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A Systematic Review of Diagnosis and Treatment Options for Tinea Imbricata

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A Systematic Review of Diagnosis and Treatment Options for Tinea Imbricata Int. J. Life Sci. Pharma Res. 2019 Oct; 9(4): (L) 28-33 ISSN 2250-0480 Review Article Dermatology International Journal of Life science and Pharma Research A SYSTEMATIC REVIEW OF DIAGNOSIS AND TREATMENT OPTIONS FOR TINEA IMBRICATA RANA ABDULAZEEM AL-BASSAM1, BASMAH SALEM AL AFARI 1 AND MANAL HASSAN MOHAMED SALEM2* 1Intern doctor, Dar Al Uloom University Riyadh, Saudi Arabia., 2Mater degree of dermatology,venereology and andrology , Doctor Abdulazeem Albassam Medical Group, Department of Dermatology, Riyadh, Saudi Arabia ABSTRACT Tinea imbricata is a cutaneous fungal disease and sometimes called (Tokelau). The causative agent is a dermatophyte known as Trichophyton concentricum. It is an endemic in developing countries particularly in South Pacific, India, Central and South America, as well as Mexico. It is generally observed in people with poor living conditions and poor personal hygiene. Predisposing factors are hot weather, humidity, and host immunity in addition to genetic factors. The patients usually presented with concentric or lamellar skin lesions. The aim of this review is to highlight important information about microbial, clinical and therapeutic aspects of tinea imbricta. In this review, we search the literature to identify articles talking different aspects of tinea imbricta. The electronic search was performed in four databases to identify eligible articles in the literature. Electronic databases were searched including MEDLINE and EMBASE using PubMed search engine. In addition, Cochrane library and ovid was searched. The titles and abstracts of the resulted articles were screened to identify eligible studies. Based on the primary screening results the irrelevant studies, duplicated and reviews were excluded. Tinea imbricta is found to be endemic in 3 main geographical regions, Southwest Pacific, Southeast Asia, and Central and South America. There is an autosomal recessive genetic factor which increases the vulnerability to tinea imbricta infection. The levels of both general and specific IgE class antibodies were higher than normal values. Usual clinical findings of tinea imbricta are multiple annular, concentric, squamous sores and may be associated with erythema. The infection usually starts in young people on the facial region and disseminate to the trunk, arms or legs.The eradication of the disease has not been possible yet, thus preventative procedures should be adopted as a strategy of disease control. KEYWORDS: Tinea, Ringworm, Dermatophytosis, Epidermophytosis MANAL HASSAN MOHAMED SALEM Mater degree of Dermatology,venereology and andrology , Doctor Abdulazeem Albassam Medical Group, Department of Dermatology, Riyadh, Saudi Arabia Received on: 26-08-2019 Revised and Accepted on: 09-10-2019 DOI: http://dx.doi.org/10.22376/ijpbs/lpr.2019.9.4.L28-33 This article can be downloaded from www.ijlpr.com L-28 Int. J. Life Sci. Pharma Res. 2019 Oct; 9(4): (L) 28-33 ISSN 2250-0480 INTRODUCTION review (including case reports and case series). The full-text of eligible studies was retrieved to allow for extraction of data related to TI. No language or Tinea imbricata (TI) is a slowly-developed date limits have been used and only human studies superficial mycosis caused by the dermatophyte were included. The results of the search were Trichophyton concentricum, which is commonly written in a logical flow of information with found in developing countries1. Lesions are highlights on disease definition, etiology, characterized by small, brownish, pruritic macules geographical distribution, clinical distribution, and and papules which later on develop into concentric treatment. rings of macular patches2. The infection typically starts in childhood, and breakthroughs slowly with an increase in age 3. The majority of patients with RESULTS AND DISCUSSION TI have lesions involving more than 50% of the skin surface area 4. The sores are fairly pruritic, and Tinea imbricata was first defined in 1686 by the also the pruritus is worsened by warm weather 5. English explorer William Dampier throughout his Skin lesions are characterized by areas of journeys in the Philippines 3,8,13. In 1878, Manson lichenification which is created after chronic reported the first clinical description of the TI excoriation. Like other fungal superficial infections, disease 3,8. In 1940, the disease was detected in patients do not have associated systemic Guatemala 3,8 and in 1945 cases was reported in symptoms6. The risk factors linked to TI are mainly Mexico 3,8 . Tinea imbricata is known by a variety found in people with similar origins with endemic of names, amongst which is Tokelau the most population since travellers do not show