Tinea Barbae

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Tinea barbae is a superficial dermatophyte infection that is limited to the bearded areas of the face and neck and occurs almost exclusively in older adolescent and adult males. The clinical presentation of tinea barbae includes inflammatory, deep, kerionlike plaques and noninflammatory superficial patches resembling tinea corporis or bacterial folliculitis. It may be viewed as an occupational disease among cattle farmers. ^[1]

Tinea barbae is caused by the keratinophilic fungi (dermatophytes) that are responsible for most superficial fungal skin infections. They infect the stratum corneum of the epidermis, hair, and nails. Several enzymes, including keratinases, are released by dermatophytes, which help them invade the epidermis. The mechanism that causes tinea barbae is similar to that of tinea capitis. In both diseases, hair and hair follicles are invaded by fungi, producing an inflammatory response. Tinea barbae is caused by both zoophilic and anthropophilic dermatophytes.

Infection caused by zoophilic dermatophytes usually is of greater severity than that produced by anthropophilic organisms. Thus, zoophilic dermatophytes are the primary cause of inflammatory kerionlike plaques, which most likely result from a more intense host reaction. Kerion formation has been described as resulting from Trichophyton rubrum infection. ^{[2, 3, 4]} T rubrum, an anthropophilic dermatophyte, can invade hair shafts and deeper tissues (although rarely), resulting in an inflammatory reaction. Usually, infection involving hair is more severe; therefore, tinea barbae caused by anthropophilic dermatophytes often has a more severe course than tinea corporis caused by the same pathogen.

Dermatomycoses may be due to pets and farm animals, sometimes from unusual dermatophytes. Trichophytonerinacei, a zoophilic dermatophyte occasionally harbored by hedgehogs, was linked with kerion-type tinea barbae in a 37-year-old man with the infection apparently transferred to his partner by direct contact from kissing. ^[5] Inflammatory tinea barbae was shown to be caused by Arthroderma benhamiae in both a patient and his guinea pig. ^[6]

The formation of kerion is postulated by 2 theories. The first theory suggests that it results from diffusion of metabolites and/or toxins from the fungus; however, kerion formation most likely results from an immunologic response to dermatophyte antigens.

Tinea barbae is caused by several dermatophytes, including zoophilic and anthropophilic organisms; however, zoophilic dermatophyte infection occurs more commonly. Frequently, animals (eg, cattle, horses, cats, dogs) constitute the source of infection. ^[7] Trichophyton species are most common, thus the term trichophytosis barbae also is used. Among zoophilic dermatophytes, Trichophyton mentagrophytes var granulosum and Trichophyton verrucosum are the most common causative agents. ^{[8, 9, 10]} Microsporum canis and Trichophyton mentagrophytes var erinacei may cause tinea barbae but are rare. ^[11]

T rubrum and Trichophyton violaceum are the most common anthropophilic dermatophytes responsible for tinea barbae; however, infections from Trichophyton megninii (endemic in Sardinia, Sicily, Portugal) and Trichophyton schoenleinii (endemic in Eurasia, Africa, Brazil) also may occur, especially in endemic regions. Infection of bearded skin by anthropophilic dermatophytes may be the result of autoinoculation from tinea pedis or onychomycosis. ^{[12, 13, 14]}

Other reported causative organisms include Trichophyton interdigitale ^[15] and Microsporum nanum. ^[16]

United States

Tinea barbae is uncommon in the United States.

International

Currently, tinea barbae is infrequent around the world. As with other dermatophytoses, tinea barbae is more common in countries in which weather is characterized by high temperatures and humidity. It represented only 5.8% of dermatophytosis in one survey from the tropical region of southern Iran. ^[17]

Tinea barbae was observed more frequently in the past before single-use razors became available, and infection frequently was transmitted by barbers who used unsanitary razors. Therefore, it is not surprising that tinea barbae once was termed barber’s itch. Now that habits and equipment have changed, this source of infection has been all but eliminated. Currently, tinea barbae is more common among rural inhabitants, and zoophilic dermatophytes constitute its primary pathogens. Dermatophytosis from zoophilic species of dermatophytes has increased in southwestern Iran, with the Trichophyton species of A benhamiae being a new cause in southwestern Iran. ^[18]

Men are affected almost exclusively by tinea barbae because the disease involves the bearded areas of the face and neck. Involvement of the same areas in healthy women and children is classified as tinea faciei.

