Tinea barbae is a dermatophytosis Overview of Dermatophytoses Dermatophytoses are fungal infections of keratin in the skin and nails (nail infection is called tinea unguium or onychomycosis). Symptoms and signs vary by site of infection. Diagnosis is by... read more that manifests in the beard area as superficial annular lesions, but deeper infection similar to folliculitis may occur. Tinea barbae may also occur as an inflammatory kerion Kerion Tinea capitis is a dermatophyte infection of the scalp. Diagnosis is by clinical appearance and by examination of plucked hairs or hairs and scale on potassium hydroxide wet mount. Treatment... read more (a large, boggy scalp mass caused by a severe inflammatory reaction to the dermatophyte) that can result in scarring hair loss.
Diagnosis of Tinea Barbae
Potassium hydroxide wet mount
Diagnosis of tinea barbae is by identifying the fungal element (hyphae) on potassium hydroxide wet mount of plucked hairs, culture, or biopsy.
Differential diagnosis of follicular-based papules and pustules in the beard area includes bacterial folliculitis Folliculitis Folliculitis is an infection of hair follicles. Diagnosis is clinical. Treatment is with topical clindamycin. (See also Overview of Bacterial Skin Infections.) The etiology of folliculitis is... read more .
Treatment of Tinea Barbae
Treatment of tinea barbae is micronized griseofulvin 500 mg to 1 g orally once a day until 2 to 3 weeks after clinical clearance (see Table: Options for Treatment of Superficial Fungal Infections* Options for Treatment of Superficial Fungal Infections* Candidiasis is skin and mucous membrane infection with Candida species, most commonly Candida albicans. Infections can occur anywhere and are most common in skinfolds, digital web spaces, genitals... read more ). Terbinafine 250 mg orally once a day and itraconazole 200 mg orally once a day have also been used.
If the lesions are severely inflamed, a short course of prednisone should be added (to lessen symptoms and perhaps reduce the chance of scarring), starting with 40 mg orally once a day (for adults) and tapering the dose over 2 weeks.