Tinea: A concise synopsis

A man aged 25 years presented to the emergency department with a 2-week history of a painful and intensely pruritic rash on his buttocks that had spread to the axillae, inguinal folds and right shin (Figure 1).He also noted changes to his left thumbnail (Figure 2).He was otherwise well and worked as army personnel. QUESTION 1What further history and examination would be of importance? QUESTION 2What are the provisional diagnosis and differentials in this case? QUESTION 3What investigations are needed for the provisional diagnosis? QUESTION 4What management can be commenced while awaiting results? QUESTION 5How can this condition be prevented? ANSWER 1Important diagnostic considerations are highlighted in Table 1.A full skin, hair and nail examination as well as dermoscopy help evaluate the extent of disease. ANSWER 2The provisional diagnosis is tinea corporis, cruris and unguium, with other potential differentials shown in Table 2.