A Case Report on Tinea Corporis: Homoeopathic Management and Clinical Insights

Definition:

Tinea corporis is a superficial fungal infection of the glabrous (non-hairy) skin, excluding the scalp, groin, hands, feet, and face. It is caused by dermatophyte fungi (mainly Trichophyton, Microsporum, or Epidermophyton species) and is characterized by annular (ring-shaped), erythematous, scaly lesions with central clearing and active, spreading borders.

Types of Tinea Corporis:

Type	Description
Tinea corporis circinata	Classical ring-shaped lesion; red, scaly border with central clearing.
Tinea profunda	Deeper infection, intense inflammation, may form plaques.
Tinea incognito	Altered appearance due to misuse of topical steroids; less scaly, atypical border.
Majocchi’s granuloma	Fungal infection involving hair follicles, nodular or granulomatous presentation.

 Etiology (Causes):

Causative Fungi:

• Trichophyton rubrum (most common)
• Trichophyton mentagrophytes
• Microsporum canis (from pets)
• Epidermophyton floccosum

Risk Factors:

• Hot and humid climates
• Excessive sweating
• Poor hygiene
• Wearing tight clothing
• Immunosuppression (diabetes, HIV)
• Contact with infected individuals, animals, or contaminated objects (towels, gym mats)

Mode of Transmission:

• Direct contact – with infected persons or animals
• Indirect contact – via fomites (clothing, towels, bedding)
• Autoinoculation – from other body areas (e.g., from feet or groin)

 Clinical Features:

Feature	Description
Lesion	Annular plaque with raised, erythematous, scaly border and central clearing
Itching	Intense, worse with sweating or at night
Distribution	Trunk, arms, legs, neck; can be solitary or multiple
Progression	Expands centrifugally; active margin with scaling and inflammation
Variations	May become vesicular or pustular at the edges

Differential Diagnosis:

Condition	Differentiating Features
Psoriasis	Well-demarcated plaques with silvery scales; no central clearing
Eczema	Ill-defined borders, intense itching, oozing in acute stages
Pityriasis rosea	Herald patch followed by Christmas-tree pattern on trunk
Lupus vulgaris	Slow-growing, reddish-brown plaques, usually face or neck, apple-jelly nodules
Nummular dermatitis	Round, coin-shaped eczematous lesions; more exudative than scaly

Investigations:

• KOH mount (10%) – Presence of septate hyphae
• Fungal culture – On Sabouraud’s dextrose agar for species identification
• Wood’s lamp – May fluoresce in Microsporum species
• Skin biopsy – Rarely required; shows fungal elements in stratum corneum

 Homoeopathic Treatment:

Homeopathic medicines treat tinea not just symptomatically but also constitutionally, to reduce recurrence and boost immune response.

Commonly Indicated Remedies:

Remedy	Key Indications
Sepia	Dry, ring-shaped eruptions; < washing; > open air; indifference, hormonal imbalance
Tellurium	Multiple overlapping ring lesions; offensive body odor; < heat, exertion
Graphites	Dry, scaly, itchy skin; oozing sticky fluid; < warmth, < at night
Sulphur	Itching, burning, dry scaly skin; < heat, bathing; psoric miasm
Psorinum	Dirty-looking skin, offensive odor; chilly; recurring fungal infections
Arsenicum album	Burning, itching eruptions; < cold, > warm applications; anxious and restless
Mezereum	Thick crusts; itching > warmth; offensive secretions; nervous, oversensitive patients
Thuja	For suppressed skin eruptions; sycotic miasm; oily skin, warty growths

Intercurrent Remedies (For Chronic/Recurrent Cases):

Remedy	Use
Psorinum	In deeply rooted psoric cases; suppressive treatments history
Tuberculinum	For tubercular miasm, especially in patients with recurrent fungal infections
Sulphur	To open up suppressed eruptions; useful as an intercurrent in any miasmatic layer

 General Management:

• Keep affected areas dry and clean
• Wear loose, cotton clothing
• Avoid sharing towels, footwear, clothing
• Use antifungal soap (if needed, with advice)
• Wash clothes in hot water
• Avoid self-use of topical steroids

References:

1. Boericke’s Materia Medica – William Boericke
2. Allen’s Keynotes – H.C. Allen
3. Skin Diseases and Homoeopathy – Dr. Ramji Gupta
4. Davidson’s Principles and Practice of Medicine
5. Miasmatic Prescribing – Dr. Subrata Banerjea
6. Clinical Dermatology – Thomas P. Habif
7. Kent’s Repertory

