Dermatophytosis (Tinea infection) infections are caused by microorganisms called dermatophytes, a group of fungi that selectively invade the keratinized tissues of humans and animals.
The growth of fungi is enhanced by the effect of certain factors, such the use of certain antibiotics, diabetes, frequent vaginal washes, intrauterine devices, pregnancy, poor hygiene and use of cortisone. Some forms of fungal infections are transmitted via skin contact, through the use of contaminated objects, such as combs, towels, seat backs, as well as through the sea water or the swimming pool water because of the humidity that favors fungal growth.
Clinical forms of fungal skin infections depending on the site localization:Infection of the scalp (Tinea capitis)
The clinical presentation of the disease varies from mild skin exfoliation to single or multiple patches of hair loss (plaques without the presence of hairs) or highly inflammatory purulent lesions.
Barber’s itch (Tinea barbae)
It is an infection around the bearded area of men. It can occur in the form of red plaques with exfoliation, follicular purulent lesions or it may have an atypical form. Ringworm (Tinea corporis)
It can be found on the trunk, upper and lower extremities, and is characterized by the occurrence of red plaques with exfoliation that are usually round in shape. These plaques have annular (ring) appearance with a central area of clearing. Jock itch (Tinea cruris)
It is a dermatophyte fungal infection of the thigh-groin region and the buttocks. It occurs as a well-demarcated red patch originally located unilaterally, which then extends bilaterally. Its surface may have scales or scab and its periphery may be raised with blisters.
Fungal infection of the hands and feet (Tinea manuum and tinea pedis)
Fungal infection of the hands usually affects the right hand of the right-handed people and the left hand of the left-handed people. It is distinguished in hyperkeratotic and dyshidrotic type. The first type is characterized by the presence of multiple small hyperkeratotic blisters which rupture and lead to the appearance of erythematosus scaly plaques. The dyshidrotic type is characterized by the appearance of multiple dispersed blisters or bullae. Following rupture they leave a pink, fluid flowing and thin exfoliation is observed in their periphery.
Fungal infection of the feet (Athlete’s foot) affects the iterdigital spaces (between the toes) but in chronic conditions it can spread to the entire foot. Initially itching and redness presents at the interdigital spaces which then become white with erosions due to wetting. On the contrary, the hyperkeratotic and dyshidrotic type appear on the soles with inflammatory hyperkeratotic and bullous plaques, respectively.Fungal nail infections – Dermatophytic onychomycosis
Is characterized by thickening of the nails (subungual hyperkeratosis), changing of the color of the nail and nail friability. Fungal nail infections – Candida nail infection
It can affect the skin surrounding the nail (paronychia) especially in people who tend to wash their hands frequently. In later stages the side of nail may appear yellow and onycholysis may occur. Candida can directly affect the body of the nail, but this occurs rarely.
Antifungal creams which are used in mild cases
Topical creams may contain ketoconazole or terbinafine depending on the type of fungus
Orally administered antifungal medicines (itraconazole, fluconazole, terbinafine)
The orally administered antifungal medicines are effective against blastomycetes and dermatophytes. They are administered for a period of 7‑10 days. Side effects include drug intolerance and elevated liver enzymes due to their metabolism in the liver.
Laser application for the treatment of fungal nail infections