Tinea — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 55 of 2024

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting tinea or death from tinea with the circumstances of a person's relevant service:

1. (1)
   having unprotected physical contact with: (a) a person infected with tinea; (b) an animal infected with tinea; (c) objects or surfaces contaminated with dermatophytes; (d) using communal showering or bathing facilities, swimming pool facilities or locker rooms; (e) soil contaminated with dermatophytes; or (f) a site of tinea on the same body; between 2 days and 3 weeks before the clinical onset or clinical worsening;

   Note: Examples of unprotected physical contact with a person could include contact sports and unarmed physical combat.

   Note: Examples of animals that can be infected with tinea include mammals, reptiles, birds, fish, arthropods, and worms.

   Note: Examples of objects that can be contaminated include brushes, hats, razors, footwear, towels or clothing. Examples of surfaces that can be contaminated include communal showers, baths, pools, locker rooms, and laundry facilities.

2. (2)
   having skin maceration at the affected site between 2 days and 3 weeks before the clinical worsening;

   Note: Situations in which skin maceration can occur are prolonged use of occlusive footwear or clothing, heavy sweating, and prolonged exposure to water.

   Note: skin maceration is defined in the Schedule-1 dictionary.

3. (3)
   having diabetes mellitus at the time of clinical worsening;
4. (4)
   having a substantially lowered immune function at the time of clinical worsening due to: (a) human immunodeficiency virus (HIV) infection; (b) glucocorticoids other than inhaled glucocorticoids; (c) solid organ transplant (excluding corneal transplant), stem cell or bone marrow transplantation;
5. (5)
   having topical glucocorticoid applied at the site of the tinea at the time of clinical worsening;
6. (6)
   having chronic renal failure at the time of clinical worsening of tinea unguium, as indicated by any of the following; (a) a glomerular filtration rate of less than 15 mL/min/1.73 m2 for a period of at least 3 months; or (b) undergoing chronic dialysis for renal failure;
7. (7)
   taking risankizumab and guselkumab at the time of clinical worsening;
8. (8)
   having peripheral artery disease of the lower limb at the time of clinical worsening of tinea affecting the foot;
9. (9)
   having chronic venous insufficiency of the lower limb at the time of clinical worsening of tinea unguium of the toes;
10. (10)
    having varicose veins of the lower limb at the time of clinical worsening of tinea unguium of the toes;
11. (11)
    having shaved the skin at the affected site within 3 weeks of clinical worsening;
12. (12)
    inability to obtain appropriate clinical management for tinea before clinical worsening;