworm than girls. It is customary to distinguish between microsporia of smooth skin and scalp. Nails are involved with the pathological process much less often.
- Zooanthroponous microsporia, the causative agent of which affects dogs, cats and humans;
- Anthroponous microsporia, the causative agent of which affects only humans;
- Geophiles - pathogens of this type of microsporia live exclusively in the soil, infection can occur only upon contact with it.
According to available statistics, microsporia affects 50 to 70 people out of 100,000. The disease is seasonal in nature and is more widespread in the warm season. In regions where hot climates prevail, infection is diagnosed much more often.
Trichophytosis can be transmitted either from animals to humans, or from person to person. Only people suffer from anthroponous trichophytosis, most often they are children. Zooanthroponous trichophytosis can be transmitted from domestic animals or from mice to humans.
- Ringworm symptoms
- The causes of ringworm
- Why is ringworm dangerous? Consequences and complications
- Ringworm diagnostics
- Answers to popular questions:
- Which doctor should I go to?
- Ringworm treatment
The symptoms of ringworm may vary slightly, depending on the location of the infection, on disorders in the functioning of the immune system and on its ability to cope with the disease.
In this regard, it is customary to distinguish:
Deprive superficial with localization on the scalp. Most often, infection occurs through contact with a sick person, or through interaction with an infected animal. If you do not get rid of superficial lichen of the scalp in childhood, then there is a danger of its transition into a chronic form after puberty of a female child. In boys aged 13-15, untreated lichen superficial of the scalp most often goes away on its own.
The symptoms of this type of ringworm are:
- A single area or multiple affected areas with thinning hair. Such foci have a rounded shape.
- On the face, patches of flaky skin may appear, the scales of which are grayish or white. They are very similar in appearance to dandruff.
The more actively the microorganisms that cause lichen begin to multiply, the more the hair begins to break. Over time, the area looks as if the hair on it was cut at a level of 1-2 mm from the skin.
- The edges of the affected area are surrounded by small bubbles. After they burst, a yellow crust forms in their place. The skin itself may be slightly hyperemic.
- The affected areas are large in diameter and can reach 10 cm, and sometimes even exceed this figure.
- Itching with a superficial ringworm is most often not observed. If it does arise, it has a rather weak degree of severity and does not cause discomfort to a person.
A patient with superficial lichen is more likely to experience psychological discomfort, since his appearance is seriously affected.
Deprive superficial, affecting smooth skin. Often this type of ringworm can be confused with lichen rosacea, but there is one significant difference between them - ringworm pink never affects the hands, feet and face. Ringworm, in turn, can occur anywhere on the body. In addition, lichen rosacea will not last more than 8 weeks, and ringworm can bother a person for many years, often changing from remission to flare-up.
Symptoms of the superficial form of ringworm affecting smooth skin are:
- A bright spot with clear boundaries. The borders themselves will be raised above the skin, forming a small ridge. It consists of pinkish blisters and papules. The middle of the spot is lighter, covered with skin scales.
- If the disease is not treated, then the spots can grow.
- The patient will have itchy skin.
Most often, superficial lichen occurs on the smooth skin of the neck and face, often appears on the lower limbs and on the trunk.
Chronic ringworm. The chronic form of ringworm in adulthood can only be found in females. The disease develops against the background of an infection that has not been treated in childhood and is exacerbated by dysfunction of the ovaries and thyroid gland. A general decrease in immune strength and hypovitaminosis can also become a push.
The symptoms of chronic ringworm are as follows:
- The affected area is the scalp (mainly the temples and the back of the head), smooth skin (mainly elbows, buttocks, thighs, palms), nail plates.
- When the area with hair is affected, the shafts themselves break at the root. The lesion does not grow by more than 10 mm, there is no inflammation, and a flaky scar forms over time.
- When smooth skin is involved in the process, the spot does not have clearly defined boundaries, it can reach large sizes. The color of the spot can be any shade, from pink to bluish. Chronic rashes are always itchy and flaky.
