What are the indications for referral to a dermatologist in cases of suspected tinea corporis?

Indications for referral to a dermatologist in suspected tinea corporis include:

• Severe or extensive disease, especially in children, where referral to a paediatric dermatologist is recommended.
• Uncertain diagnosis where clinical features do not clearly confirm tinea corporis.
• Failure of topical antifungal treatment or unsuccessful treatment in primary care.
• Frequent recurrences of the infection despite treatment.
• Immunocompromised patients, depending on clinical judgement.
• Persistent signs of infection after initial management, suggesting possible treatment failure due to non-adherence, inappropriate corticosteroid use (leading to tinea incognito), drug resistance, or other underlying causes.

Referral urgency depends on clinical judgement and severity of the case. Skin sampling for fungal microscopy and culture should be arranged to support diagnosis and guide treatment, and oral antifungal treatment considered if indicated.