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Tinea corporis, tinea cruris, tinea nigra, and piedra

      Tinea infections are among the most common dermatologic conditions throughout the world. Skin ringworm infections, such as tinea corporis and tinea cruris, are primarily caused by the dermatophytes Trichophyton rubrum, Trichophyton mentagrophytes, and Microsporum canis. Tinea nigra is an infection of the palms or soles, which may be associated with travel to endemic regions (eg, Southeast United States and Central America). Black or white nodules found along the shaft of the hair may be infections with Piedraia hortae, or Trichosporon species, better known as “black piedra” or “white piedra.” To avoid a misdiagnosis, identification of dermatophyte infections requires both a fungal culture on Sabouraud's agar media, and a mycologic examination, consisting of a 10% to 15% KOH preparation, from skin scrapings. Topical antifungals may be sufficient for treatment of tinea corporis and cruris and tinea nigra, and the shaving of hair infected by piedra may also be beneficial. Systemic therapy, however, may be required when the infected areas are large, macerated with a secondary infection, or in immunocompromised individuals. Preventative measures of tinea infections include practicing good personal hygiene; keeping the skin dry and cool at all times; and avoiding sharing towels, clothing, or hair accessories with infected individuals.
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      References

        • Faergemann J.
        • Mörk N.J.
        • Haglund A.
        • Ödegård A.
        A multicentre (double-blind) comparative study to assess the safety and efficacy of fluconazole and griseofulvin in the treatment of tinea corporis and tinea cruris.
        Br J Dermatol. 1997; 136: 575-577
        • Hay R.J.
        • Moore M.
        Mycology.
        in: Champion R.H. Burton J.L. Burns D.A. Breathnach S.M. Textbook of dermatology. 6th edition. Blackwell Science, United Kingdom1998: 1277-1376
        • Drake L.A.
        • Dinehart S.M.
        • Farmer E.R.
        • Goltz R.W.
        • Graham G.F.
        • Hordinsky M.K.
        • et al.
        Guidelines of care for superficial mycotic infections of the skin: tinea corporis, tinea cruris, tinea faciei, tinea manuum, and tinea pedis.
        J Am Acad Dermatol. 1996; 34: 282-286
        • Kohl T.D.
        • Lisney M.
        Tinea gladiatorum.
        Sports Med. 2000; 29: 439-447
        • Sadri M.F.
        • Farnaghi F.
        • Danesh-Pazhooh M.
        • Shokoohi A.
        The frequency of tinea pedis in patients with tinea cruris in Tehran, Iran.
        Mycoses. 1998; 43: 41-44
        • Ginter G.
        Microsporum canis infections in children: results of a new oral antifungal therapy.
        Mycoses. 1996; 39: 265-269
        • Beller M.
        • Gessner B.D.
        An outbreak of tinea corporis gladiatorum on a high school wrestling team.
        J Am Acad Dermatol. 1994; 31: 197-201
        • Martin A.G.
        • Kobayashi G.S.
        Superficial fungal infection: dermatophytosis, tinea nigra, piedra.
        in: Feedberg I.M. Eisen A.Z. Wolff K. Austen K.F. Goldsmith L.A. Katz S.I. Fitzpatrick's dermatology in general medicine. 5th edition. McGraw-Hill, USA1999: 2337-2357
        • Elgart M.L.
        • Warren N.G.
        Superficial and deep mycoses.
        in: Moschella S.L. Hurley H.J. Dermatology. 3rd edition. WB Saunders, Philadelphia1992: 869-941
        • Terragni L.
        • Marelli M.A.
        • Oriani A.
        • Cecca E.
        Tinea corporis bullosa.
        Mycoses. 1993; 36: 135-137
        • Grekin R.C.
        • Samlaska C.P.
        • Vin-Christian K.
        Diseases resulting from fungi and yeasts.
        in: Odon R.B. James W.D. Berger T.G. Andrews' diseases of the skin. 9th edition. WB Saunders, Philadelphia2000: 358-416
        • Noble S.L.
        • Forbes R.C.
        • Stamm P.L.
        Diagnosis and management of common tinea infections.
        Am Fam Physician. 1998; 58: 163-177
        • Farag F.
        • Taha M.
        • Halim S.
        One-week therapy with oral terbinafine in cases of tinea cruris/corporis.
        B J Dermatol. 1994; 131: 684-686
        • Bourlond A.
        • Lachapelle J.M.
        • Aussems J.
        • Boyden B.
        • Campaert H.
        • Conincx S.
        Double-blind comparison of itraconazole with griseofulvin in the treatment of tinea corporis and tinea cruris.
        Int J Dermatol. 1989; 28: 410-412
      1. Fulvicin U/F.
        in: Repchinsky C. Welbanks L. Bisson R. Compendium of pharmaceuticals and specialties: The Canadian drug reference for health professionals. Webcom Limited, Toronto2002: 678
      2. Lamisil.
        in: Repchinsky C. Welbanks L. Bisson R. Compendium of pharmaceuticals and specialties: the Canadian drug reference for health professionals. Webcom Limited, Toronto2002: 870-872
      3. Sporanox capsules.
        in: Repchinsky C. Welbanks L. Bisson R. Compendium of pharmaceuticals and specialties: the Canadian drug reference for health professionals. Webcom Limited, Toronto2002: 1581-1583
        • Montero-Gei F.
        • Perera A.
        Therapy with fluconazole for tinea corporis, tinea cruris, and tinea pedis.
        Clin Infect Dis. 1992; 14: S77-S81
      4. Nizerol tablets.
        in: Repchinsky C. Welbanks L. Bisson R. Compendium of pharmaceuticals and specialties: the Canadian drug reference for health professionals. Webcom Limited, Toronto2002: 1139-1140
        • Pariser D.M.
