Tinea Barbae

Aka: Tinea Barbae

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II. Epidemiology

  1. Adult males
  2. Seen now in farmers related to animal exposure

III. Etiology

  1. Trichophyton verrucosum
  2. Trichophyton mentagrophytes

IV. Pathophysiology

  1. Dermatophyte infection of the beard and mustache area
  2. Trichomycosis (Invasion of Hair Shaft)
    1. Resembles Tinea Capitis infection

V. Symptoms

  1. Pruritus
  2. Local tenderness

VI. Signs

  1. Distribution
    1. Beard and mustache area
    2. Eyelashes and eyebrows (rare)
  2. Pustular Folliculitis
    1. Hair Follicles surrounded by inflammation
      1. Papules and Pustules
      2. Superimposed exudate and crust
    2. Hair easily removed
  3. Circular reddish patches with scale
    1. Hairs broken off at surface

VII. Differential Diagnosis

  1. Bacterial Folliculitis (Staphylococcus Aureus)
  2. Furuncle or Carbuncle
  3. Acne Vulgaris
  4. Rosacea
  5. Perioral Dermatitis
  6. Pseudofolliculitis Barbae
  7. Contact Dermatitis
  8. Herpes Simplex Virus (Eczema herpeticum)

VIII. Labs: Potassium Hydroxide (KOH) of plucked hair

  1. Hyphae seen invading Hair Shaft

IX. Management: Systemic Antifungal Medications

  1. Treat for 2-3 weeks after lesion resolution (typically requires 4-6 weeks of treatment)
  2. See Tinea Capitis for Antifungal Medication options and dosing

X. Complications

  1. Staphylococcus Aureus superinfection
  2. Kerion

XI. Reference

  1. Fitzpatrick (1992) Color Atlas Dermatology
  2. Hainer (2003) Am Fam Physician 67(1):101-8 [PubMed]

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