the common synonyms used in the South Pacific region symptoms of diseases even after long and close stay 3,8. Other common names of TI include bakwa, with patients. Additionally, low socioeconomic gogo, cacapash, elegant tinea, chimbere ́, Indian class, poverty, low level of education and poor tinea, Chinesetinea, circinate tinea, concentric tinea, wellness are predisposing factors 7-9. Women are a Gilbertese disease, grille ́, human ring worm, lace lot more commonly affected by TI in the grown-up tinea, half-cracked tinea, and also shishiyotl 3,8.TI is population 10, while this sex difference is turned brought on by the anthropophilic dermatophyte T. around in children 11. Direct transmission is not concentricum (Blanchard 1895). It is instead just commonly reported with the TI infection. A T-cell like T. mentagrophytes 3,8, T. concentricum defect triggered by an autosomal recessive top provides with quick, septate hyphae, many quality has actually been suggested, yet not chlamydospores, as well as no arthroconidia 3,8,13. 8. confirmed12. The available evidence regarding the The culture is made in media such as Sabouraud epidemiological aspects of TI is not sufficient. dextrose or Sabouraud with certain antibiotics such Thus, the aim of this review is to highlight as cycloheximide and chloramphenicol, and important information about microbial, clinical and sometimes in sugar agar. The nests of TI developed therapeutic aspects of tinea imbricta. in 1-3 weeks at room temperature (25°). They are creamy colored, waxy, crateriform or cerebriform METHODS with the brown facility and also white fine-grained edge. The bottom is amber in shade 3,8,15. Sabouraud peptone agar with certain antibiotics The electronic search was performed in four was used to suppress bacterial growth in the culture databases to identify eligible articles in the where some strains needed for enhancement of literature. Electronic databases were searched thiamine 3,8,13. One would be thermo sensitive, with including MEDLINE and EMBASE using PubMed growth at 20-25 ° C, and also one would be thermo- search engine. In addition, Cochrane library and forgiving, with growth at 28-30 ° C 3,8,13. A study ovid was searched.. We used 13 different search validated PCR boosting and also sequencing of the terms for each engine such as “Trichophyton inner transcribed spacer-rDNA areas14. TI is concentricum ”, “Tinea ”, “imbricata ”, “chronic ”, endemic in 3 main geographical regions, Southwest “mycosis,” , “superficial ” , “T. Concentricum”. Pacific, Southeast Asia, and Central and South The studies were screened for presence of America. Endemic areas in Southwest Pacific eligibility criteria such as addressing TI region are Fiji 3,8,13, Samoa 3,8,13 ,13,Solomon Islands epidemiology, laboratory or clinical features, 8,14,15 , Tahiti, Tokelau , Papua New Guinea16, etiology, host immune response, or management. In Indonesia17,18, and New Zealand 3,8,13,19. Endemic purpose to make the review more comprehensive, areas in Southeast Asia are India 3,8,13, China, any available study design was included in this This article can be downloaded from www.ijlpr.com L-29 Int. J. Life Sci. Pharma Res. 2019 Oct; 9(4): (L) 28-33 ISSN 2250-0480 Thailand20,Malaysia8,, and Philippines32.Endemic usually simple. Differential diagnosis consists of areas in Central and South America3,8,13,21,22 are different tineas induced by Epidermophyton Guatemala, El Salvador, Panama, Colombia and floccosum, T. mentagrophytes26,27, T. tonsurans28, 29 Brazil 3,8,13 TI occurs in warm tropical and and Microsporum audouinii , pityriasis versicolor" . 30 13 subtropical climates along a slightly cold weather at imbricata", second syphilis , yaws , erythema annulare centrifugum 30, sarcoidosis31, and an elevation of 1.000-2.500 m over the water level. 3 However, both climates share a really high erythema gyratum repens . The clinical humidity rate (80 %) 3,8,13 .TI impacts topics presentation of TI is relentless and spontaneous 3,8,14 renovation is incredibly uncommon3 .In the 1950s, residing in bad locations . Malnutrition, iron 3,8,13 shortage, poor health, and poor housing are TI was managed by griseofulvin . A study important risk factors . TI would be somewhat compared the efficiency of griseofulvin (1 g/day for extra common in adult girls as well as male 4 weeks), fluconazole (200 mg/week for 4 weeks), children 15,22. Some writers rejected sex and age itraconazole (400 mg/day for 1 week), and distinctions3,8. Based on some studies23, 24, there is terbinafine (250 mg/day for 4 weeks). Substantial an autosomal recessive genetic factor which remission was completed in the terbinafine and increases the vulnerability to TI infection. On the griseofulvin treated patients, continued as long as 8 other hand, a study found a dominant autosomal weeks after completion of the treatment. The inheritance pattern;
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