1.What is the difference between ringworm and dermatologists’ diagnosis of ringworm? A: Ringworm is the name of a disease that is often mentioned in people’s daily lives, but is the ringworm that people talk about the same as the ringworm that doctors diagnose? The answer is no. Clinically, ringworm is a fungal infection that affects the skin, hair, and nails of humans and animals. Currently, superficial fungal diseases are still named according to the site of onset (such as ringworm of the head, ringworm of the body, ringworm of the femur, ringworm of the hands, ringworm of the feet, ringworm of the nail, etc.), and a few are named according to the morphology of the lesions, such as ringworm of the flowers and ringworm of the superficial tiles. Although ringworm and tinea cruris are called ringworm, they are actually caused by the microscopic rod-shaped bacillus and are not true ringworm. In addition to this, there is also psoriasis, which is well known to the general public, so is psoriasis ringworm? The clinical psoriasis refers to the common psoriasis and neurodermatitis, because it more often grows in the neck like the skin of a cow, hard and hard, scratching like rotten wood, repeated attacks, itching, so called psoriasis, but also not the real ringworm. The previous year in the clinic had encountered a 13-year-old patient with common psoriasis, the local doctor told him he had psoriasis, his father gave himself to ashwagandha oral for half a year, eventually causing abnormal liver function. So when you encounter similar problems in your daily life, you should go to a hospital to see a specialist, not to be your own doctor or purchase your own medication at a pharmacy for treatment. 2. What is the classification of ringworm? There are three categories of fungal skin diseases; superficial fungal disease, subcutaneous fungal disease, and deep fungal disease] At present, superficial ringworm is still named according to the site of onset, including ringworm of the head, ringworm of the body, ringworm of the femur, ringworm of the hands, ringworm of the feet, and ringworm of the nail, etc. A few are named according to the form of the lesion, such as ringworm of the flowers and ringworm of the tiles. Ringworm is mainly caused by the genus Trichophyton, Microsporum, and S. epidermidis that invade the skin, hair, and nail plate of humans and animals. 3.Who is prone to ringworm? Fungi like warm and humid, the optimum growth temperature is 22℃～36℃, relative humidity is 95%～100%, and the optimum pH is 5.0～6.5. Fungi are all over the nature, among 50,000～250,000 kinds of fungi recorded, less than 200 kinds are related to human diseases. Divided into pathogenic fungi [it is pathogenic itself] and conditionally pathogenic fungi [Candida, these fungi can exist normally in the body surface and body cavity without causing disease], except for a few cases, human fungal infection sources are from the external environment, through inhalation, ingestion or trauma implanted and acquired. A small number of fungi can cause disease in normal people most of them only under special conditions, mostly invade the weakened host. With the development of modern medicine, the use of broad-spectrum antibiotics, glucocorticoids, immunosuppressants, antitumor drugs, etc. has increased, organ transplantation, burn resuscitation, various catheter and intubation techniques, the application of intravenous hypernutrition, etc., although prolonging the life of the patient, but long-term illness makes the body resistance to decline, the infection of conditionally pathogenic fungi increased significantly. The PH value of the skin and appendages of diabetic patients is suitable for fungal growth and reproduction, and those with hyperhidrosis of the hands and feet, the skin and nail plate have been soaked soft, so that their ability to resist fungal invasion is reduced or even disappeared. The moist environment is also suitable for fungal growth, reproduction and pathogenesis, which greatly increases the chance of infection. The clinical manifestations of common dermatophytoses and their treatment are introduced: 4. Tinea capitis (commonly known as “scalp head”): broken hair, white scales, papules, pustules, ooze, scabs, and scarring on the scalp. It should be clinically distinguished from seborrheic dermatitis, psoriasis, and scalp impetigo and abscesses Tinea corporis and Tinea Femoris: papules, blisters, or papules that develop from the center outward, with reduced inflammation in the center and a ring of scattered papules, blisters, papules, scabs, and scales connecting the edges, with multiple concentric circles of damage reappearing in the center and significant itching. It should be clinically differentiated from pityriasis rosea, psoriasis and contact dermatitis, eczema, and scabies. Tinea pedis (commonly known as pediculosis): divided into blister type, hyperkeratotic type, and impregnated erosion type, which may manifest as erythema, papules, blisters, papules, scales, diffuse keratin thickening, roughness, impregnated whitening, fissures, and bleeding. It should be clinically differentiated from sweat blister type eczema, palmoplantar pustulosis, and chronic eczema. Tinea nail (commonly known as gray nail): It may begin as a small cloudy area on the surface of the finger M toe nail, dotted, irregular type, nail depression, nail transverse groove, brittle or thickened nail, white or yellowish brown, uneven surface of the nail plate, rough and lusterless. It should be clinically differentiated from psoriasis, lichen planus, eczema, or nail disease due to baldness. Lichen planus: hyperpigmented and/or hypopigmented plaques covered with a few fine bran-like scales, which may be dotted, coin-shaped, or fused into patches, usually on the trunk and other sebaceous gland-rich areas such as the chest, back, neck, upper arms, armpits, and abdomen. The onset of the disease is slow and insidious, sometimes the lesions can be a variety of colors such as gray, yellowish, light red, brown or skin color, such as raindrop distribution. It should be clinically differentiated from pityriasis simplex, vitiligo, and pityriasis rosea. The diagnosis of dermatophytosis must also be made with the help of fungal microscopy of dander or nail shavings and fungal culture. Treatment of dermatophytosis? With the improvement of people’s standard of living and the great improvement of sanitary conditions, ringworm disease has been