The diagnosis and management of tinea

Tinea refers to superficial infection with one of three fungal genera—Microsporum, Epidermophyton, and Trichophyton—collectively known as dermatophytes. These infections are among the most common diseases worldwide and cause serious chronic morbidity. Griseofulvin treatment and school screening programmes almost eradicated tinea capitis (scalp infection) as an endemic condition in the developed world in the 1950s, but it re-emerged as a public health problem in the United Kingdom in the 1990s, with infection rates of at least 12% in school children.1 Increased mass tourism and mobile populations may have contributed to the changing epidemiological trends.2 Newly developed polymerase chain reaction based techniques, although useful in rapid diagnosis of dermatophytosis,3 are still not widely available. Although the number and range of antifungal drugs are limited compared with antibiotics, most are highly effective for fungal disease acquired in temperate climates. This review aims to familiarise the reader with the various clinical presentations of tinea, to outline the steps that should be taken for accurate diagnosis, and to evaluate the most appropriate treatment regimens.