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Tinea

Checked: 23-08-2020 by Vicky Ryan Next Review: 23-08-2021

Principles of Management

Local clinicians recommend:

Primary Care Dermatology Society (PCDS) Tinea clinical guidance

NICE (National Institute for Health and Care Excellence): https://cks.nice.org.uk/#?char=F

Please always refer to the BNSSG Formulary: remedy.bnssgccg.nhs.uk/formulary-adult/chapters/13-skin/132-infections-of-the-skin/

IMPORTANT POINTS TO REMEMBER:

Topical steroids and calcinuerin inhibitors can modify the appearance and mask the symptoms of fungal infection resulting in “Tinea Incognito” This can often be mistaken for eczema, psoriasis or folliculitis.

Always consider fungal infection in localised rashes that do not resolve with topical steroids particularly if they are unilateral.

Red Flags

Coexisting conditions

Complications are more likely if there are predisposing causes such as Diabetes, systemic immunosuppressants and HIV/AIDS. Even mild fungal infection of nails should be investigated and treated to prevent comorbidity in these cases.

Kerion

If tinea capitis is left untreated kerion infection of the scalp may develop (Fungal infection that beds in the scalp deeply). This can look like clusters of boils and can be mistaken for a bacterial infection. Send scrapings and plucked hairs for mycology as well as swabs for infection and refer early if suspected as it can cause permanent scarring and hair loss.

Secondary skin infection

Bacterial infections can also be triggered by severe tinea infections and should be treated with antibiotics if necessary.

Referrals

Sirona Community Dermatology service offer individually tailored treatment plans and offer support with management.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.