A GLOBAL PERSPECTIVE ON RINGWORM: EPIDEMIOLOGY, BURDEN OF DISEASE, PUBLIC HEALTH IMPLICATIONS AND TREATMENT CHALLENGES - REVIEW ARTICLE

Abstract

Ringworm (dermatophytosis) has emerged as a significant global public health challenge, particularly in tropical regions like India. The disease manifests primarily as tinea corporis and tinea cruris, affecting skin, nails, and hair. An increasing trend of chronic and recurrent dermatophytosis has been observed, with more frequent reports in dermatology clinics. This has led to heightened interest in the condition at both national and international dermatology conferences. The World Health Organization (WHO) estimates that 20-25% of the global population is affected by superficial fungal infections, with nearly a billion individuals experiencing skin, nail, or hair fungal conditions.

Factors such as poor hygiene, overcrowding, and increased physical activity in hot and humid climates contribute to the high prevalence of ringworm. The rising incidence in children and the higher susceptibility of adults aged 21-50 years are linked to outdoor activities and lifestyle choices, including the use of tight-fitting clothing and synthetic fabrics, which trap moisture and create ideal conditions for fungal growth. Furthermore, the widespread and irrational use of topical steroid-antifungal combinations has worsened the situation, contributing to chronic and treatment-resistant infections.

Despite the escalating number of cases, management guidelines remain outdated. Physicians often rely on hit-and-miss treatment strategies, as current antifungal medications show diminished efficacy. Research on dermatophytosis and its treatment must be reinvigorated, emphasizing molecular mechanisms of antifungal resistance and the role of nonpharmacologic measures in preventing reinfection. The financial burden on families, where multiple members are affected, also calls for a more comprehensive public health approach to tackle this pervasive issue.