From the Guidelines
Ringworm typically does not cause eosinophilia. Ringworm (dermatophytosis) is a fungal infection of the skin caused by dermatophytes that primarily affects the superficial layers of the skin, hair, or nails. While the body does mount an immune response to the fungal infection, it rarely triggers significant eosinophilia, which is an elevated level of eosinophils (a type of white blood cell) in the blood. Eosinophilia is more commonly associated with allergic reactions, parasitic infections, certain medications, and some autoimmune disorders. The immune response to dermatophyte infections primarily involves cell-mediated immunity with T-lymphocytes rather than eosinophil activation. If a patient with ringworm shows eosinophilia, clinicians should consider other concurrent conditions as the cause of the elevated eosinophil count rather than attributing it to the fungal infection itself, as suggested by the guidelines for the investigation and management of eosinophilia in returning travellers and migrants 1, 2, 3, 4.
Key Points to Consider
- The guidelines for the investigation and management of eosinophilia in returning travellers and migrants do not mention ringworm as a common cause of eosinophilia 1, 2, 3, 4.
- Eosinophilia is often associated with helminth infections, which are not typically related to fungal infections like ringworm 3.
- The treatment for ringworm involves topical or oral antifungal medications, without any specific need to address eosinophil levels 1, 2, 3, 4.
- Clinicians should consider other concurrent conditions as the cause of elevated eosinophil counts in patients with ringworm, rather than attributing it to the fungal infection itself 1, 2, 3, 4.
Recommendations for Practice
- When diagnosing and managing eosinophilia, consider the most common causes, such as helminth infections, and investigate accordingly 1, 2, 3, 4.
- If a patient with ringworm presents with eosinophilia, investigate for other potential causes of the elevated eosinophil count, rather than attributing it to the ringworm infection 1, 2, 3, 4.
- Treatment for ringworm should focus on eradicating the fungal infection using antifungal medications, without specific consideration for eosinophil levels unless other conditions are suspected 1, 2, 3, 4.
From the Research
Ringworm and Eosinophilia
- There is no direct evidence in the provided studies to suggest that ringworm causes eosinophilia 5, 6, 7, 8, 9.
- The studies primarily focus on the treatment of tinea corporis, tinea cruris, and tinea capitis using various antifungal medications, such as griseofulvin, terbinafine, itraconazole, and fluconazole.
- None of the studies mention eosinophilia as a symptom or a consequence of ringworm infection.
Treatment of Ringworm
- The studies compare the efficacy of different antifungal medications in treating ringworm infections 5, 6, 7, 8, 9.
- Terbinafine, itraconazole, and fluconazole are found to be effective in treating ringworm infections, with varying degrees of success 5, 6, 7, 8.
- Griseofulvin is also used to treat ringworm, but its efficacy is found to be similar to or lower than that of the other medications 5, 6, 7, 8.
Laboratory Measurements
- Some studies mention laboratory measurements, such as complete blood count and liver function enzymes, but none of them report on eosinophilia specifically 6, 8.
- The studies focus on the clinical and mycological outcomes of the treatments, rather than on the hematological effects of ringworm infection.