Dr. Tariq Jagnarine
Family Medicine, Endocrinology / Diabetes
Earthworm, or tinea, refers to several types of infectious fungal infections in the upper skin, scalp, and nails. It’s called earthworms because itchy measles have a ring-like appearance. However, earthworms are not about worms.
Earthworms can affect different parts of the body. It is caused by a fungus that eats ceratin, a protein found in skin, hair and nails. Children under 15 are particularly vulnerable to earthworms.
CASES
Earthworm is caused by a type of ceratin-eating fungus. These are called dermatophytes. Dermatophytes attack the skin, scalp, hair and nails because those are the only parts of the body that have enough keratin to attract them. Dermatophytes are microscopic spores that can survive on the surface of the skin for months. They can also survive in towels, combs, soil and other household objects. They are very durable.
If a person or animal has the infection, they can deposit fungal spores on objects and surfaces when they touch them. Anyone who touches those objects can become infected. Children usually show symptoms when they become infected, but many adults do not. The older an individual is, the more likely their immune system is to protect him. However, they can still be a carrier.
RISK FACTORS
The following risk factors either increase the chance of developing a worm or worsen the symptoms:
* Age 15 and under
* Have a weakened immune system
* Use medications that lower the immune system
* Living in a warm, humid climate
* Being in close contact with infected people or animals
* Share clothes or towels with someone who has the infection
* Having hyperhidrosis, a condition where the person is sweating more than usual
* Play contact sports, for example, wrestling
* Wearing tight clothing
SYMPTOMS
Different worms affect different parts of the body.
Worms (tinea capitis): This is most common in younger children, and sometimes affects adults. It is more common in urban environments where people live closer together, giving the fungus more opportunities to spread. This is characterized by small patches of scaly skin that appear on the scalp. The pieces can feel tender or painful and inflamed. Hair cuts off or near the patch criterion, or large irritated sores, form on the scalp, and may freeze pus. The person may have a temperature and swollen glands or lymph nodes, but this is rare.
* Body worms (skin) (tinea corporis): This can affect babies, children and adults. This is seen with a rash with a ring-like appearance, the skin may be red and inflamed around the outside of the ring, but looking right in the middle, joining rings that feel a little higher, especially under the rash.
* Groin infections (tinea cruris): Also known as jock itch, this is more common in young men. People may feel itching, especially in and around the groin, redness and burning sensation in the affected area, from flaking and hard skin on the inner thighs. These symptoms get worse when walking, running, or exercising, and tight clothing makes the symptoms worse.
* Tinea pedis: An athlete’s foot is a common foot infection.
* Tinea unguium: Also known as onychomycosis, it is an infection in the nail bed.
* Worms in the bearded area: This affects males that can grow facial hair, and is often the result of contact with a worm animal. This can include: redness, swelling, and full-blown lumps, with hair loss, which usually resolve after raw swollen glands, exposed skin and soft, high spongy patches that exacerbate fatigue
DIAGNOSIS
Healthcare workers can usually diagnose a worm or apple infection after examining the affected area and asking the patient about their medical history and symptoms. They may take a small scratch of the skin, which won’t hurt, and examine it under a microscope to look for fungal features.
The skin problem is caused by some other disorder, such as psoriasis. Further tests are not usually needed, unless the symptoms are particularly severe. If the symptoms have not improved after treatment, a small piece of infected skin may need to be removed and sent to the laboratory for analysis.
TREATMENT
Treatment depends on the type of worms:
* RINGWORM SCALP
The most common treatments for scalp worms are oral antifungal (tablets). However, the choice of medicine will depend on the type of fungi involved.
* Terbinafine (Lamisil): The side effects are usually mild and do not last long. They can include diarrhea and nausea. People with a history of liver disease should not take terbinafine.
* Griseofulvin (Grisovin): The side effects, which usually disappear fairly quickly, can include headache, indigestion and nausea.
* Anti-fungal shampoos: These help prevent the spread of earthworms, and can speed up recovery, but do not cure it.
* Shaving a child’s head: There is no evidence that this reduces worm infection or speeds up recovery time.
SKIN RINGWORM AND LAND DEFINITION
Most cases are treated with anti-fungal creams. If the symptoms are severe, or cover a large part of the body and do not respond to OTC medications, doctors may prescribe topical strength prescription or oral medication. Oral medications can have some side effects, including stomach upset, rash, or abnormal liver function.
CARING FOR THE SKIN DURING EFFECT
It is important to wash the area lightly. Taking good care of the skin can help improve recovery.
* Gently wash the skin
* Dry skin thoroughly, but gently.
* Pat the skin with a towel in tender areas, but do not rub.
* Make sure any folds and areas between the toes are thoroughly dried.
* Change socks or underwear more often than usual if they cover an infected area.
* Always treat the feet and toes at the same time, as infection often spreads from one area to another.
* Where possible, wear loose clothing and underwear, such as boxers.
COMPLETED
Fungal infections rarely spread below the surface of the skin. The risk of any serious illness is minimal. However, without treatment, earthworms can spread from one part of the body to another. If the skin is broken, bacteria can enter and cause infection.
People with HIV and other immune system conditions are more likely to experience the spread of worms. It is harder to get rid of the infection if the immune system is weak.
PREVENTION
The following tips may help prevent earthworms if it occurs in a household:
* If the source of infection is a pet, it should be treated by a vet.
* Everyone should wash their hands regularly and thoroughly with soap.
* All household members should check themselves for signs of worms.
* People should not share combs, hair brushes, clothes, bedding, towels or shoes.
* Anyone with worms should not scrape affected areas as this increases the risk of spreading the infection.
* People should avoid walking around the house with bare feet.
* Laundry should be washed in hot water with fungicidal soap.
* Keeping cool and wearing loose clothing can help reduce the risk.
Earthworms are a treatable skin disease, and early intervention by healthcare workers is needed to avoid scarring in the long term.
