Tinea barbae

Last Updated: 2020-11-23

Author(s): Anzengruber, Navarini

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)
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  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.
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