Tinea versicolor: Symptoms, causes, and treatment

Tinea versicolor, now called pityriasis versicolor, is one of the most common skin infections in tropical and subtropical areas of the world. It is a fungal infection where an overgrowth of yeast leads to discolored patches on the body.

While the infection is not dangerous or contagious, it can be embarrassing for those dealing with it.

This common fungal infection disrupts the normal pigmentation of the skin. This results in small patches of skin that may be lighter or darker in color than surrounding skin. Tinea versicolor most commonly affects a person’s trunk and shoulders.

The infection is caused by the fungus Malassezia furfur. This fungus occurs naturally on the skin and can multiply in a yeast-like fashion, leading to tinea versicolor.

Share on PinterestTinea versicolor is a fungal infection of the skin that causes discoloration.

A person is likely to notice tinea versicolor only when spots start to appear on the skin. These spots may be lighter or darker than the surrounding the skin, and are often more noticeable when the surrounding skin is tan.

Though most common around the trunk and neck, these spots may appear anywhere on the body.

Further symptoms may include:

• Itchy patches of spots
• Spots that grow slowly over time, potentially forming into patches

Symptoms may disappear or become reduced in cooler weather and may return when the weather becomes hot and humid.

In tinea versicolor, a fungus that lives on healthy skin grows too quickly and causes the discolored patches of skin.

This overgrowth can be triggered by a combination of environmental and biological factors. These factors include the following:

• Oily skin
• Living in a hot, humid climate
• A weakened immune system
• Hormonal fluctuations

Teenagers often experience hormonal fluctuations, so teens may be more at risk of developing tinea versicolor. However, this infection can happen to people of all ages, ethnicities, and genders.

Tinea versicolor is not dangerous. However, anyone who develops a persistent skin rash should check with a doctor to rule out other more serious conditions.

Diagnosing tinea versicolor is often very straightforward. A doctor can diagnose it simply by looking at it.

If an adequate determination cannot be made with a simple exam, the dermatologist may try either scraping off a bit of infected skin to examine under a microscope or looking at the skin under a special lamp known as a Wood’s lamp.

When a dermatologist suspects tinea versicolor and examines the skin under a Wood’s lamp, they are looking for a distinct greenish skin color. It is this greenish color that confirms the infection.

A patient with diagnosed tinea versicolor should also check with a doctor if any of the following occur:

• Over-the-counter and self-care measures do not help the rash
• The rash spreads and covers a large area of the body
• The infection recurs

Share on PinterestTypical treatment options offered by doctors include specific creams and lotions.

Many treatment options are available for tinea versicolor. What a doctor uses to treat tinea versicolor depends on factors such as climate, area infected, thickness of the infection, and where on the body the infection appears.

The most typical treatment options include:

• Creams and lotions containing selenium sulfide, ketoconazole, or pyrithione zinc
• Medicated shampoos and body washes for use during times when flares are expected, such as during periods of very hot, humid weather
• Oral antifungal medication for use when large areas of the body are infected

It is important for people to follow all instructions on how to use the medicine. Failure to use the full amount or inconsistency in the usage may cause the infection to grow back quickly.

Home remedies and lifestyle tips

Tinea versicolor can be prevented and managed with some simple home remedies and lifestyle changes. Keeping the skin clean and oil-free is the most important thing that can be done to keep a tinea versicolor infection from occurring.

Over-the-counter lotions and creams can help both prevent and treat mild flare-ups. Some example products include:

• Clotrimazole cream or lotion
• Terbinafine cream or gel
• Miconazole cream
• Selenium sulfide 1 percent lotion
• Zinc pyrithione soap

Keeping the skin covered and avoiding prolonged exposure to ultraviolet light is also important. This includes ultraviolet light from being outside and from using a tanning bed.

Prevention

The most effective method of prevention is hygiene. Removing excess oils and dirt from the skin can help protect someone from contracting this infection.

Antifungal lotions and shampoos that are available over the counter offer a good means of prevention. These same products can also help keep a mild infection under control.

