⚕️ FREE MSRA PODCAST – Tinea (Ringworm)
🎧 A high-yield breakdown of this common fungal skin infection – perfect for exams and daily clinical practice.

🧠 Key Learning Points

📌 Definition
• Tinea (ringworm) is a superficial fungal infection caused by dermatophytes, affecting keratinised tissues: skin, hair, or nails.
• The name "ringworm" refers to the classic ring-shaped rash – no actual worms involved!

📌 Causes & Risk Factors
• Caused by dermatophyte fungi: Trichophyton, Microsporum, Epidermophyton
• Spread via direct contact (people, animals) or fomites (towels, combs, gym floors)
• Risk factors:

• Warm, moist environments (e.g., communal showers)

• Immunosuppression

• Poor hygiene

• Tight clothing

• Children (especially Tinea capitis)

• Afro-Caribbean children in urban UK areas → high-yield MSRA point
  🧠 Mnemonic: “DAMP” – Direct contact, Animals, Moisture, Poor hygiene

📌 Pathophysiology
• Dermatophytes digest keratin → triggers inflammation
• Body reacts → erythema, scaling, itching
• Tinea capitis: infects hair shaft → brittle, black dot appearance
• Kerion: severe boggy inflammatory mass → urgent dermatology referral

📌 Symptoms
• Red, scaly, itchy patches
• May be ring-shaped (Tinea corporis)
• Tinea capitis: scaling + patchy alopecia, black dots, kerion
• Nail involvement: thick, brittle, discoloured nails
🧠 Mnemonic: “RING” – Redness, Itching, No hair (in scalp), Gritty nails

📌 Differential Diagnosis
• Alopecia areata (non-scaly)
• Seborrhoeic dermatitis
• Psoriasis (silvery plaques)
• Folliculitis
• Eczema
• Secondary syphilis (palms/soles + systemic)
• Id reaction (autoeczematisation)

📌 Diagnosis
• Clinical appearance + history
• Microscopy (KOH prep) – rapid confirmation
• Culture – slower but identifies fungal species
• Use scalp scrapings, plucked hairs, or toothbrush sampling
🧠 Tip: Keep samples at room temperature – refrigeration kills fungi!

📌 Management
• Topical antifungals (e.g., clotrimazole) for mild skin cases
• Oral antifungals (e.g., terbinafine, griseofulvin) for:

• Tinea capitis

• Nail involvement

• Widespread/severe infections
  • Tinea capitis:

• Oral treatment is essential (fungus inside the hair shaft)

• Add antifungal shampoo (e.g., ketoconazole) for 2 weeks to reduce transmission

• Screen/treat close contacts & pets
  • Urgent referral for kerion
  • Reinforce hygiene: don’t share towels/hats, clean brushes

📌 Complications
• Secondary bacterial infection (cellulitis)
• Chronic skin changes
• Spread to other sites or contacts
• School outbreaks (esp. tinea capitis)

📌 Prognosis
• Excellent if treated
• Risk of recurrence if risk factors not addressed
• Carriers may shed spores without symptoms → contribute to transmission

📎 More MSRA Resources for Tinea
📝 Revision Notes: https://www.passthemsra.com/topic/tinea-revision-notes/
🧠 Flashcards: https://www.passthemsra.com/topic/tinea-flashcards/
💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/tinea-accordion-qa-notes/
🚀 Rapid Quiz: https://www.passthemsra.com/topic/tinea-rapid-quiz/
🎓 Full Course: https://www.passthemsra.com/courses/dermatology-for-the-msra/

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