Hair appears on the face at puberty; therefore, tinea barbae may occur almost exclusively in older adolescent and adult males.

Prognosis usually is good for tinea barbae. Inflammatory lesions undergo spontaneous remission within a few months; however, if untreated, they leave scarring alopecia. Noninflammatory tinea barbae lesions are more likely to be chronic and may not tend to resolve spontaneously. In superficial chronic tinea barbae, alopecia may occur in the center of the lesions; however, this is not common.

For patient education resources, visit the Skin Conditions and Beauty Center. Also, see the patient education article Ringworm on Body.

Al-Ali S, Elledge R, Ilchyshyn A, Stockton P. When the cows come home: occupational tinea barbae in a cattle farmer. Br J Oral Maxillofac Surg. 2017 Jan 13. [Medline].

Beswick SJ, Das S, Lawrence CM, Tan BB. Kerion formation due to Trichophyton rubrum. Br J Dermatol. 1999 Nov. 141(5):953-4. [Medline].

Gupta G, Burden AD, Roberts DT. Acute suppurative ringworm (kerion) caused by Trichophyton rubrum. Br J Dermatol. 1999 Feb. 140(2):369-70. [Medline].

Singh S, Sondhi P, Yadav S, Ali F. Tinea barbae presenting as kerion. Indian J Dermatol Venereol Leprol. 2017 Nov-Dec. 83 (6):741. [Medline].

Sidwell RU, Chan I, Francis N, Bunker CB. Trichophyton erinacei kerion barbae from a hedgehog with direct osculatory transfer to another person. Clin Exp Dermatol. 2014 Jan. 39(1):38-40. [Medline].

Braun SA, Jahn K, Westermann A, Bruch-Gerharz D, Reifenberger J. [Tinea barbae profunda by Arthroderma benhamiae. A diagnostic challenge]. Hautarzt. 2013 Oct. 64(10):720-2. [Medline].

Davis DF, Petri WH, Hood AF. Dairy farmer with a rapidly enlarging lip lesion: tinea barbae. Arch Dermatol. 2006 Aug. 142(8):1059-64. [Medline].

Kiska DL, Cynamon MH. Photo quiz. Tinea barbae caused by Trichophyton verrucosum. Clin Infect Dis. 1997 Oct. 25(4):805, 871. [Medline].

Maeda M, Nakashima T, Satho M, Yamada T, Kitajima Y. Tinea barbae due to Trichophyton verrucosum. Eur J Dermatol. 2002 May-Jun. 12(3):272-4. [Medline].

Wollina U, Hansel G, Uhrlaß S, Krüger C, Schönlebe J, Hipler UC, et al. Deep facial mycosis due to Trichophyton verrucosum-molecular genetic identification of the dermatophyte in paraffin-embedded tissue-case report and review of the literature. Mycoses. 2018 Mar. 61 (3):152-158. [Medline].

Kick G, Korting HC. Tinea barbae due to Trichophyton mentagrophytes related to persistent child infection. Mycoses. 1998 Nov. 41(9-10):439-41. [Medline].

Kawada A, Aragane Y, Maeda A, Yudate T, Tezuka T, Hiruma M. Tinea barbae due to Trichophyton rubrum with possible involvement of autoinoculation. Br J Dermatol. 2000 May. 142(5):1064-5. [Medline].

Szepietowski JC, Bielicka E, Maj J. Inflammatory tinea barbae due to Trichophyton rubrum infection – autoinnoculation from fingernail onychomycosis?. Case Rep Clin Pract Rev. 2002. 3:254-6. [Full Text].

Szepietowski JC, Matusiak L. Trichophyon rubrum autoinoculation from infected nails is not such a rare phenomenon. Mycoses. 2008. 51:345-346.

Trotha R, Graser Y, Platt J, et al. Tinea barbae caused by a zoophilic strain of Trichophyton interdigitale. Mycoses. 2003 Feb. 46(1-2):60-3. [Medline].

Ratka P, Slusarczyk E, Sloboda T, Kusmierski W. [Case of tinea barbae profunda caused by Microsporum nanum]. Przegl Dermatol. 1983 Sep-Dec. 70(5-6):549-52. [Medline].