If the nail plate is involved in the pathological process, then first of all its color changes. It transforms from light pink to gray. The nail grows cloudy, dulls, begins to crumble. There are two options for changing the nail plate: it becomes either thinner or thicker.
Infiltrative-suppurative form of deep ringworm. This type of disease affects only human hair follicles. This form of the disease can only be contracted from an animal.
The symptoms of deep ringworm are as follows:
- The rise in body temperature.
- Swollen and tender lymph nodes.
- Concomitant skin rashes of an allergic nature.
- General weakness and malaise.
Large red plaques appear on the head, their diameter can reach 10 cm or more. They have an uneven surface with raised bumps above it. Outwardly, deep ringworm resembles a tumor. This type is due to the fact that there is suppuration of the hair follicles. This inflammatory process is accompanied by swelling of the skin, which raises the plaque above the surface.
- A person experiences pain at the site of inflammation. If the follicle is opened, then purulent contents will be released from it.
- As the inflammation fades away, loose crusts with a brown tint appear in the middle of the plaque. If a man is exposed to the disease, then plaques can form on his mustache and beard.
- The abortive form of the disease is characterized by the appearance of pale spots that do not have clearly defined boundaries. Symptoms of the disease are mild, itching is not very pronounced.
- An erythematous-edematous type of ringworm can occur in childhood or in women. This form of the disease is characterized by the presence of severe inflammation and allergic skin reactions. The surface of the spot is covered with small scales.
The papular squamous form of the disease affects the chest and face. In this case, the formed plaque rises above the surface of the skin, has pronounced tubercles, and is covered with dense skin scales. Itching of the skin is pronounced to a large extent.
The causes of ringworm
There can be only one reason for the appearance of ringworm - this is an infection from a carrier of the fungus. Carriers can be both humans and animals (most often these are stray dogs or cats).
The skin of a healthy person gets an element of wool, a particle of the dermis, soil or hair shaft, which contains a pathogenic fungus. It penetrates deep into healthy skin or nail and begins to multiply. If hair follicles are located nearby, then the fungi gradually germinate in them, occupying the entire space of the bulb. After that, they begin to rise up the hair, accumulating in large concentrations between the hair scales. As the disease progresses, the fungi destroy the stem. As a result, the hair breaks down due to the increased weight. Around the remainder of the hair shaft, the fungus continues to multiply, forming a white sheath. It can be seen without special magnifying equipment. This is the mechanism of ringworm infection.
The ways of infection are as follows:
- The transmission is flexible from animal to human. In this regard, children are at greatest risk. After all, it is they who often come into contact with stray animals. Moreover, parents should know that puppies and kittens of homeless animals often get sick with ringworm, on whose fur until a certain time the symptoms of lesion may not be visible. In addition to stray cats and dogs, domestic animals, for example, pigs, goats, rams, etc., are also natural sources of infection. Rodents can be carriers of the infection.
Transmission of the fungus from a sick person to a healthy person by contact and household means. The danger in this regard is represented by household items, combs, underwear and clothing that the patient used. For a long time, fungal spores continue to maintain their vital activity on car seats, on sofas, on soft toys, carpets, etc. They can live without a human or other living organism for several months.
- Contact with the diseased skin of an infected person can be dangerous in terms of transmission of the fungus.
- Ringworm infection can occur in a hairdressing salon where the rules for disinfecting equipment are not followed.
However, experts point out that infection with a fungus after a short contact with healthy skin does not always occur. In order for mycotic organisms to begin to multiply on the skin, in hair follicles, on nails, they need favorable conditions. If the human immune system is strong, then it will not allow the pathological activity of the fungus. In this regard, the integrity of the skin is also important.
Factors that create favorable conditions for ringworm infection include the following:
Maceration of the skin. This process is characterized by softening of the dermis as a result of prolonged contact with water. This also includes hyperhidrosis of the palms and feet, violations of the chemical composition of the secretion secreted by the sebaceous and sweat glands.
- Frequent contact with land or animals related to professional activities.
- Any injuries, scratches, abrasions, cracks, burns, abrasions, calcification of the skin, that is, everything that leads to a violation of its integrity.