greatly reduced. However, with the irregular selection of antibiotics by the population, the increase in human weight, the increase in the number of diabetic patients, and the keeping of pets at home, many patients come to the clinic] [Only the systematic treatment of ringworm of the head, ringworm of the nail and intractable ringworm of the body, ringworm of the femur, and ringworm of the hands and feet,] 5. ringworm of the head: ringworm of the head was once widespread in China after the founding of the country, and after decades of prevention and treatment according to the five-word policy of shaving, serving, applying, washing, and eliminating, the disease has basically been The disease has been largely controlled, and there are few new cases at present. The oral medicine is ashwamycin or itraconazole. Ashwagandha: children 15-20mg/(kg?d), divided into 3 oral doses, adults 0.6-0.8g/d, 1 time or divided into 2 times, the course of 21 days. Itraconazole: children at 5mg/(kg?d) for 6 weeks. Ashwagandha and Itraconazole are fat-soluble, so eating more fatty food can promote drug absorption. Terbinafine: 62.5mg/d for children weighing <20kg, 125mg/d for 20kg-40kg, 250mg/d for >40kg, for 6 weeks. The above three drugs should be used with caution in patients with poor liver function. Disinfection Patients’ used towels, hats, pillowcases, combs and other household utensils and haircutting tools should be disinfected by boiling. The fungal microscopy of the disease should be performed 3-4 weeks after taking the medication, and then rechecked every 2 weeks, and only after 3 consecutive negative microscopies. 6. Tinea corporis, tinea cruris, ringworm: external antifungal medication is the main treatment, [external application time is 4-8 weeks, the fungus is in the stratum corneum] when the whole body is generalized, internal itraconazole and terbinafine can be taken at the same time as external medication. Ringworm, nail fungus, etc. that you have at the same time should be actively treated and close contact with other patients, including animals with ringworm, should be avoided. Close clothing should be disinfected. Obese people should keep their skin dry. Avoid abuse of corticosteroids, immunosuppressants, etc. 7. Tinea capitis: external antifungal medication is the main treatment, and for those who do not have good results with simple external medication, oral antifungal medication such as itraconazole, terbinafine or fluconazole can be taken. If the eczema-like changes are secondary to infection, the secondary infection should be treated first. There are many factors that affect the efficacy of tinea capitis. The wide distribution of the causative ringworm and the variety of transmission routes determine the long-term nature of the use of antifungal drugs. In addition to treatment, preventive measures should be taken to avoid cross-infection by paying attention to personal hygiene, changing socks regularly, and not sharing bathing utensils with other people, as well as treating ringworm in other members of the family at the same time. 8. Nail fungus: Internal antifungal medication is the mainstay, itraconazole with intermittent shock therapy. 0.2g, 2 times/day for 7 days, stop for 21 days, and then the 2nd shock. A total of 2 shocks were given for nail lesions and 3 shocks for toenail lesions. Because itraconazole is highly fat soluble, optimal absorption can be achieved by taking the drug immediately after meals. Terbinafine 0.25g per night for 6 weeks to 3 months for nail lesions and longer than 3 months for toenail lesions. Fluconazole O.15g once a week for 9 months; also 0.1z every other day for 3 months. The above mentioned internal drugs should be used with caution for abnormal liver function. [The exposed part of the nail plate, the skin around the nail plate is called the nail contour, the deep into the proximal part is called the nail root, under the nail root is called the nail matrix, and the crescent-shaped light-colored area near the nail root is called the nail half-moon] [The nail grows 0.1 mm per day. Nails 12-14 mm, 120 days. Toenail is one second of the growth rate of finger nail] 9. Prevention of dermatophytosis? Towels, hats, pillowcases, combs and other household utensils used by patients with ringworm and haircutting tools should be boiled and disinfected to eliminate the source of infection Actively treat patients and make sure to disinfect and isolate them. Pets with ringworm should also be treated actively. To cut off the transmission route, health promotion and management should be strengthened for nurseries, kindergartens, small schools, barber stores, etc. Patients with ringworm should be actively treated for ringworm and nail fungus that they also have, and avoid close contact with other patients, including animals with ringworm. Close clothing should be disinfected. Obese people should keep their skin dry and cool, dress loosely, pay attention to personal hygiene, change shoes and socks regularly, and air-dry changed shoes in a ventilated place. Patients with ringworm should also pay attention to avoid stimulation by adverse physical and chemical factors. Do not share bathing equipment with others to avoid cross-infection, and treat ringworm in other members of the family at the same time. It is also important to avoid the abuse of corticosteroids, immunosuppressants, antibiotics, etc. Patients with diabetes should actively treat the primary disease and control blood sugar. 10.Is my finger and toe nails uneven, rough, and grayish-yellow that means gray nails? No, nail fungus should be differentiated from nail dystrophy, psoriasis, lichen planus, chronic eczema caused by nail disease and nail warts, nail tumors, etc. Their clinical manifestations are similar, and nail fungal microscopy and fungal culture must be performed to confirm the diagnosis. 11. Is tinea pedis when the hands and feet are blistered and flaky? No. Tinea capitis can be divided into blistering, hyperkeratotic, and macerated erosions. Blistering tinea capitis is similar to eczema with sweat blisters, which are deep blisters with no redness around them. The doctor will confirm the diagnosis through consultation, history, medication, observation of the lesions, and fungal examination. 12. Can ringworm be cured? Ringworm can be cured, but it can be relieved in autumn and winter without treatment. However, it can be mild and heavy at times. After cure, the patient can be re-infected.