A couple of years ago I spent a series of months battling a disease that left me slightly disfigured (and itchy beyond belief). It started as a rough, red patch of skin on the lower half of my face—right next to my mouth, no less. As it evolved past Halloween and refused to heal even into the new year, somewhere along the way (around Thanksgiving) it became clear I’d been suffering the wrath of a fungus among us.
Ah…the dreaded ringworm infection. So attractive. Nothing says “pariah” as effectively as this simple fungal disease’s manifestation. When the indistinct, itchy splotch gives way to a shiny pink circle rimmed with a slight crust of infected skin, there’s almost nothing else it could be, hence the misnomer-ish name. (Though the location of my last episode imparted the distinct impression that it might in fact be a herpes blister. Pretty.)
And guess what? I have a new one to show off. This one’s smack in the middle of the apple of my cheek (I guess I scratch my face at work more than I should, in spite of the fifty-plus hand-washings a day).
Thankfully, this one’s responded more readily to my ministrations. It’s almost completely gone only a couple of weeks after it appeared. After the last experience I wasn’t going to leave anything to chance—I attacked it as if I’d diagnosed myself with skin cancer. Dermal blight begone!
I had no idea where I’d gotten this nasty thing. Was it the teacup kittens I’ve been treating? But I’d been so careful with them, scrubbing my hands raw afterwards with chlorhexidine and rinsing under my short-short nails with a miconazole solution to ward off the evil. It must have been someone else.
On Saturday (the morning from Hell) I finally identified the culprit. It was the blind kitten who—incidentally—can now see. He’s been something of an ongoing charity case with all his persistent eye issues, indefatigable mange infestation and chronic flea magnetism. Add to that mix a fungal infection, which I’d initially suspected and tested for, but whose diagnosis had defeated me—until now.
His owner’s arms and neck were covered with shocking ringworm lesions he’d attributed to overzealous mosquitoes. So much for ease of self-diagnosis. There were huge, angry, obvious fungal colonies just bursting with health.
So you know, some of us are more susceptible to these fungal infections than others. And not all dermatophytes, as this life form is known, are created equal. I’m convinced that some have super-powers. Furthermore, my dermatologist informed me last week that animal originating ringworm infections have more oomph than the soil-related version avid gardeners will sometimes contract. They have more staying power, hence the need to use oral drugs to combat their effects before they get their sea legs deep into your skin.
What could I do? After explaining we’d have to re-culture his kitten’s skin and dip him with a Lym-sulfur solution pending the results, I referred him to his doctor—immediately! He asked for a remedy. As much as I wanted to help, veterinarians are bound by a strict legal code to refrain from doing so. But ethically? I could not let this man walk out the door without telling him that more than likely they were fungal lesions but that I could do nothing about them.
If they were on me, I went on to explain, I’d take myself to the emergency room. Short of that, I’d buy some athlete’s foot medication. But I emphasized that I wasn’t recommending he do so—under no circumstances would I make a human recommendation, I’d reiterated.
Yesterday (Sunday) he’d left me three urgent messages describing his elderly mother’s similar lesions. I begged him to ask a physician. Please! You both need medical attention! What else could I say?
No doubt about it. Hell hath no fury like a Saturday morning in a vet hospital.
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Poor Dr.Patty...
I knew what the picture was even before reading your post and promptly started getting itchy.
A friend of mine got ringworm from a stray kitten she found somwhere. Since the spot was on her leg, she treated hers with straight bleach.
I'm a gardener, but I've never caught ringworm from my hobby. I only wear gloves when I know I'm either going to get stabbed, poked or if I'm sticking my hands in what could possibly be something nasty, otherwise, no gloves.
Hope you week get better.
Stacy September 3rd, 2007 11:58:00 AM
This one gave me the heebie-jeebies - because it happened to me. I was student teaching in a high school, and picked up some form of ringworm there - the teacher I was working with had it too. Then I went to visit my parents for a long weekend, and gave it to them AND their cat. Thankfully I got rid of it a few weeks and topical fungal cream later, but it took my parents and cat longer to shake it, as they apparently keep reinfecting each other! :-(
zandperl September 3rd, 2007 12:18:00 PM
Yikes. I'm a little itchy just thinking about it! Glad to hear it's starting to clear up for you and you were able to track down the source.
