Dermatophytosis, also known as ringworm, is a fungal infection of the skin. Typically it results in a red, itchy, scaly, circular rash. Hair loss may occur in the area affected. Symptoms begin four to fourteen days after exposure. Multiple areas can be affected at a given time.About 40 types of fungus can cause ringworm. They are typically of the Trichophyton, Microsporum, or Epidermophyton type. Risk factors include using public showers, contact sports such as wrestling, excessive sweating, contact with animals, obesity, and poor immune function. Ringworm can spread from other animals or between people. Diagnosis is often based on the appearance and symptoms. It may be confirmed by either culturing or looking at a skin scraping under a microscope.Prevention is by keeping the skin dry, not walking barefoot in public, and not sharing personal items. Treatment is typically with antifungal creams such as clotrimazole or miconazole. If the scalp is involved, antifungals by mouth such as fluconazole may be needed.Globally, up to 20% of the population may be infected by ringworm at any given time. Infections of the groin are more common in males, while infections of the scalp and body occur equally in both sexes. Infections of the scalp are most common in children while infections of the groin are most common in the elderly. Descriptions of ringworm date back to ancient history. Signs and symptoms
Infections on the body may give rise to typical enlarging raised red rings of ringworm.
Admission to hospital is generally not needed. Medication
The infection is frequently penicillin resistant. There are a number of antibiotics options including amoxicillin/clavulanate, clindamycin, or metronidazole in combination with benzylpenicillin (penicillin G) or penicillin V. Piperacillin/tazobactam may also be used. Surgery
The pus can be removed by a number of methods including needle aspiration, incision and drainage, and tonsillectomy. Incision and drainage may be associated with a lower chance of recurrence than needle aspiration but the evidence is very uncertain. Needle aspiration may be less painful but again the evidence is very uncertain.Treatment can also be given while a patient is under anesthesia, but this is usually reserved for children or anxious patients. Tonsillectomy can be indicated if a patient has recurring peritonsillar abscesses or a history of tonsillitis. For patients with their first peritonsillar abscess most ENT-surgeons prefer to "wait and observe" before recommending tonsillectomy. Epidemiology
It is a commonly encountered otorhinolaryngological (ENT) emergency.The number of new cases per year of peritonsillar abscess in the United States has been estimated approximately at 30 cases per 100,000 people. In a study in Northern Ireland, the number of new cases was 10 cases per 100,000 people per year. In Denmark, the number of new cases is higher and reaches 41 cases per 100,000 people per year. Younger children who develop a peritonsillar abscess are often immunocompromised and in them, the infection can cause airway obstruction.