Fungal Skin Infections  
 

Fungi usually make their homes in moist areas of the body where skin surfaces meet: between the toes, in the genital area, and under the breasts. Common fungal skin infections are caused by yeasts (such as Candida) or dermatophytes, such as Epidermophyton, Microsporum, and Trichophyton.. Many such fungi live only in the topmost layer of the epidermis (stratum corneum) and do not penetrate deeper. Obese people are more likely to get these infections because they have excessive skinfolds. People with diabetes tend to be more susceptible to fungal infections as well.

Strangely, fungal infections on one part of the body can cause rashes on other parts of the body that are not infected. For example, a fungal infection on the foot may cause an itchy, bumpy rash on the fingers. These eruptions (dermatophytids or identity or id reactions) are allergic reactions to the fungus. They do not result from touching the infected area.

Doctors may suspect a fungal infection when they see a red, irritated, or scaly rash in one of the commonly affected areas. They can usually confirm the diagnosis by scraping off a small amount of skin and having it examined under a microscope or placed in a culture medium where the specific fungus can grow and be identified.

Dermatophytoses (Ringworm, Tinea)

Dermatophytoses are fungal infections of the skin and nails caused by several different fungi and classified by the location on the body. Dermatophyte infections are also called ringworm or tinea.

  • Symptoms of dermatophytoses include rashes, scaling, and itching.
  • Doctors usually examine the affected area and view a skin or nail sample under a microscope or sometimes do a culture.
  • Antifungal drugs applied directly to the affected areas or taken by mouth usually cure the infection.

Dermatophytes are molds (fungi) that need the protein keratin for nutrition. Keratin is the structural material that makes up the outer layer of human skin. It is also the main structural material of hair and nails. To survive, dermatophytes must live on skin, hair, or nails (a nail infection is called tinea unguium or onychomycosis) Infection may occur almost anywhere on the skin, including the feet, scalp, body and beard area.

Dermatophyte infections in humans are caused by Epidermophyton,Microsporum, and Trichophyton. These organisms may inhabit a person permanently and never cause an infection. When they do cause an infection (resulting in ringworm or tinea), it is often because the affected area's blood supply is poor or because the person's immune system is suppressed (for example, by diabetes, cancer, or HIV infection). Unlike candidiasis, these fungal infections cannot infect internal organs or blood.

Symptoms

Dermatophyte infections are sometimes called ringworm or tinea. Despite the name, a ringworm infection does not involve worms. The name arose because of the ring-shaped skin patches created by the infection. Symptoms vary depending on the location of the infection. Most often, there is little or no inflammation and the infected areas are mildly itchy with a scaling, slightly raised border. These patches can come and go intermittently. Occasionally, inflammation is more severe and suddenly causes large and small fluid-filled spots to appear (usually on the foot) or an inflamed, swollen patch on the scalp that sometimes oozes pus

Diagnosis

Doctors can frequently identify a ringworm infection by its appearance. To confirm the diagnosis, doctors take skin scrapings and view them under a microscope. Doctors do a culture (the process of growing an organism in a laboratory for identification) only if the person has a scalp or nail infection.

Treatment

Treatment varies by site but always involves antifungal drugs that are applied to the affected area (topical) or are taken by mouth.

 

Reference: Merck Manual




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