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DermSpaceby Mediverse

Tinea corporis

Also called ringworm, dermatophytosis

Dermatophyte infection of body skin: an expanding ring with an active scaly border and central clearing. The organism lives at the advancing edge, which is where the scraping must come from.

Try the case
Annular plaque of tinea corporis with an active scaly border
Hover or drag to examine with the dermatoscopeCDC/ Dr. Lucille K. Georg · Public domain

How it looks

A single annular erythematous plaque with a raised, scaly, advancing border and central clearing on the forearm.

PlaqueScaleErythemaAnnularLocalized

Rose is the lesion, grey the pattern the lesions make, green where on the body it lives.

Across skin tones

The border may look hyperpigmented or subtly violaceous rather than red in deeply pigmented skin; the ring geometry and scale remain the reliable clues.

Don't miss

A 'ringworm' that got bigger and stranger on topical steroids is tinea incognito, the steroid erased the border while the fungus spread.

Forms & variants

  • Tinea capitis (and kerion)

    Scalp disease of children: patchy scale with broken hair shafts; a kerion is the boggy, inflammatory mass form. Both need systemic therapy, topical alone always fails.

  • Tinea faciei and tinea barbae

    Face and beard-area disease, often partially treated and atypical; pustular beard involvement suggests a zoophilic species from animal contact.

  • Tinea cruris

    Groin plaques with a scaly advancing border sparing the scrotum, usually seeded from the patient's own feet, so both sites are treated.

  • Tinea pedis and tinea manuum

    Interdigital maceration or dry moccasin scaling of the feet; 'two feet, one hand' involvement is the classic pattern of tinea manuum.

  • Tinea unguium (onychomycosis)

    Thickened, yellowed, crumbly nail plates with subungual debris; confirm with clippings before committing to months of systemic therapy.

  • Tinea incognito

    Tinea altered by topical steroids: the ring loses its scale and border while quietly spreading. When a 'dermatitis' flares whenever steroids stop, scrape it.

Symptoms & course

  • Itch
  • Slow centrifugal spread over weeks
  • Often a contact, pets, wrestling, family

Diagnostic approach

  • KOH preparation of scale from the active border, branching hyphae confirm
  • Fungal culture when KOH is negative but suspicion persists

Differential, and how to separate them

  • Nummular eczema

    Favours it: Uniform coin without clearing, very itchy

    Against it: Tinea clears centrally and KOH shows hyphae

  • Psoriasis

    Favours it: Silvery scale, extensor symmetry

    Against it: Psoriasis does not migrate outward as a ring

Management principles

  • Topical antifungal (azole or terbinafine) for limited disease
  • Oral therapy for extensive, follicular, or nail disease
  • Never topical steroids alone, they feed the ring (tinea incognito)

Clinical pearl: Scrape the edge, not the centre: the centre is where the organism used to be.

Keep going

Try the case: The ring that keeps growingCompare with Nummular eczemaBack to the Atlas