OSCE — Tinea & Dermatophytosis (Ringworm)

Brief (to candidate)

You will assess a patient with a presentation consistent with Tinea & Dermatophytosis (Ringworm).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Tinea (dermatophytosis, ringworm) is a superficial fungal infection of keratinised tissue by dermatophyte moulds of three genera — Trichophyton (skin, hair, nails), Microsporum (hair, skin; many fluoresce green under Wood's lamp), and Epidermophyton floccosum (skin and nails, never hair). Dermatophytes secrete keratinases that digest keratin in the stratum corneum, hair shafts, and nails; they cannot invade living tissue. The clinical lesion is the annular, erythematous, scaly plaque with a raised, advancing, scaly border (active edge) and central clearing — the ringworm pattern — and is named by site: corporis, cruris, pedis (interdigital/moccasin/vesicular), capitis (black-dot/kerion/favus).^[1]

Candidate tasks

1. Clarify onset, severity, associated features, and red-flag symptoms.
2. State focused examination priorities.
3. List first-line investigations and any named score/criteria.
4. Give immediate resuscitation steps.
5. Outline definitive management with doses/routes where standard.
6. Name complications and disposition (ward / HDU / theatre / discharge safety-net).
7. Mention one special-population modifier (pregnancy, child, elderly, CKD).
8. Give immediate resuscitation steps.
9. Outline definitive management with doses/routes where standard.
10. Name complications and disposition (ward / HDU / theatre / discharge safety-net).
11. Mention one special-population modifier (pregnancy, child, elderly, CKD).

Examiner checklist

Model outline

Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.^[1]