- Overcrowding, which is especially important for children's groups, increases the risk of contracting ringworm.
- Disregard for personal hygiene rules. It is known that fungal spores are easily washed off with water when they come into contact with the skin of a healthy person.
- Skin infections and a decrease in the body's immune defenses in general. In this regard, depression, stressful situations, chronic diseases, acute infections, etc., have a negative effect.
Why is ringworm dangerous? Consequences and complications
Ringworm does not pose a serious threat to human health or life. Most often, after getting rid of the disease, the hairline is completely restored.
However, if the disease provokes suppuration and inflammation on the scalp, then this can lead to hair loss without the possibility of their subsequent restoration.
Children who have suffered from ringworm in an infiltrative-suppurative form may in the future have one or several bald spots on their heads. In addition, there is a risk of secondary infection.
Diagnostics consists in examining the patient, in specifying the characteristics of his life (the presence of contacts with animals, the presence of an outbreak of the disease in a kindergarten).
To detect mycotic cells and fungal mycelium, microscopic examination of skin scrapings is performed. To clarify the diagnosis, a culture study is carried out to determine the type of inflammatory causative agent.
Luminescent research using a Wood lamp makes it possible to examine not only the patient himself, but also contact persons. If there is a fact of infection, then the mycelium of the fungus will be highlighted in green.
These diagnostic measures will be enough to make a diagnosis.
Answers to popular questions:
- Is ringworm contagious? Yes, ringworm is an infectious and highly contagious disease.
- Can ringworm go away without treatment? The possibility of self-disposal of the body from ringworm exists, but it is negligible. Science knows several cases when the disease passed without any medical intervention, however, these are isolated phenomena. Most often, the infection, causing inflammation once, begins to spread further. If the disease develops in childhood and has not been treated with therapy, then it will persist until adulthood.
Can ringworm recur? The disease can develop again if there was a new fact of infection, or the treatment was not completed. The body is unable to build immunity against the ringworm fungus.
- Does ringworm itch or not? The disease causes itching, and in some cases it can give the patient severe anxiety.
- Can I wash with ringworm? The disease is not a contraindication to the implementation of hygiene procedures. During illness, it is best not to take a bath, but a shower.
- What if I get ringworm during pregnancy? Do not panic if the infection develops during gestation, since these mycotic organisms are not able to exert a pronounced effect on either the child or the woman. In case of infection, you should consult a doctor and undergo the treatment recommended by him. During pregnancy, oral medications are not prescribed to get rid of the infection; it will be enough to use ointments that the doctor prescribes.
Which doctor should I go to?
If an adult or a child has symptoms of ringworm, a doctor should be consulted immediately. This can be a specialist dermatologist or infectious disease specialist.
The doctor, using the diagnostic methods available to him, will confirm or deny the fact of infection and prescribe the appropriate treatment. It is worth remembering that without therapy, ringworm can provoke very unpleasant consequences in the form of baldness or suppuration, and can also be spread to the people around.
In addition, there is a possibility that under the symptoms of ringworm there are diseases such as: atopic dermatitis, psoriasis, lichen planus, alopecia areata, etc.
Read more: Alopecia areata (alopecia areata) in children and adults
Treatment for ringworm cannot be very quick. Typically, therapy takes from a month to 6 weeks. To prevent the disease from becoming chronic, all recommendations prescribed by the doctor must be followed strictly.
Treatment must be carried out by a specialist, since attempts to get rid of the infection on their own can also lead to chronicity of the process. In this case, the disease will periodically remind of itself, capturing all new areas of the skin and scalp.
If, during the diagnosis, a single focus of lichen is found on the skin, and the patient feels well, then only local treatment can be prescribed. However, it is only practiced when the rash is located on the skin without vellus or coarse hair. The patient is advised to treat the affected surface with iodine at 5% concentration in the morning, and then apply antimycotic ointments. In the evening before applying the ointment, the skin is treated with salicylic acid.