Why on earth those folks haven't gone to the doc yet is beyond me!
CDC September 3rd, 2007 12:43:00 PM
Dr. Patty,
I love your blog and I think you’re a wickedly funny genius, but I have a bone to pick with you on this entry. First of all, any cat or dog can have and transmit ringworm, even if there are no visible signs, so let’s not be too quick to blame the poor, little, previously-blind kitten.
I spend all of my time doing rescue and shelter work. Ringworm is a dangerous condition for a shelter animal to have, not because the condition is inherently dangerous (it’s not), but because a conscientious shelter won’t knowingly adopt out an animal with ringworm. Therefore, an animal with obvious lesions is labeled “unadoptable” and may have to be killed to create space for incoming “adoptable” animals. All of this happens because people are repelled by and fearful of ringworm, an attitude that vets perpetuate much more than human doctors do. Come on Dr. Patty—a recommendation to visit the emergency room?
Ringworm is a superficial condition for both animals and humans. No matter how bad the infection is, it is still limited to the skin. It’s no more dangerous to a cat or a human than dandruff is. Furthermore, it is self-limiting in cases where the patient is not immunocompromised. Even in an immunocompromised individual, however, ringworm is still just an unsightly fungal infection of the skin. When I get ringworm lesions, as I often do, I use a topical over-the-counter antifungal cream that’s labeled for use on ringworm.
Doctors Karen Moriello and Sandra Newbury are two vets who have done a considerable amount of research on the condition. Doctor Moriello has published numerous articles in JAVMA for anyone who is interested, and Dr. Newman’s interest in ringworm stems from her work as a shelter vet; she is a shelter vet who wants to stop killing animals for ringworm. You can google an excellent web page they both contributed to: Dermatophyte Treatment in a Nutshell.
Heather #2 September 3rd, 2007 02:09:00 PM
Thing skin care secret #2084: try using diluted vinegar as your daily skin toner. Seriously.
Thing One September 3rd, 2007 05:09:00 PM
Depending on where you live, emergency rooms are going to get you treatment far faster than your average doctors office. Again I said depending on where you live. It may also be that the client didn't have a regular doctor. Finding one as a new patient is also going to take you alot longer than simply visiting an emergency room. So I think that was valid advice.
Marie September 3rd, 2007 08:48:00 PM
I had this once right after I adopted my cats. Of course, I thought they were the cause. Turns out it was from one of those whirlpools they use at nail salons. Itchy, itchy for sure. Fortunately, I didn't pass it on to my cats.
Dr. Patty - another good place to refer people is to a pharmacist. Just like you, they can't diagnose, but when I showed my pretty little circle to the pharmacist at my local drugstore, he said, while he wasn't a doctor - they he thought some nice spray athlete's foot powder might help. And he recommended that I check out ringworm online.
2CatMom September 3rd, 2007 09:57:00 PM
here's a weird one: i used to break out in yucky ringworm circles whenever my mom switched the laundry soap from Tide to most anything else. i believe Gain and Sun were the two most offensive brands. i'd break out on my arms and legs a few days after wearing freshly-laundered clothing and they wouldn't clear up until we switched back.
charity September 4th, 2007 02:41:00 AM
Heather: You're right--ringworm needn't be an ER condition. But you should have seen this guy's arms and neck! I'd never seen so many aggressive lesions!! And this is one client who would have refused to follow any advice (for himself) unless I got serious with him. This case looks like it needs oral meds ASAP. Plus, I don't know what else he might be dealing with, physically. For all I know he had a kidney transplant five years ago and still takes anti-rejection meds. Can't be too careful with someone else's health. I'll always remember the pregnant client with a scabies kitten who had to be hospitalized with a severe allergic reaction to plain-old garden variety mange. Nuff said.
Dr. Patty Khuly September 4th, 2007 08:36:00 AM
charity, I'm guessing that was hives! My husband has the same issue -- it's not Tide vs. other detergents, but unscented vs. scented. any scented detergent makes him itch or break out in hives; anything unscented is OK.
oh, allergies. you suck so much.
Laura September 4th, 2007 02:46:00 PM
er, obviously I meant that _for him_ it's not Tide vs. other detergents!
Laura September 4th, 2007 02:48:00 PM
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