Ringworm

Infection and Treatment of Ringworm


Site of Infection, Pathology and Disease Symptoms

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Infection of ringworm can develop almost anywhere on the human body, including the arms, legs, feet, hands and face. Exposed wounds and cuts are a common site for the fungi to easily penetrate the skin and infect our body. Dermatophytes require a protein known as keratin for nutritional prosper. As a result they must live on outermost layer (stratum corneum) of the skin, hair, or nails to survive because this is where the keratin is found on our body.  This infection causes a red, itchy, ring-like rash to form at the site of infection, this where the name "ringworm" comes from. The infection may also cause severe hair loss and scarring if on the scalp of the head. The rash can also become inflamed and swell which can create a bullous (sac of fluid trapped under skin) particularly on the foot. 
As of now, research suggests that the fungus only targets the outer stratum corneum layer of the skin and not any deeper. However the rash can spread to areas around the site of infection if not treated properly. If the ringworm infection is underneath the nail, it will cause thickening and discoloring of the nail. 
Early infection of ringworm is often characterized by slight itch or burning sensation on the region of infection. As time goes on, the ring-shaped rash will turn red and scaly and will continue to be more irritated. In areas of the scalp, feet, or groin the pathogen will target the site in the form of patches instead of red rings and in serious cases it can cause blistering of the skin.


Treatment

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Anti-fungal drugs are used to treat ringworm infections, these drugs are called Azoles. Azoles function by inhibiting the production of a lipid in fungi. This lipid helps regulate the permeability of the fungi microbe's membrane, this lipid is known as ergosterol. By inhibiting the manufacturing of ergosterol, the integrity of the invading pathogen's membrane collapses and the entire cell ruptures. This renders the fungi unable to function properly and stops the infection from spreading. 
If diagnosed quickly enough, ringworm infections can be healed after 2-4 weeks depending on the severity of the infection. Most moderate ringworm infections can be treated with over-the-counter topical creams, lotion, powders, or oral pills.  But in extreme cases, such as scalp infections, they can take up to 4 months to fully heal with the help of strong antifungal medications prescribed by a physician. 
Some preventative measures we can take in order to avoid ringworm infections are:
  • Wearing footwear in public places such as pools, locker rooms, and saunas
  •  Not sharing towels, sports gear or uniforms with others
  • Replacing your underwear and socks at least once a day
  • Keeping abrasions and wounds covered until fully healed
  • Visiting the veterinarian if you suspect your pet has a ringworm infection
  • Consistently wash your hands!

 



         Resources

       For additional information check out these sites:
  • Centers for Disease Control and Prevention 2014, https://www.cdc.gov/fungal/diseases/ringworm/index.html

  • Denise M. Aaron Merck Manual 2020, https://www.merckmanuals.com/professional/dermatologic-disorders/fungal-skin-infections/overview-of-dermatophytoses

  • Watkins, Jean. “Symptoms and Treatment of Ringworm Infections.” 2014  http://search.ebscohost.com.ezproxy.afmk.talonline.ca/login.aspx?direct=true&db=rzh&AN=95544925&site=eds-live&scope=site