Additionally, taking some extra steps to keep dry in hot and humid weather and avoiding excessive exposure to sunlight may help to stop the growth of tinea versicolor.

Outlook

The outlook for people who contract tinea versicolor is very good. It is not generally painful, only mildly itchy, and is not contagious.

Despite being generally responsive to treatments, it is an easily recurring infection and difficult to get completely under control.

Tinea Versicolor | Michigan Medicine

Topic Overview

What is tinea versicolor?

Tinea versicolor (say “TIH-nee-uh VER-sih-kuh-ler”) is a fungal infection that causes many small, flat spots on the skin. The spots can be flaky or mildly itchy. The many small spots may blend into large patchy areas, usually on the oily parts of the upper body like the chest and back. The spots can be either lighter or darker than the skin around them.

What causes tinea versicolor?

Tinea versicolor is caused by a fungus. This fungus lives all around us, including on the skin. Normally, regular washing and showering removes dead skin and fungi (more than one fungus). But in hot and humid weather, such as during the summer or in tropical areas, fungi may grow more rapidly. As these fungi grow in number, their natural balance on the skin is affected, the normal color of the skin changes, and spots appear.

People with oily skin, especially teens and young adults, are more likely to get tinea versicolor. It does not spread from person to person.

Other things that increase your chance of getting tinea versicolor include:

• Having an impaired immune system, which can occur during pregnancy or from some illnesses.
• Using certain medicines, such as corticosteroids, antibiotics, or birth control pills.

What are the symptoms?

Symptoms of tinea versicolor include small, flat, round or oval spots that may, over time, form patches. The spots occur on oily areas of skin on the upper chest, back, or upper arms or, less often, on the upper thighs, neck, or face.

The spots can be lighter or darker than the skin around them. If your skin tends to get darker with sun exposure, the spots may be easier to see in the summer because they don’t tan with the rest of your skin. For people whose skin is lighter during the winter, the spots may be harder to see at that time of year.

The spots are flat and may be white, pink, red, tan, or brown, depending on your skin color. Each person’s spots are usually just one color. The spotted skin may be scaly. Although it’s not common, your skin may itch, especially when you are hot.

How is tinea versicolor diagnosed?

Your doctor often can tell if you have tinea versicolor by looking at the spots.

He or she may look at a sample (scraping) of the infected skin under a microscope. The test used most often for this is the KOH test. This can show whether the problem is caused by a fungus.

How is it treated?

Treatment can prevent the rash from spreading and improve the appearance of your skin. The condition is easy to treat. But not everyone chooses to get treatment. You only need to treat the infection if it bothers you or causes problems.

Products that you put on your skin (topical treatments) are the most common treatment for tinea versicolor.

• These may include antifungal shampoos, creams, and foams. Shampoos can be used on the body as well as the head and may be easier to use than creams or foams.
• Depending on how strong the medicine is, you may or may not need a prescription for these products. For example, shampoos used to treat tinea versicolor usually contain selenium sulfide. They are available in 2.5% strength with a prescription and in 1% strength without a prescription (for example, Selsun Blue, Head and Shoulders).
• You may need to use the product once or twice each day for 1 to 2 weeks or longer.

If the infection is severe, returns often, or does not get better with skin care, your doctor may prescribe antifungal pills. Pills tend to be easier for people to use than the products that you put on your skin. They may also work better at curing the rash. But they have side effects and can affect your heart and liver, so you may need blood tests while you’re taking them. People with liver problems, heart problems, or other health problems may not be able to take the pills.

Treatment kills the fungi quickly. But it can take months for the spots to disappear and for your skin color to return to normal. Also, the infection tends to come back after treatment. It may come and go over the years. In general, it tends to get better as you get older.

Can tinea versicolor be prevented?

If you have frequent problems with tinea versicolor, there are a couple of things you can do so that it is less likely to come back.

• Use antifungal skin creams, shampoos, or solutions at least once a month. Ask your doctor if you should use them more often.
• Talk to your doctor about taking antifungal pills once a month. Most people don’t need to do this, but it can help in some cases.