If there are several plaques on the body, then the treatment of the disease is carried out in a hospital setting. At the same time, local therapy must be supplemented with oral medication.
Ointments for the treatment of ringworm have a thick consistency, remain on the skin for a long time, do not drain and do not smear much. In addition, they are not able to penetrate deeply into the cells of the epidermis, which means that the risk of side effects is minimal. They may include clotrimazole, ketoconazole terbinafine, mycoconazole.
The application of ointments is recommended to be combined with preliminary treatment of the skin with iodine, as this helps to dry the lichen, provide an antiseptic effect.
Doctors prescribe the following ointments to treat ringworm:
- Salicylic ointment. It cannot be applied to the skin of the face. The ointment has an antimycotic and anti-inflammatory effect; after its application, the treated surface should be covered with a sterile cloth.
- Sulfuric ointment in 10% or 10% concentration. It helps to get rid of mycotic organisms and bacteria, has a positive effect on the process of skin regeneration.
- Sulfur tar ointment. It is applied to the surface of the lichen and to the surrounding tissues. If the skin around is swollen, then a sterile bandage should be applied over the ointment.
- Mycospore. This ointment contributes to the destruction of the cells of mycotic organisms, it must be applied in a thin layer.
- Wilkinson's ointment.
- Lamisil. Has a destructive effect on fungi, prevents their further reproduction.
- Prescription antimycotics for the topical treatment of ringworm are Vidal's milk and Lassar's paste. They are made to order in a pharmacy.
If the skin around the treatment area is contaminated, it should be washed. This is done not with ordinary water, but with disinfectants, for example, a solution of furacilin, potassium permanganate, miramistin.
Antimycotic gels are also often prescribed by dermatologists for topical treatment of ringworm. They are quickly absorbed and do not stain clothes, therefore they are easy to use.
In addition, gels contain high concentrations of drugs:
- Exifin gel in 1% concentration based on terbinafine.
- Mikogel KMP, in addition to the antimycotic effect, has an antibacterial effect. The main active ingredient is miconazole.
For the treatment of the scalp, it is more convenient to use antifungal drugs in the form of solutions. They have good permeability and do not stain hair. They can be used for the treatment of deprive of smooth skin as a preparation before applying an ointment or gel.
The following solutions are considered the most effective:
- Vocadin based on iodine.
- Iodicirin based on iodine and glycerin.
- Nitrofungin based on 1-chloro-4-nitrophenol. A modern and effective agent that has antimycotic and antibacterial effect.
In addition to local treatment, it is possible to prescribe drugs with an antifungal effect in tablet form. They contribute to the destruction of the fungus from the inside. However, it is worth remembering that such funds can only be recommended by a doctor. Although they have a pronounced therapeutic effect, antimycotics can cause side effects.
Popular oral medications include:
- Griseofulvin. It is a natural antimycotic with a narrow spectrum of action against the fungi that cause ringworm. The full course of therapy is up to 15 days.
- Orungal. The course of taking this itraconazole-based drug lasts up to 15 days.
- Lamisil with the active ingredient terbinafine can be recommended for 6 weeks.
- Fluconazole. The course of treatment with this drug is up to 8 weeks.
The effectiveness of the therapy is assessed using a fluorescent lamp. At the end of the therapeutic course, a second skin scraping will be performed. If the fungi continue to be present on the integument of a person, then the treatment is either continued or the drug is replaced with another.
Do not give up the doctor's recommendation to shave off the hair in the affected area. This will allow not only to apply the product more economically, but also to increase the effectiveness of the treatment.
It is important to take precautions within the family if there is a person with ringworm. To prevent its spread, shampoos with antimycotic components can be used as a prophylaxis: ketoconazole (1%), zinc pyrithione (up to 1%), selenium sulfide (1.5%), povidone-iodine.
Children with uncomplicated ringworm are treated at home. They should not attend educational institutions for 14 days or more from the start of therapy.
The author of the article: Kuzmina Vera Valerievna | Endocrinologist, nutritionist
Education: Diploma of the Russian State Medical University named after NI Pirogov with a degree in General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).
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