Ringworm?

Specialties School

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Long-time lurker, first-time poster. Just some background, I work at a PK-12th grade special needs school. A few months ago we had a student that had a rash very similar to ringworm, in multiple spots. Very large areas. Mom insisted it was eczema and brought in a Dr's note when requested stating it was eczema and not contagious. Interestingly enough, more and more students in their classroom (and staff) developed this same ringworm like rash. It eventually spread to a few classrooms (we have PTs, OTs, and SLPs that go between all rooms). I spoke with our RN and my district says they can attend school if it's covered and treatment has begun. Which is what I had been doing.

Today I received a call from our Health Department stating a parent had complained that there was a ringworm outbreak and we weren't properly handling it. I gave a brief overview of what happened, and also said I hadn't seen any new cases come through my office in over a month. She kind of laughed and said it was reportable anyway she just wanted to make sure we didn't need help.

What is your protocol for ringworm? Anything above what I've done?

Farawyn

12,646 Posts

Clean clean clean, especially in the gym, but not limited to.

Kids who have it must cover areas.

ArryOtter

40 Posts

We don't have an official gymnasium (outside year round in FL), but all of our classrooms are portables. In addition to our regular cleaning, they've added in a fungicidal cleaner as well. It's hard too because ALL of our classrooms have carpet. :/ I just wanted to make sure I wasn't missing anything on our end to prevent.

tamarae1

116 Posts

Ours is the same - gotta be covered in school. Treatment is necessary to contain it and to keep the kid comfortable. I'm in a school where most of the parents can't (or just won't) buy a box of bandaids. I'll hit it with hydrocortisone before I put a bandage on it to help with the inflammation and itching for the student and I will call the parent daily until they take the student to the doctor. Eventually parents get tired of talking to me. I also remind the student no matter the age to always always always wash hands with soap and water extra well if they touch it for any reason.

Specializes in School Nursing, Pediatrics.

Ugh, I hate that "it is eczema" statement!! NO IT ISN'T! It is round, rough, red, and clearly ringworm and needs treatment or it spreads easily! I have had many "fights" with parents over this and then they finally get it diagnosed and come back and say "you were right", well, yeah, I've been telling you that for a week now, that is why you have to come and get Babycakes and he can't stay in school!

We also have the keep it covered policy and be on treatment for them to stay in school.

Specializes in School nursing.
Ugh, I hate that "it is eczema" statement!! NO IT ISN'T! It is round, rough, red, and clearly ringworm and needs treatment or it spreads easily! I have had many "fights" with parents over this and then they finally get it diagnosed and come back and say "you were right", well, yeah, I've been telling you that for a week now, that is why you have to come and get Babycakes and he can't stay in school!

We also have the keep it covered policy and be on treatment for them to stay in school.

This. I just saw a case recently as I actually don't see it much in the older student population unless they have much younger siblings at home. Cover it, no school exclusion, even prior to treatment. If it is in area that cannot be covered, then home they go for diagnosis and treatment.

I've actually referred out more staff for it then students on my end. Usually staff with infants or toddlers at home. Their face when I see it and tell them to make an appointment with their doctor to rule out ringworm (though I can't diagnosis and tell them I'm never sure what it is) is priceless. I also ask them if their child at home has a similar rash and they have always said yes...

Specializes in school/military/OR/home health.

When I was a very new mom, the owner of the home daycare my daughter went to told me that my daughter had ringworm, without a doubt, and I needed to treat it. Being a nurse with no dermatology knowledge, I panicked and immediately started treating it with an antifungal. Well, it started spreading and looking worse. I took her to the pediatrician and lo and behold, it was eczema.

Just thought it was funny I had an experience in reverse of the normal ringworm vs eczema argument.

ArryOtter

40 Posts

We have a student diagnosed with nummular eczema and it does look pretty much exactly like ringworm. To the point, their Dr had them on an oral antifungal after it wouldn't go away for a while. Finally they decided it was eczema and treated with a different cream and it's faded a lot. Definitely had me fooled though.

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