Some doctors believe that fungi that remain in clothing may cause the infection to return. Normal washing and cleaning is usually effective in removing the fungus from clothes. But for persistent tinea versicolor, you may need to dry-clean your clothes or wash them in the hottest possible water.

Symptoms, Causes, Diagnosis, and Treatment

Tinea versicolor, also known as pityriasis versicolor, is a superficial fungal infection caused by an overgrowth of yeast that occurs naturally on the skin. The rash that develops is characterized by distinct patches of discolored skin and mild itching that can be effectively treated with over-the-counter antifungal products, although it can take some time for skin color to return to normal. It’s most common in teenagers and young adults but isn’t contagious.

Tinea versicolor rash.
Raimo Suhonen / DermNet / CC BY-NC-ND

Symptoms

The tell-tale symptom of tinea versicolor is a rash that appears as small flat patches of discolored skin with defined borders. The rash may be hypopigmented (lighter than the surrounding skin) or hyperpigmented (darker than the surrounding skin), in shades ranging from white, red, pink, or brown.

Patches of tinea versicolor rash can slowly increase in size to join with nearby spots to create large areas of discolored skin. Sometimes the spots diminish or disappear during the cooler seasons, but come back with the return of hot, humid weather.

Sun exposure may make tinea versicolor more obvious because the affected areas won’t tan.

The infection most often develops on the back, chest, and shoulders, but can also appear on the arms, neck, and face. Other symptoms of tinea versicolor include mild itching and dryness or scaliness.

Causes

The yeasts that cause tinea versicolor belong to the Malassezia family, including Pityrosporum orbiculare and Pityrosporum ovale. These yeasts exist naturally on the outer layer of skin (stratum corneum) and hair follicles of normal, healthy skin.

Though generally harmless, these yeasts can sometimes experience overgrowth and convert into their pathogenic mycelial phase known as Malassezia furfur, resulting in the outbreak of the rash.

Hypopigmentation occurs when the yeast produces a chemical that turns off melanocytes—special skin cells that produce melanin, the pigment responsible for skin, eye, and hair color. Hyperpigmentation is the result of inflammation caused by the fungal infection.

There are a number of things that lead to yeast overgrowth, including:

Tinea versicolor can occur at any age but is most common in adolescence and early adulthood (a time when the sebaceous glands are particularly active). It’s also commonly seen in tropical and semi-tropical climates.

Diagnosis

Most cases of tinea versicolor can be diagnosed by a doctor based on the appearance of the rash, although it can sometimes be confused with a number of other rashes, including:

When additional testing is necessary to differentiate tinea versicolor from other rashes, the diagnosis can be confirmed with any of several tests:

• A KOH test can confirm the rash’s characteristic “spaghetti and meatballs” appearance beneath the microscope.
• The Wood’s light examination will make the yeast glow a pale yellow beneath a black light.
• Fungal cultures, while infrequently used, can confirm infection by growing the fungus on a culture medium.

Treatment

Tinea versicolor almost always can be effectively eradicated with a topical, over-the-counter (OTC) antifungal soap, shampoo, or cream. Zinc pyrithione 1% shampoo, which is easier to find than the soap, is also effective against tinea versicolor.

Among the most common such products are:

• Lotrimin AF (clotrimazole)
• Selsun Blue (selenium sulfide)
• Zinc pyrithione soap or shampoo
• Monistat (miconazole)
• Lamisil (terbinafine)

For cases of tinea versicolor that are especially severe or that don’t respond to OTC treatments, prescription medications may be required. Oral antifungals such as Diflucan (fluconazole) as well as prescription antifungal creams and shampoos, such as Nizoral (ketoconazole), are among the options often used.

Note that even though treatment kills the pathogenic yeasts, skin discoloration can persist for weeks or months until melanocytes are able to produce melanin again.

Tinea versicolor has a recurrence rate of around 80% after two years, and re-treatment may be needed. For people who are prone to developing tinea versicolor, regular use of an antifungal soap or wash can help prevent the rash from recurring. Once a month is customarily recommended, but some people may need to use antifungal products more often, especially in the warm weather months.

