Case Report

Tinea Corporis

By: Nurul Ayni

Supervisor: Irma Tarida L, dr. Sp.KK

DERMATOLOGY AND VENEREOLOGY DEPARTEMENT

MARDI WALUYO GENERAL HOSPITAL BLITAR
MEDICAL FACULTY ISLAMIC UNIVERSITY OF MALANG
2018
 IDENTITY
• Name : Mrs.T
• Age : 60 years old
• Sex : Female
• Adress : Bonsari-Blitar
• Job : Farmer
• Religion : Islam
• Marriage Status : Maried
• Examination Date: March 21st 2018
 HISTORY

Chief Complaint
• Itching

History of present illness

• Patient feel itchy started since 1 year
ago. Itching occurs throughout the body,
especially on the back, abdomen, arms,
and legs . Itching is getting worse when
sweating. The skin is scaly and felt dry.
 Medical History
• Since 1 year ago, the patient has been taking skin
ointments from the pharmacies, but the itch still
repeating

Family History
• No family history
Past Medical History
• No past medical history of dermatology disease
• Two weeks ago the level of blood sugar was
elevated until 260 gr/dl. The patient has been
taking hyperglycemia drugs from general
practitioner.

Allergy
• No allergy history drugs or food
 Physical Examination

 General Condition
Good condition
 Consciousness
Compos mentis, GCS 4 5 6
 Vital Sign
Pulse : 90 x/menit,
RR : 21 x/menit,
Tax : not performed
 Physical Examination

• Head to Toe
1. Eyes : normal
2. Thorax : cor dan pulmo normal
3. Abdomen : soefl, bowel sounds (+), timpanyc,
tenderness (-)
4. Extremities : swelling extremities (-/-)
 Physical Examination
• Dermatology status

Lower abdominal, arms, legs, and back area :

Erythematous macule, policyclic, sharrply demarcated, the
edges rise with central healing, skuama (+).
Pottasium Hydroxide10-20% test

Hyphae (+)
 DIAGNOSIS

Diagnosis
• Tinea Corporis

Differential Diagnosis

• Eritrasma
• Candidiasis cutis
• Pityriasis rosea
 PLANNING TREATMENT
Therapy

• Ketoconazole tab 1 x 200mg for 4 weeks

• Interhistin 2x1 tab prn
• Miconazole 2% cream 2 dd ue

Education

• Don’t wear tight clothes

• Keep the dryness of affected skin
• Keep hiegenitas

Follow up

• Evaluate lesion and chief complain

• Evaluate hyphae after 4 week of treatment
 FOLLOW UP
March 21st 2018 April 2nd 2018

Itching occurs throughout the Itching on the back,

Complaints body, especially on the back, abdomen, arms, and legs
abdomen, arms, and legs began to decreased

Erythematous macule, Erythematous macule,

Physical policyclic, sharrply demarcated policyclic, sharrply
Examination , the edge rise with central demarcated, the edge rise
healing, skuama (+). (-), central healing(+),
skuama (+).
 FOLLOW UP
Picture

March 21st 2018

April 2nd 2018

 Definition

• Tinea corporis is a superficial fungal

infection of the hairless surface of the
skin except the palms, plantar, and
buttocks. Clinical manifestations are
increased itchiness during sweating.

The type of dermatophyte causing tinea corporis

• T. rubrum, T. mentagrophytes, M. audouinii, M.

canis
 History
Case Theory
• Patient live in the tropical • Tinea can occur in any climate
country even though usually in the
tropics.
• The patient felt the itch on her • Tinea corporis report pruritus
back, abdomen, arms, and and rash in hairless surface of
legs the skin except the palms,
plantar, and buttocks.
• Itching is getting worse when • Generally, tinea cause itching
sweating sensation and it is intensified
when sweating
 Dermatology Status
Case
• Erythematous macule,
policyclic, sharrply demarcated
or multiple papul or vesicle on
the edge with central healing,
skuama (+).
Theory
• The typical lesion is anular,
eritematous, sharply
demarcated or multiple papule
or vesicle on the edge of
polycyclic active lesion with
central healing.
 Differential Diagnosis

1. Eritrasma
In Dermatology status  No central healing

2. Candidiasis cutis
Dermatologi status  Satellite Lession with scalloped edges
Pottasium hydroxide  Pseudohifae and blastosporae.
 Differential Diagnosis

3. Pityriasis rosea
Complaints  Followed by prodromal symptoms
Lesion  Macula erythema with the longest diameter
according to the skin folds and cover by skuama
 Laboratory
Case Theory
• A 20% pottasium • 20% KOH of skin scraping may
hydroxide (KOH) be revealing numerous
examination of skin septate, long hyphae and
scraping found hyphae spore amongst epithelial cells
visualize under the
microscope.
 Treatment
Case Theory
• Ketoconazole 1 x 200 mg for 4 • Treatment options in tine such as
weeks Alilamin groups ( Terbinafin and
butenafin) and Azole group
• Miconazole 2% cream 2 dd ue
• Oral ketoconazole at 3-6 mg/kg/d
or 200mg/day may be given for 4
weeks.
• Topical azole groups (miconazole,
ketoconazole, clotrimazole) 2
times daily for 4-6 weeks
• Treatment is given 4-6 weeks until
clinical improvement and
Pottasium hydroxide test negatif
result
 Conclusion
• This patient was diagnosed “Tinea Corporis” because the
distinctive lesion on the predilection place apropriate with the
theory of tinea corporis.

• The results of KOH were founded a hyphae on mycroscope

• Tinea corporis can treated with oral ketoconazole 200 mg once

daily for 4 weeks, miconazole 2% cream twice a day, and
interhistin as antihistamin agent for itching complain.