Learn about ringworm (tinea corporis) diagnosis, including clinical documentation, ICD-10 codes (B35.x), treatment options, and differential diagnosis. This resource provides information for healthcare professionals on identifying, documenting, and coding ringworm infections in clinical settings. Explore dermatophytosis, fungal infections, skin rash, antifungal medications, and KOH prep for accurate diagnosis and coding of tinea.
Also known as
Dermatophytosis
Fungal infections of the skin like ringworm.
Other superficial mycoses
Includes other fungal skin infections, some overlapping with ringworm types.
Subcutaneous mycoses
Deeper fungal infections, which can sometimes be related to untreated ringworm.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the ringworm infection of the scalp?
Yes
Code B35.0: Tinea capitis
No
Is it of the beard?
When to use each related code
| Description |
|---|
| Ring-shaped rash, itchy skin |
| Athlete's foot (tinea pedis) |
| Jock itch (tinea cruris) |
Coding ringworm as B35.9 (unspecified) when a more specific type is documented leads to inaccurate data and potential payment issues.
Incorrectly coding the body site affected by ringworm can impact severity and treatment reporting, impacting reimbursement and quality metrics.
Failure to identify and code ringworm modified by topical steroids (tinea incognito) can lead to underreporting disease severity and complexity.
Q: How to differentiate tinea corporis (ringworm) from other annular skin lesions in adult patients presenting with overlapping symptoms?
A: Differentiating tinea corporis from other annular lesions like granuloma annulare, nummular eczema, and psoriasis can be challenging due to overlapping symptoms. Key clinical features to consider include the presence of scaling, central clearing, and a well-defined, raised border in tinea corporis. Pruritus is often present but not always. Potassium hydroxide (KOH) microscopy of skin scrapings is crucial for confirming the diagnosis by visualizing fungal hyphae. Dermoscopy can also aid in diagnosis by revealing comma-shaped or corkscrew-shaped hyphae. Consider implementing dermoscopy in your practice for rapid, non-invasive evaluation of suspected fungal infections. Explore how incorporating KOH microscopy and dermoscopy can enhance diagnostic accuracy in dermatological practice and reduce misdiagnosis rates. If clinical suspicion remains high despite a negative KOH, a fungal culture should be considered. For atypical presentations, a skin biopsy may be necessary to rule out other conditions. Learn more about the nuances of dermoscopic patterns in various dermatophytoses.
Q: What are the most effective oral and topical antifungal treatment strategies for recurrent tinea corporis in patients with underlying comorbidities?
A: Recurrent tinea corporis can be challenging to manage, especially in patients with comorbidities like diabetes, immunodeficiency, or obesity. These conditions can predispose individuals to fungal infections and complicate treatment. Effective management requires addressing the underlying comorbidity and implementing a comprehensive antifungal strategy. Topical antifungals like terbinafine, clotrimazole, and miconazole are often first-line for localized infections. However, for recurrent or widespread infections, oral antifungals like terbinafine, itraconazole, or fluconazole may be necessary. The choice of oral antifungal depends on the severity and location of the infection, as well as potential drug interactions. Consider implementing a longer treatment duration for recurrent cases, typically 4-6 weeks for oral antifungals and 2-4 weeks for topicals. Explore how optimizing treatment duration and addressing underlying comorbidities can minimize recurrence rates. Patient education regarding hygiene practices, such as keeping the affected area dry and avoiding sharing personal items, is also crucial. Learn more about the latest guidelines for managing tinea corporis in patients with complex medical histories.
Patient presents with complaints consistent with tinea corporis, commonly known as ringworm. The patient reports an itchy, circular rash characterized by a raised, scaly border and central clearing. Onset of the lesion was approximately [duration] ago, located on the [location of lesion]. The patient denies fever, chills, or systemic symptoms. Physical examination reveals a well-demarcated, erythematous, annular plaque with a slightly raised, scaly edge consistent with the clinical presentation of dermatophytosis. Differential diagnoses considered include nummular eczema, granuloma annulare, and psoriasis. KOH microscopy performed in office revealed the presence of hyphae, confirming the diagnosis of ringworm infection. Treatment plan includes topical antifungal therapy with clotrimazole cream 1 twice daily for [duration]. Patient education provided regarding hygiene practices to prevent the spread of infection, including keeping the affected area clean and dry, avoiding sharing personal items, and washing hands thoroughly. Follow-up appointment scheduled in [duration] to assess treatment response and provide further management as needed. ICD-10 code B35.4 (Tinea corporis) assigned.