A Word From Verywell

Although tinea versicolor is a benign skin condition, people who have it often feel self-conscious about the skin discoloration it causes. The best way to deal with any embarrassment caused by this rash is to take steps to prevent it from worsening until the skin returns to normal.

The first of these is the be highly vigilant about sun protection. Any degree of tanning can exacerbate the contrast between the tanned skin and skin affected by the rash.

Equally important is to steer clear of oily body lotions or creams, as oil can make the rash worse. For sunscreen, choose a product that is labeled oil-free or noncomedogenic.

Fungal Infections of the Skin

Tinea Versicolor:

Tinea Versicolor is a common skin condition that is caused by an overgrowth of fungus that normally resides on our skin. This overgrowth results in uneven skin color and sometimes scale. It is usually completely without symptoms, but occasionally can be itchy. It most commonly appears as white-to-pink-to-tan-to-dark-brown spots on the skin of the neck, upper back, shoulders, and chest. It is more common in warm/moist seasons and climates. Transplant recipients are more prone to getting Tinea Versicolor due to their immunosuppression. It is generally not an infection that will make you ill. It is diagnosed when examination of a skin scrapping under the microscope shows fungus.

Note: Please click on the thumbnails below to display a larger image.

It is treated with either topical or oral medications. In transplant recipients, treatment with oral medication is avoided if possible, secondary to the potential drug interactions with their immunosuppressive medications and side effects of the oral antifungals. Topical selenium sulfide or topical antifungal creams are commonly used and found very effective. Tinea versicolor commonly reoccurs. To prevent recurrences, treatment with topical selenium sulfide once to twice a month is often effective.

Onychomycosis:

This is a fungal infection of the nails. This more commonly affects the toenails than the fingernails. Infected nails appear thick, discolored (often yellow or brown), and with crusty debris under the nail edge or on top of the nail. These nails can be difficult to cut and can cause irritation to the skin around them. This is a very common infection. Infection of the nails with fungus can be difficult to treat. Treatment often requires an oral antifungal medication. In transplant recipients these medications have to be used with great caution due to their risk of drug interaction with the immunosuppressive medications the transplant recipient is taking, and due to the side effects of the antifungal medication (especially on the liver of liver transplant recipients). Treatment with topical antifungal creams is not effective for treatment of the nail. There are medicated nail polishes available with few side effects.

Recommended steps to control fungus are as follows:

• Wear dry wool or cotton socks (avoid synthetic socks made of nylon
• Wear shoes that allow the foot to breath, such as leather
• Wear dry shoes
• Apply antifungal powder to shoes

Thick nails can be difficult to care for. It is recommended that the toenails be cut straight across, so as to avoid ingrown nails and pain. Routine toenail trimming by a podiatrist may be very beneficial.

Tinea pedis:

This is a fungal infection of the feet, often referred to as athlete’s foot. Affected feet are often itchy. The sole of the foot will appear red with scale and occasional vesicles (small bubbles just under the skin surface). The space between the toes is commonly involved with accumulation of white appearing scale and occasional small sores. It is diagnosed when examination of a skin scrapping under the microscope shows fungus.

This can generally be treated with over the counter antifungal creams used regularly. Some cases will require evaluation and treatment by your physician. Care should be taken to control re-infection. See recommended steps to control fungus, listed above in the onychomycosis section.

Note: Please click on the thumbnails below to display a larger image.

Tinea cruris:

This is a fungal infection of the groin. It is characterized by red, scaly skin that can become “raw”. It is often very itchy and can burn, if very irritated. It is diagnosed when examination of a skin scrapping under the microscope shows fungus. It is treated with topical antifungal creams. It is important to keep this area very dry by toweling dry after a shower and then using a cool blow dryer or fan to the area. Loose fitting clothing helps to avoid excess irritation.

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What Is Tinea Versicolor? Symptoms, Causes, Treatment, and Prevention

Favorite Orgs for Essential Tinea Versicolor Info

Mayo Clinic

The Mayo Clinic offers a wealth of patient care information related to various health topics, including tinea versicolor. You’ll find an overview of symptoms, causes, complications, treatments, and prevention tips. Got a skin concern? Use the website’s Find a Doctor tool to locate a dermatologist.