Ansari S, Hedayati MT, Zomorodian K, Pakshir K, Badali H, Rafiei A, et al. Molecular Characterization and In Vitro Antifungal Susceptibility of 316 Clinical Isolates of Dermatophytes in Iran. Mycopathologia. 2016 Feb. 181 (1-2):89-95. [Medline].

Rezaei-Matehkolaei A, Rafiei A, Makimura K, Gräser Y, Gharghani M, Sadeghi-Nejad B. Epidemiological Aspects of Dermatophytosis in Khuzestan, southwestern Iran, an Update. Mycopathologia. 2016 Feb 17. [Medline].

Bonifaz A, Ramirez-Tamayo T, Saul A. Tinea barbae (tinea sycosis): experience with nine cases. J Dermatol. 2003 Dec. 30(12):898-903. [Medline].

Furlan KC, Kakizaki P, Chartuni JC, Valente NY. Sycosiform tinea barbae caused by trichophyton rubrum and its association with autoinoculation. An Bras Dermatol. 2017 Jan-Feb. 92 (1):160-161. [Medline].

Buruiana AM, Mihali CV, Popescu C. Sequence-Based Identification of a Zoophilic Strain of Trichophyton interdigitale in a Rare Case of Tinea Blepharo-Ciliaris Associated with Tinea Barbae. Mycopathologia. 2015 Jul 12. [Medline].

Laureano AC, Schwartz RA, Cohen PJ. Facial bacterial infections: folliculitis. Clin Dermatol. 2014 Nov-Dec. 32 (6):711-4. [Medline].

Wall D, Fraher M, O’Connell B, Watson R, Timon C, Stassen LF, et al. Infection of the Beard area. Kerion: a review of 2 cases. Ir Med J. 2014 Jul-Aug. 107(7):219-21. [Medline].

Kapdagli H, Ozturk G, Dereli T, et al. Candida folliculitis mimicking tinea barbae. Int J Dermatol. 1997 Apr. 36(4):295-7. [Medline].

Kurita M, Kishimoto S, Kibe Y, Takenaka H, Yasuno H. Candida folliculitis mimicking tinea barbae. Acta Derm Venereol. 2000 Mar-Apr. 80(2):153-4. [Medline].

Jasterzbski TJ, Schwartz RA. Pseudofolliculitis cutis: a vexing disorder of hair growth. Br J Dermatol. 2015 Apr. 172 (4):878-84. [Medline].

Baran W, Szepietowski JC, Schwartz RA. Tinea barbae. Acta Dermatoven APA. 2004. 13:91-4. [Full Text].

Tanuma H, Doi M, Nishiyama S, Katsuoka K. A case of tinea barbae successfully treated with terbinafine. Mycoses. 1998 Jan-Feb. 41(1-2):77-81. [Medline].

Kwasniewska J. Current antifungal agents in dermatology. Postepy Dermatol (Poznan). 1997. 14:129-35.

Ceburkovas O, Schwartz RA, Janniger CK. Tinea capitis: current concepts. J Dermatol. 2000 Mar. 27(3):144-8. [Medline].

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs and Administration

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, New York Academy of Medicine, American Academy of Dermatology, American College of Physicians, Sigma Xi

Disclosure: Nothing to disclose.

Jacek C Szepietowski, MD, PhD Professor, Vice-Head, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University; Director of the Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Poland

Disclosure: Received consulting fee from Orfagen for consulting; Received consulting fee from Maruho for consulting; Received consulting fee from Astellas for consulting; Received consulting fee from Abbott for consulting; Received consulting fee from Leo Pharma for consulting; Received consulting fee from Biogenoma for consulting; Received honoraria from Janssen for speaking and teaching; Received honoraria from Medac for speaking and teaching; Received consulting fee from Dignity Sciences for consulting; .

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Paul Krusinski, MD Director of Dermatology, Fletcher Allen Health Care; Professor, Department of Internal Medicine, University of Vermont College of Medicine

Paul Krusinski, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD.

Franklin Flowers, MD Department of Dermatology, Professor Emeritus Affiliate Associate Professor of Pathology, University of Florida College of Medicine

Franklin Flowers, MD is a member of the following medical societies: American College of Mohs Surgery

Disclosure: Nothing to disclose.

Tinea Barbae

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