Causes• Trichophyton: Skin, hair, nail infections• Microsporum: skin, hair infections• Epidermophyton: skin, nail infections

Symptoms • Tinea pedis (athlete’s foot): Soggy interdigital scaling, a diffuse dry scaling of the soles• Tinea of the nails: Yellow and crumbly nails, subungual hyperkeratosis, separation of the nail from its bed, finger nail lesions• Tinea of the hands: Erythema of one palm with a characteristic powdery scale in creases• Tinea of the groin (upper inner thigh): Demarcated plaques with peripheral scaling, few vesicles or pustules may be seen within the lesions• Tinea corporis (trunk and limbs): Plaques with scaling and erythema, few vesicles and pustules may be seen• Tinea capitis (scalp): Cause bald and scaly areas

Complications • Permanent scarring alopecia• Induce vesication on the sides of the fingers and palms

Differential diagnosis• Scalp: Alopecia areata, psoriasis, seborrhoeic eczema, carbuncle• Feet: Erythrasma, interdigital intertrigo• Trunk: Discoid eczema, psoriasis, candidiasis• Groin: candidiasis, erythrasma, intertrigo, psoriasis• Nails: Psoriasis, paronychia, trauma, ageing changes• Hand: Chronic eczema, granuloma annulare, dyshidrotic eczema

Diagnose• Microscopic examination of skin scraping, nail clipping or plucked hair• Cultures• Wood’s light

Treatment

• Local: Miconazole, clotrimazole, benzoic acid ointment, magenta paint, topical nail preperations, topical ciclopirox, tioconazole nail solutions• Systemic: Terbinafine, itraconazole, griseofulvin