American Academy of Dermatology (AAD)

The AAD is another excellent source for trustworthy information about tinea versicolor. Its website not only provides a comprehensive overview of this skin infection but you’ll find self-care tips and a handout on how to care for a child with tinea versicolor. There’s also a tool to locate a board-certified dermatologist near you.

American Osteopathic College of Dermatology (AOCD)

The mission of the AOCD is to provide support and education in the field of dermatology. Its website provides images of tinea versicolor, as well as information on symptoms and causes. There’s even a video explaining how to self-treat the infection at home.

KidsHealth

Looking for more information on tinea versicolor? KidsHealth provides resources for parents, kids, teenagers, and educators. Other useful tools on the website include videos, expert answers, and newsletters.

Favorite Resources for Online Support

MDLive

Need advice on a skin condition? For $75 (or less) you can speak with an MDLive dermatologist online and get a quick answer anytime, anywhere. Send a few photos of your skin for a doctor to diagnose your condition — and if necessary, they’ll write a prescription.

SkyMD

This is another affordable way to consult a dermatologist online. The board-certified dermatologists from SkyMD are available 24/7 to diagnose your skin condition and write a prescription, if necessary.

Pediatric Fungal Infections | Children’s National Hospital

What are fungal infections?

Skin fungi live in the top layer of skin cells in moist areas of the body, such as between the toes or in the groin and diaper area. Sometimes, the normal balances that keep fungi in check are upset, resulting in an infection.

Some fungal infections cause only a small amount of irritation, while other types penetrate deeper and can cause itching, swelling, blistering, or scaling.

In some cases, fungal infections can cause reactions elsewhere on the body. A child can develop a rash on the finger or hand associated with an infection of the scalp or foot, for instance.

There are many types of fungal skin infections that require clinical care by a physician or other healthcare professional. Those listed below are the most common.

Tinea Infections (Ringworm)

What is ringworm (tinea infection)?

Different fungi, depending on their location on a child’s body, cause ringworm. Ringworm is characterized by ring-shaped red, scaly patches with clear centers. The risk of contracting ringworm increases if the child:

• Is malnourished
• Has poor hygiene
• Lives in a warm climate
• Has contact with other children or pets that have ringworm
• Is immunocompromised by disease or medication

Did you know?

Ringworm is a misleading term that refers to the circular appearance of the fungal lesion. There are no worms involved.

What are the most common types of ringworm?

The most common types of ringworm include the following:

• Athlete’s foot (tinea pedis or foot ringworm)
  This common condition mostly affects teen and adult males, and is rarely found in children before puberty. Many things can cause athlete’s foot, include sweating, not drying the feet well after swimming or bathing, wearing tight socks and shoes, and warm weather conditions. Symptoms of athlete’s foot may include:
  • Whitening of the skin between the toes
  • Scaling of the feet
  • Itchy rash on the feet
  • Blisters on the feet
• Jock itch (tinea cruris or groin ringworm)
  This condition is more common in males and occurs more often during warm weather conditions. It is very rare in females. Symptoms of jock itch may include:
  • Red, ring-like patches in the groin area
  • Itching in the groin area
  • Pain in the groin area
  • Does not usually involve the scrotum
• Scalp ringworm (tinea capitis)

Scalp ringworm is highly contagious, especially among children. It occurs mainly in children between the ages of 2 and 10, but rarely in adults. Symptoms of scalp ringworm may include:

• Red, scaly rash on the scalp
• Itching of the scalp
• Hair loss on the scalp
• Rash elsewhere on the body

Ringworm of the scalp can also develop into a kerion, a large, tender lesion over the area of the initial ringworm. This is caused by a hypersensitivity to the ringworm and may be associated with a rash elsewhere on the body and tender lymph nodes in the neck.