        • Pariser R.J.
        • Ruoff G.
        • Ray T.L.
        Double-blind comparison of itraconazole and placebo in the treatment of tinea corporis and cruris.
        J Am Acad Dermatol. 1994; 31: 232-234
        • Lachapelle J.M.
        • De Doncker P.
        • Tennstedt D.
        • Cauwenbergh G.
        • Janssen P.A.J.
        Itraconazole compared with griseofulvin in the treatment of tinea corporis/cruris and tinea pedis/manuum: an interpretation of the clinical results of all completed double-blind studies with respect to the pharmacokinetic profile.
        Dermatol. 1992; 184: 45-50
        • Nozickova M.
        • Koudelkova V.
        • Kulikova Z.
        • Malina L.
        • Urbanowski S.
        • Silny W.
        A comparison of the efficacy of oral fluconazole 150 mg/week versus 50 mg/day in the treatment of tinea corporis, tinea cruris, tinea pedis, and cutaneous candidosis.
        Int J Dermatol. 1998; 37: 701-708
        • Parent D.
        • Decroix J.
        • Heenen M.
        Clinical experience with short schedules of itraconazole in the treatment of tinea corporis and/or cruris.
        Dermatology. 1994; 189: 378-381
        • Mok W.Y.
        Nature and identification of Exophiala werneckii.
        J Clin Microbiol. 1982; 16: 976-978
        • Tseng S.S.
        • Whittier S.
        • Miller S.R.
        • Miller S.R.
        • Zalar G.L.
        Bilateral tinea nigra plantaris and tinea nigra plantaris mimicking melanoma.
        Cutis. 1999; 64: 265-268
        • Shannon P.L.
        • Ramos-Caro F.A.
        • Cosgrove B.F.
        • Flowers F.P.
        Treatment of tinea nigra with terbinafine.
        Cutis. 1999; 64: 199-201
        • Blank H.
        Tinea nigra: a twenty-year incubation period.
        J Am Acad Dermatol. 1979; 1: 49-51
        • Göttlich E.
        • de Hoog G.S.
        • Yoshida S.
        • et al.
        Cell-surface hydrophobicity and lipolysis as essential factors in human tinea nigra.
        Mycoses. 1995; 38: 489-494
        • Conant N.F.
        • Smith D.T.
        • Baker R.D.
        • Callaway J.L.
        Tinea nigra palmaris.
        in: Manual of clinical mycology. 3rd edition. WB Saunders, Philadelphia1971: 494-502
        • Palmer S.R.
        • Bass J.W.
        • Mandjana Rmandojana R.
        • Wittler R.R.
        Tinea nigra palmaris and plantaris: a black fungus producing black spots on the palms and soles.
        Pediatr Infect Dis J. 1989; 8: 48-50
        • Merwin C.F.
        Tinea nigra palmaris: review of literature and case report.
        Pediatrics. 1965; 36: 537-541
        • Gupta G.
        • Burdern A.D.
        • Shankland G.S.
        • Fallowfield M.E.
        • Richardson M.D.
        Tinea nigra secondary to Exophiala werneckii responding to itraconazole.
        Br J Dermatol. 1997; 137: 483-484
        • Carr J.F.
        • Lewis C.W.
        Tinea nigra palmaris: treatment with thiabendazole topically.
        Arch Dermatol. 1975; 111: 904-905
        • Sayegh-Carreño R.
        • Abramovits-Ackerman W.
        • Gión G.P.
        Therapy of tinea nigra plantaris.
        Pharmacol Ther. 1989; 28: 47-48
        • Burke W.A.
        Tinea nigra: treatment with topical ketoconazole.
        Cutis. 1993; 52: 209-211
        • Smith J.D.
        • Murtishaw W.A.
        • McBride M.E.
        White piedra (Trichosporosis).
        Arch Dermatol. 1973; 107: 439-442
        • Drake L.A.
        • Dinehart S.M.
        • Farmer E.R.
        • Goltz R.W.
        • Graham G.F.
        • Hordinsky M.K.
        Guidelines of care for superficial mycotic infections of the skin: piedra.
        J Am Acad Dermatol. 1996; 34: 122-124
        • Figueras M.J.
        • Guarro J.
        • Zaro L.
        New findings in black piedra infection.
        Br J Dermatol. 1996; 135: 157
        • Coimbra Jr., C.E.A.
        • Santos R.V.
        Black piedra among the Zoró Indians from Amazônia (Brazil).
        Mycopathologia. 1989; 107: 57-60
        • Kwon-Chung K.J.
        • Bennett J.E.
        Piedra.
        in: Cann C. Colaiezzi T. Hunsberger S. Medical mycology. Lea & Febiger, Philadelphia1992: 183-198
        • de Almeida Jr., H.L
        • Rivitti E.A.
        • Jaeger R.G.
        White piedra: ultrastructure and a new microecological aspect.
        Mycoses. 1990; 33: 491-497
        • Gold I.
        • Sommer B.
        • Urson S.
        • Schewach-Millet M.
        White piedra.
        Int J Dermatol. 1984; 23: 621-623
        • Gip L.
        Black piedra: the first case treated with terbinafine (Lamisil).
        Br J Dermatol. 1994; 130: 26-28
        • Benson P.M.
        • Odom R.B.
        White piedra.
        Arch Dermatol. 1983; 119: 602-604
        • Walzam M.
        • Leeming J.G.
        White piedra and Trichosporon beigelii: the incidence in patients attending a clinic in genitourinary medicine.
        Genitourin Med. 1989; 16: 331-334
        • Mostafa W.Z.
        • Al Jabre S.H.
        White piedra in Saudi Arabia.
        Int J Dermatol. 1992; 31: 501-502