What’s that Weird-Looking Rash?

We know it by a misnomer: ringworm.

It’s itchy and scaly, almost otherworldly in appearance, because this skin rash is notable for its expanding or overlapping rings. Despite the name, it has nothing to do with a worm. It’s actually caused by a fungus that takes up residence on the dead tissues of your skin, hair, nails, and even your scalp.

The scientific name for ringworm of the body is tinea corporis, but it’s also been nicknamed tinea gladiatorum because wrestlers, who battle each other in hand-to-hand combat — or at least skin-to-skin contact — often pick up the highly contagious disease from teammates and opponents.

“Ringworm is one of the most common skin conditions we see,” says Scott Elman, M.D., a dermatologist with the University of Miami Health System and the director of Outpatient Dermatology Services at Jackson Memorial Hospital. “It happens a lot more frequently than people realize.”

That’s because the 40-plus fungi that cause the unpleasant rash — Trichophyton, Microsporum, and Epidermophyton being the most common — love South Florida’s hot and humid weather. In fact, “it’s not just ringworm that thrives in our climate but also other fungal infections like dandruff,” Dr. Elman adds. “Sweating offers an ideal breeding ground.”

Tinea coporis is related to athlete’s foot, also known as tinea pedis, and jock itch, tinea cruris. On the scalp, dermatologists refer to it as tinea capitis.

Though common, ringworm in the body is often confused with other skin conditions.

We see quite a few misdiagnoses because it tends to mimic eczema and psoriasis.

Dr. Scott Elman

There are, however, some notable differences.

• Ringworm is highly contagious. Neither eczema nor psoriasis are.
• The ringworm rash is distinguishable by its circular shape, but remains clear in the center.
• Sometimes there are small bumps that differ in color, from red on white skin to brown or gray, even purple on dark skin. They can be treated with anti-fungal medicine.

Eczema, on the other hand, is a chronic inflammatory skin condition that shows up as red and inflamed skin patches. Though there is no cure, patients can manage it with moisturizers and topical steroids.

Psoriasis is another inflammatory disease that also shows up with scaly, thick plaques that appear silvery. Unlike ringworm, it’s a chronic condition.

Know the differences between the rashes. A misdiagnosis usually leads to improper treatment and prolongs the discomfort. Dr. Elman says that many patients with ringworm show up at his clinic because the rash they treated as eczema or psoriasis — often with over-the-counter medication — has grown worse, not better.

In a medical office, the dermatologist can gently scrape the rash’s surface and examine for the presence of fungus under a microscope. The physician will then offer a prescription anti-fungal cream.  In severe cases, a patient may have to take oral anti-fungal medication. Ringworm is not life-threatening, but left untreated it can spread to other parts of the body.

“It doesn’t go deeper and it’s not fatal, but it can be unsightly,” Dr. Elman adds.

Ringworm can affect people of all ages and gender. But it tends to be more common in children and in adults with a compromised immune system. It’s also hard to prevent, particularly if a person frequents places like swimming pools and locker rooms and shares equipment.

That said, Dr. Elman offers several ways to minimize the chances of contracting it:

Know how ringworm spreads in order to prevent it. 

Ringworm is most commonly spread by direct skin-to-skin contact with an infected person, but it can also be caught from an animal or by touching items used by someone with the fungal infection.

Avoid tight clothing.

Add thick clothing to that — particularly in hot, humid weather. Change out of sweaty items as soon as you can.

Shower right after practice or a match.

If you play sports, keep your uniform and gear clean and dry.

Don’t share — or ask to share — towels, bedding, clothes, combs or brushes with teammates.

Practice good hygiene.

Wash your hands. Make sure common areas in schools and locker room are kept tidy and clean.

Check your pet regularly for signs of a fungal infection.

A veterinarian should be on the lookout for ringworm, too. But you can also examine your dog or cat for a patch (or patches) of missing fur, a telltale sign of a fungal infection.

Ana Veciana-Suarez is a regular contributor to the University of Miami Health System. She is an acclaimed author and journalist who has worked at The Miami Herald, The Miami News, and The Palm Beach Post. Visit her website at anavecianasuarez.com or follow her on Twitter: @AnaVeciana.

Tags: Dr. Scott Elman, itchy skin, presence of fungi, skin care in Miami, skin infection