• Nail ringworm (tinea unguium)
  Nail ringworm is an infection of the finger or toenail, characterized by a thickened, deformed nail. This condition is found more often in toenails than fingernails, and is more common in adolescents and adults than young children. Symptoms of nail ringworm may include:
  • Thickening of the ends of the nails
  • Yellow color to the nails
• Body ringworm (tinea corporis)
  This skin infection is characterized by a ring-like rash on the body or the face. This occurs in all ages and is more common in warmer climates. The symptoms of body ringworm may include:
  • Red, circular lesion with raised edges the middle of the lesion may become less red as the lesion grows
  • Itching of the affected area

Ringworm resembles many skin conditions. Always consult a physician for a diagnosis.

How is ringworm diagnosed?

Ringworm is usually diagnosed based on a medical history and physical examination of the child. The lesions of ringworm are unique, and usually allow for a diagnosis simply on physical examination. The physician may also order a culture or skin scraping of the lesion to confirm the diagnosis.

What is the treatment for ringworm?

Because the fungi can live indefinitely on the skin, recurrences of ringworm are likely, and treatment may need to be repeated. Specific treatment will be determined by the physician based on:

• The child’s age, overall health, and medical history
• Extent of the condition
• Location of the ringworm
• The child’s tolerance for specific medications, procedures, or therapies
• Expectations for the course of the condition
• Child or parent’s opinion or preference

Treatment for scalp ringworm (tinea capitis) may include the following:

• Oral anti-fungal medication – this medication is usually prescribed for four to eight weeks. Some children require longer treatment
• Use of a special shampoo (to help eliminate the fungus)
• If a kerion is present (a large, tender, swollen lesion), the physician may order additional medications, such as steroids, to help reduce the swelling
• Ringworm of the body, groin, and foot is usually treated with a topical anti-fungal agent or an oral antifungal medication. The length of the treatment depends on the location of the ringworm

What is tinea versicolor?

Tinea versicolor is a common fungal skin infection characterized by lighter or darker patches on the chest or back. This infection, which prevents the skin from tanning evenly, occurs most often in adolescence and early adulthood.

What are the symptoms of tinea versicolor?

Typically the only symptom of tinea versicolor is white or light brown patches. The patches may scale slightly, but they rarely itch or hurt. Other common characteristics of the infection include:

• White, pink, or brown patches
• Infection only on the top layers of the skin
• Rash on the trunk
• No rash on the face
• Patches worsen in the heat or humidity
• Patches worsen if the child is on steroid therapy or has a weakened immune system
• Patches are most noticeable in the summer

The symptoms of tinea versicolor may resemble other skin conditions. Always consult a physician for diagnosis.

How is tinea versicolor diagnosed?

Tinea versicolor is usually diagnosed based on a medical history and physical examination of the child. The patches are unique, and usually a diagnosis can be made on physical examination. The physician may also use an ultraviolet light to see the patches more clearly or take skin scrapings of the lesions to confirm the diagnosis.

What is the treatment for tinea versicolor?

Treatment usually includes the use of dandruff shampoo on the skin as prescribed by the physician. The shampoo is left on the skin overnight and washed off in the morning, and may be required for several nights.

Tinea versicolor usually recurs, requiring additional treatments, and sometimes improves temporarily. The physician may prescribe topical creams, oral antifungal medications, or monthly shampoo treatments.

This infection can also cause a change in skin color, which can take several months to return to normal.

Identifying and Managing Fungal Skin Infections

Fungal skin infections typically will not go away by themselves and may spread if not appropriately managed.¹ Fungal skin infections are common worldwide diseases; an estimated 20% to 25% of the world’s population suffers from one of them.¹ The most common infections in prepubertal children are ringworm on the scalp (tinea capitis) or the body (tinea corporis). In adolescents and adults, the most common infections are jock itch (tinea cruris) and athlete’s foot (tinea pedis) (figure).³

Fungal skin infections are more likely to develop in people living in tropical climates or who wear tight, nonbreathable clothing. Obese individuals or persons with diabetes also are at higher risk.¹

ATHLETE’S FOOT (TINEA PEDIS)

What Is It?

