[Medical Q&A] Are tinea corporis and eczema the same thing?

Planner: Chinese Medical Association

Reviewer: Professor Yang Ying, Military Medical Research Institute

Ringworm and eczema are not the same thing! The symptoms of the two are similar, but the causes and treatments are very different.

Tinea corporis: refers to dermatophyte infection on smooth skin other than the scalp, hair, palms, soles, and nail plates. The pathogenic fungi are mainly composed of anthropophilic and zoophilic dermatophytes. Zoophilic dermatophyte infection is often related to keeping pets, such as cats, dogs, rabbits, etc. The most obvious skin damage caused is inflammation, with blisters and pustules. The lesions are small, the number is large, and the itching is severe. Scratching can cause local eczema-like changes, which are easy to misdiagnose. The lesions caused by anthropophilic dermatophyte infection are often not very obvious in inflammation, appearing in large flakes and small in number. They are prone to occur in the elderly, children, and immunocompromised patients. The abuse of corticosteroid preparations can cause the skin lesions of tinea corporis to appear as erythema with unclear boundaries. At this time, it is often easy to misdiagnose as dermatitis or eczema, and mycological examinations are required for differentiation.

Eczema: It is a common allergic and inflammatory skin disease. It is characterized by diverse rashes, symmetrical distribution, severe itching, recurrent attacks, and easy to become chronic. It can occur at any age, any part, and any season, but often relapses or worsens in winter. Acute eczema generally develops rapidly, with polymorphic skin lesions, dense patches of erythema, papules, papulovesicles or blisters, easy to exude, unclear edges, and scattered small papules and papulovesicles around, often accompanied by erosion and scarring. If secondary infection occurs, pustules or pus crusts may appear. The degree of itching felt by patients varies depending on the severity of the disease, the location of the lesion, and the patient's tolerance. The disease is often aggravated by scratching, washing with soap, and scalding with hot water. If secondary infection occurs, it may be accompanied by local lymphadenopathy, fever, and general discomfort. If acute eczema is treated appropriately and promptly, the rash may gradually improve and subside, but it is easily stimulated by internal and external factors and relapses, manifesting as acute attacks or conversion to subacute and/or chronic eczema.

Tinea corporis and eczema have similar symptoms, but the treatment is very different.

Treatment of tinea corporis: In principle, topical antifungal preparations are used as the main treatment. For those infected with zoophilic dermatophytes, the inflammatory response is often severe and the treatment time is long. It is best to combine oral medication and avoid close contact with animals with tinea. It should be noted that pets with tinea can be carriers without symptoms, that is, pets with completely normal appearance may also carry pathogenic fungi, causing close contacts to suffer from tinea corporis, which is easy to be overlooked.

Treatment of eczema: First, we need to find out the patient's triggers and causes of the disease, understand the patient's medical history, work environment and living habits in detail, check for allergens, try to avoid adverse external stimuli and ensure skin cleanliness, conduct anti-allergic treatment, and in severe cases, immunomodulatory treatment should be performed.

Special reminder: Do not use corticosteroid ointments casually to treat tinea corporis. Tinea corporis is caused by fungi. Hormones not only cannot kill the fungi, but will make the fungi grow more happily, causing the tinea corporis to become more and more serious.