Tinea barbae

Last Updated: 2020-11-23

Author(s): Anzengruber F., Navarini A.

ICD11: -

Barber’s itch, ringworm of the beard, tinea sycrosis

  • Causative organism
    • Mostly T. verrucosum, T. mentagrophytes var. interdigital and T. rubrum.

  • Transmission is usually from infected animals (cattle, rodents). This can be an occupational disease, e.g. in the case of farmers.

  • In the case of infection, immunosuppression should be considered.

  • In some cases there is also a tinea manuum which can be regarded as causative.

  • Erythematous, scaly, follicular bound, partly abscessed plaques, nodes and pustules.

  • Painless epilation is possible

  • Locoregional lymph node adenopathy.

  • In some cases red. AZ with febrile temperatures.

  • In most cases, it does not make sense to carry out a smear test. 
  • We recommend epilation of an affected tuft of hair with subsequent mycological examination (native and culture).

Scarred healing and spontaneous remission possible.

  • If zoophilic dermatophytes are detected, all animals with which contact has existed should be examined (especially cattle and rodents). 

  • Examination of other persons in the household.

  • Rassur of the beard.

  • The therapy should be carried out with both topical and systemic antifungals!

 

Topical Therapy

  • Clotrimazole Cream (Canesten® Cream)

  • Terbinafin cream (Terbinafin® cream 1%)
  • Ketoconazole cream (Nizoral® cream 2%)
  • Amorolfine cream (Loceryl® 0.25% cream)
  • Griseofulvin cream: not available in Switzerland
  • Bifonazole cream: not available in Switzerland
  • Econazole cream (Pevaryl® cream 1%)

  • Ciclopirox Cream (Ciclocutan® Cream or similar)

  • If necessary, the use of steroid-containing preparations in cases of severe inflammation should be discussed.

  • Ketoconazole-containing shampoo (Ketozol® shampoo, Keto-med® shampoo, Lur® shampoo, Nizoral® shampoo): leave on for 5-10 minutes. Repeat on the following 2 days.

  • Shampoo containing Ciclopirox (Sebiprox®-Shampoo): leave on for 5-10 minutes. Repeat on the following 2 days.

  • Pregnancy: Only #Nystatin is allowed.

 

Systemic Therapy

  • Terbinafin (Lamisil®, Myconormin®) p.o. 250 mg 1x per day for 4-6 weeks.
  • Alternative: itraconazole (e.g. Sporanox®) p.o. 200 mg 1x per day for 7 days
  • Alternative: Fluconazole (e.g.: Diflucan®) p.o. 50 mg 1x per day for 14 days
  • Alternative: Griseofulvin p.o. 500 mg 2x per day (not available in Switzerland)

  1. Foti C, Diaferio A, Daddabbo M, Angelini G. Tinea barbae associated with erythema nodosum in an immunocompetent man. Journal of the European Academy of Dermatology and Venereology 2001;15:250-1.
  2. Holló P, Simon G. TINEA BARBAE DUE TO TRICHOPHYTON VERRUCOSUM. Mycoses 2002;45:25-. 
  3. Trotha R, Graser Y, Platt J, et al. Tinea barbae caused by a zoophilic strain of Trichophyton interdigitale. Fallbericht. Tinea barbae, hervorgerufen durch einen zoophilen Stamm von Trichophyton interdigitale. Mycoses 2003;46:60-3. 
  4. Zupan-Kajcovski B, Boersma BR. [Diagnostic image (268). A man with 'pyodermia' in the beard area]. Ned Tijdschr Geneeskd 2006;150:729.
  5. Jackson, J. (2016). Infectious folliculitis. Uptodate.com. Retrieved 30 May 2016, from http://www.uptodate.com/contents/infectious-folliculitis?source=see_link&sectionName=FUNGAL+FOLLICULITIS&anchor=H604478886#H604478886