Athlete’s foot, the most common fungal skin infection, occurs when feet perspire and warm moisture accumulates, especially on the skin in the areas between the toes.⁴ The genus Trichophyton, a fungus, is the most common cause. Risk factors include wearing tight shoes or exposing one’s feet to the floors of communal showers or bathrooms where others walk barefoot.² The 3 most common presentations are interdigital, moccasin, and inflammatory.¹

Signs and Symptoms

Interdigital: The most common type of athlete’s foot, it typically occurs between the toes. The skin there may peel, crack, or become red and itchy.¹

Moccasin: This form thickens the skin on the sole and sides of the foot. The thickened skin becomes dry and may crack.¹

Inflammatory: Less common than the other forms, this type typically presents as fluid-filled blisters, possibly uncomfortable or painful, on the bottom of the feet. They may also appear between the toes, on top of the foot, or on the heel.¹

Treatment

Athlete’s foot is generally well managed with topical antifungal creams, such as terbinafine or butenafine. Patients who are predisposed to severe forms of athlete’s foot should consult a physician about taking oral medications such as itraconazole or terbinafine tablets. Susceptible patients include those who have the moccasin or inflammatory presentation, are unresponsive to topical treatment, or have diabetes.^3,4 See table for more medication information. To help eliminate the infection and prevent recurrence, patients should wear wide, permeable footwear, frequently change socks, and manually dry the skin in between the toes after bathing.^3,4

JOCK ITCH (TINEA CRURIS)

What Is It?

This fungal skin infection involves the upper inner thighs and usually occurs in young males in whom moisture tends to accumulate between the scrotum and thigh. Though jock itch may occur on 1 or both sides of the thighs, the scrotum is minimally affected.3 Trichophyton is the most common cause of jock itch. Risk factors include living in a warm climate, often wearing moist or tight clothing, and being obese.²

Signs and Symptoms

Jock itch presents as a rash with a scaly, pink border, which may become itchy and painful.² To distinguish jock itch from erythrasma, a bacterial skin disease, a clinician may perform a test called a Wood’s lamp examination; erythrasma, but not jock itch, will produce a coral red fluorescence.³

Treatment

Jock itch is managed with topical antifungal creams, lotions, or gels, such as terbinafine, ketoconazole, miconazole, clotrimazole, naftifine, and potentially ciclopirox.^2,4 Patients who do not respond to these medications or have inflamed, widespread infections should consult a doctor about taking oral medications such as itraconazole or terbinafine tablets (table).²

BODY RINGWORM (TINEA CORPORIS)

What Is It?

Body ringworm can form anywhere on the skin and spread to other body parts, and to other people in close bodily contact with the original patient. Fungi such as those in the genera Trichophyton or Microsporum typically cause this infection.⁴

Signs and Symptoms

Body ringworm presents as pink or red patches that have scaly borders and a clear center. These “rings” generally range from 1 cm to 5 cm in width, but can be larger. Body ringworm— sometimes itchy or uncomfortable—may be mistaken for other dry-skin conditions such as eczema or psoriasis. To determine the diagnosis, a clinician can examine a sample of infected tissue treated with potassium hydroxide preparation under a microscope, looking for the telltale fungus.³

Treatment

For mild to moderate body ringworm, treatment involves topical anti-fungals such as ciclopirox, naftifine, or terbinafine. ⁴ Patients who do not respond to these treatments or have other debilitating diseases should consult a physician about taking oral medication such as itraconazole or terbinafine tablets (table).²

SCALP RINGWORM (TINEA CAPITIS)

What Is It?

Highly contagious, scalp ringworm most commonly occurs in children, particularly children of African heritage aged 3-9 years.^{3, 4} Trichophyton fungus causes about 95% of cases.³

Signs and Symptoms

Early signs include a dry, itchy rash on the head. Sometimes, there may be patches of hair loss or flaking that resembles dandruff. The classical presentations of scalp ringworm, however, are “black dot”—in which hair shafts break at the scalp surface—and “gray patch”—in which hair shafts break above the surface, leaving short stubs.2,3

Scalp ringworm may progress to form a kerion—a large, swollen, painful patch that crusts and oozes pus. Kerions develop when the body’s immune system reacts to the fungus and tries to attack it.⁴ The infected patient may also present with swollen, enlarged lymph nodes, a factor that helps clinicians differentiate scalp ringworm from other dry skin conditions.^1,3

