Tinea Barbae
Tinea barbae is an uncommon dermatophytosis of the beard and moustache areas with invasion of coarse hairs; thus, it is a condition almost exclusively found in adult males [1]. Historically, tinea barbae was frequently transmitted by barbers using contami
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Tinea Barbae Lauren Kole and Boni Elewski
10.1
Introduction
Tinea barbae is an uncommon dermatophytosis of the beard and moustache areas with invasion of coarse hairs; thus, it is a condition almost exclusively found in adult males [1]. Historically, tinea barbae was frequently transmitted by barbers using contaminated razors before single-use razors became readily available. Currently, in most cases, the causative organisms are zoophilic ectothrix, namely, Trichophyton mentagrophytes and Trichophyton verrucosum, acquired from animals. The clinical presentation is variable and may be severe with intense inflammation or superficial and less inflammatory, similar to tinea corporis [2]. Diagnosis typically relies on clinical presentation with confirmatory mycological culture [3]. The treatment of tinea barbae requires oral antifungal therapy [2].
10.2
Background
Tinea barbae is most frequently seen in tropical countries with high temperatures and high humidity. The incidence has decreased in recent years due to the increased availability of disposal razors, as the infection was regularly transmitted by barbers using unsanitary razors. Today, tinea barbae is more often found among rural inhabitants exposed to zoophilic dermatophytes from sources such as cattle, horses, cats, and dogs (Table 10.1). The species commonly isolated include T. mentagrophytes and T. verrucosum. Microsporum canis and T. mentagrophytes var. erinacei are less common. In certain geographic regions, other anthropophilic dermatophytes,
L. Kole, M.D. (*) • B. Elewski, M.D. Department of Dermatology, University of Alabama, Birmingham, 414 CEFH, 1720 2nd Avenue South, Birmingham, AL 35294, USA e-mail: [email protected]; [email protected] J.A. Zeichner (ed.), Acneiform Eruptions in Dermatology: A Differential Diagnosis, DOI 10.1007/978-1-4614-8344-1_10, © Springer Science+Business Media New York 2014
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L. Kole and B. Elewski
68 Table 10.1 Zoophilic etiologies of tinea barbae and their animal sources
Zoophilic dermatophytes Trichophyton mentagrophytes Trichophyton verrucosum Microsporum canis Trichophyton mentagrophytes var. erinacei
Animal sources Rodents Cattle and horses Dogs and cats Hedgehogs
Trichophyton schoenleinii, Trichophyton violaceum, and Trichophyton megninii, are endemic and can cause tinea barbae [2]. Recently, there have been several case reports of Trichophyton rubrum infections caused by autoinoculation from onychomycosis and tinea pedis [4, 5].
10.3
Clinical Presentation
Tinea barbae, as the name suggests, is a dermatophyte infection of the bearded areas of the face and neck of adult males [1]. The clinical presentation maybe either one of two types: inflammatory or noninflammatory, depending on the infecting fungus and the patient’s immune response. The zoophilic dermatophyte infections typically cause severe, deep inflammation, characterized commonly by inflammatory nodules and multiple follicular pustules [4]. Abscesses, sinus tracts, kerion-like plaques, and bacterial superinfections may also occur. Furthe
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