CASE PRESENTATION: TINEA CORPORIS

Presented by: Dr. Paras Choubitker, MD Part 2 (Practice of Medicine)
HOD: Dr. S.K. Sharma
Institution: RKDF Homoeopathic Medical College Hospital and Research Centre
Date: [Insert Date]
Diagnosis: Tinea Corporis (Ringworm of the Body)

 1. PATIENT INFORMATION

• Name: Mr. Rahul Verma
• Age/Sex: 28 years / Male
• Occupation: Gym Trainer
• Address: [Insert Address]
• Date of First Visit: 3rd February 2025
• OPD No.: 2025/11

 2. CHIEF COMPLAINTS

Complaints	Duration	Description
Ring-shaped itchy patches on chest and back	4 months	Itching < at night and sweating; red, scaly, expanding lesions
Burning after scratching	4 months	Temporary relief followed by more irritation
Recurrent eruptions	1 year	Symptoms subside with creams but recur

 3. HISTORY OF PRESENT COMPLAINTS

• First noticed lesion after using shared towel at gym.
• Treated with antifungal cream (OTC) with temporary relief.
• Recurrence every 2–3 months.
• No fever, pain, or systemic involvement.
• Itching worsens with heat and sweating.

 4. PAST HISTORY

• No major illness or surgeries
• No history of allergies or skin conditions
• No diabetes or immunosuppressive disorders

 5. FAMILY HISTORY

• No similar complaints in family
• Father is hypertensive

 6. PERSONAL HISTORY

• Appetite: Normal
• Thirst: Increased
• Bowel: Normal
• Urine: Normal
• Sleep: Disturbed due to itching
• Habits: Regular gym-goer, occasional alcohol
• Thermal reaction: Hot patient

 7. MENTAL GENERALS

• Irritable and short-tempered
• Anxious about appearance due to profession
• Sensitive to criticism
• Ambitious, perfectionist
• Disturbed sleep due to worry about recurrence

 8. TOTALITY OF SYMPTOMS

1. Multiple ring-shaped lesions on chest and back
2. Itching < night, < heat, < sweating
3. Burning after scratching
4. Recurrent fungal infection
5. Sensitive to appearance, anxious personality
6. Irritability and perfectionist nature
7. Sleep disturbed due to itching
8. Thermal hot patient

 9. REPERTORIAL TOTALITY

Repertory Used: Kent’s Repertory / Synthesis

Rubrics	Chapter
Skin; eruptions; ringworm	Skin
Skin; eruptions; itching; night	Skin
Skin; eruptions; circular	Skin
Skin; eruptions; moist; itching	Skin
Mind; sensitive to criticism	Mind
Sleep; disturbed; itching from	Sleep
Generals; heat; aggravates	Generals

Remedies Considered: Tellurium, Sepia, Sulphur, Psorinum
Selected Remedy: Tellurium 200
(Chosen for classic multiple overlapping ring-shaped lesions, < heat/sweat, offensive odor, anxious personality)

 10. PRESCRIPTION

• Tellurium 200C, 1 dose stat
• Placebo, BD × 14 days
• General Advice:
  • Avoid sharing towels/clothing
  • Wear loose, breathable clothing
  • Dry skin properly after bathing
  • Avoid topical steroids

 11. FOLLOW-UP

Follow-up 1 (After 2 weeks)

• Itching reduced by 60%
• Lesions beginning to shrink
• No new eruptions

➡ No repetition of Tellurium; continued placebo

Follow-up 2 (After 1 month)

• Lesions significantly faded
• Occasional itching only in evenings
  ➡ Intercurrent Remedy: Psorinum 200C, 1 dose
  (To clear miasmatic background; history of suppressed eruptions with recurrence)

Follow-up 3 (After 2 months)

• Skin clear
• No recurrence
• Mentally more confident and stable

➡ No medicine; advised routine follow-up

 12. CONSENT FROM PATIENT

“I, Mr. Rahul Verma, voluntarily consent to the homeopathic treatment. I understand the nature of my skin condition and the approach taken. I grant permission to use my anonymized case for academic purposes.”

Signature:
Name: Mr. Rahul Verma
Date: 3rd February 2025

 13. REFERENCES

1. Boericke’s Materia Medica – William Boericke
2. Kent’s Repertory
3. Allen’s Keynotes – H.C. Allen
4. Skin Diseases and Homoeopathy – Dr. Ramji Gupta
5. Davidson’s Principles and Practice of Medicine
6. Miasmatic Prescribing – Dr. Subrata Banerjea