Ringworm

Question 1

Symptoms?

Answer 1

• Scaly, red or pink ring-shaped flat patch, the centre may be dry clear coloured skin.
• Slightly raised overlapping rings (1-5cm)
• Pruritus (itchiness)
• Asymmetrical distribution

Question 2

Questions?

Answer 2

Tell me about the nature, site and duration of any symptoms: itching, flaky skin?

• Have you tried any previous treatments, including any over-the-counter medications?
• Do you know anybody that you came in close contact with is experiencing similar problems?
• Do you have any co-mobilities that you know of? For example, underlying cause of immunosuppression?

Question 3

Red flags?

Answer 3

If the patient is diabetic refer to doctor

If the ringworm is present on patient scalp, then refer to doctor as they will need prescription for antifungal tablets and shampoo

In a asymptomatic patient with tinea infection of the nails.

Unresponsive to appropriate treatment

Signs of bacterial infection

Severe, affecting other parts of the body.

If patient is a child should be referred to the GP surgery.

Question 4

Treatment?

Answer 4

Clotrimazole:

• Clotrimazole cream
• Canestan cream and liquid (1%)
• Apply 2-3 times a day for both adult and child

OR

Miconazole

• Daktarin cream (2%) and powder (2%)
• Apply twice daily continuing for 10 days after lesions have healed for both adult and child

OR

Benzoic Acid with Salicylic Acid Ointment

• Apply twice daily
• Not for under 18