Treatment

Scalp ringworm must be treated with systemic anti-fungal medications because topical, external options will not penetrate the hair shaft.^1,3 Systemic options include terbinafine (better for those infected with Trichophyton) or griseofulvin (better for Microsporum).⁵ Patients who are not documented with Trichophyton and develop a kerion must be promptly treated with griseofulvin; failure to do so may result in scarring or hair loss.³ A short course of a corticosteroid like prednisone is appropriate for severe lesions or kerions.⁴

Along with taking medication, patients must wash with 1% or 2.5% selenium or 2% ketoconazole shampoo at least twice a week to reduce transmission. While children may attend school during treatment, imidazole or ciclopirox cream should be applied to their affected scalp areas to minimize the chance of infecting others.⁴

WHEN SHOULD A PATIENT TALK TO A DOCTOR?

While over-the-counter topical antifungals are appropriate first choices for mild skin infections known to be fungal, an affected patient should contact a physician if adverse effects are noted, if symptoms have not improved after the recommended treatment duration (typically 2-4 weeks), or if there is any doubt about the nature of the infection. A physician may perform examinations to confirm or change the diagnosis, and, if necessary, prescribe stronger oral antifungal medications or anti-inflammatory corticosteroids. Patients with diabetes or another immunocompromising condition should speak with a physician before initiating any antifungal treatment.^6-11

REFERENCES

1. Salmon N, Fuller C. Fungal skin infections: current approaches to management. Prescriber. 2013;24(9):31-37. doi: 10.1002/psb.1046.

2. Aaron DM. Overview of fungal skin infections. Merck Manual Consumer Version website. www.merckmanuals.com/home/skin-disorders/fungal-skin-infections/ overview-of-fungal-skin-infections. Updated April 2017. Accessed June 15, 2017.

3. Ely JW, Rosenfeld S, Seabury Stone M. Diagnosis and management of tinea infections. Am Fam Physician. 2014;90(10):702-710.

4. Aaron DM. Overview of dermatophytoses. Merck Manual Professional Version website. www.merckmanuals.com/professional/dermatologic-disorders/ fungal-skin-infections/overview-of-dermatophytoses. Updated April 2017. Accessed June 15, 2017.

5. Elewski BE, Cáceres HW, DeLeon L, et al. Terbinafine hydrochloride oral granules versus oral griseofulvin suspension in children with tinea capitis: results of two randomized, investigator-blinded, multicenter, international, controlled trials. J Am Acad Dermatol. 2008;59(1):41-54. doi: 10.1016/j.jaad.2008.02.019.

6. Terbinafine hydrochloride cream [package insert]. Parsippany, NJ: Novartis Consumer Health, Inc; 2008.

7. Lexicomp Online database. https://online-lexi com.proxy.libraries.rutgers.edu/ lco/action/doc/retrieve/docid/patch_f/750. Accessed June 7, 2017.

8. Butenafine hydrochloride cream [package insert]. Whitehouse Station, NJ: Bayer HealthCare LLC; 2017.

9. Miconazole nitrate cream [package insert]. Sarasota, FL: WellSpring Pharmaceutical Corporation; 2010.

10. Clotrimazole cream [package insert]. Woonsocket, RI: CVS Pharmacy; 2013.

11. Naftifine hydrochloride cream [package insert]. Hayward, CA: Impax Generics; 2017.

Lydia Chou, PharmD, is a graduate from Rutgers University’s Ernest Mario School of Pharmacy.

90,000 Types of fungal infections, treatment of fungal infections

The term fungal infections in dermatology means an acute or chronic disease caused by a fungal flora, which can be both pathogenic for humans and conditionally pathogenic, that is, causing a pathological process under certain circumstances, a decrease in resistance on the part of the human body.

The world of mushrooms is extremely wide and diverse.About 400 types of fungi are known that can cause disease in humans, affecting both the skin and mucous membranes, and internal organs, causing severe damage to the health of the person who is the carrier of the infection.

In recent years, due to the massive, uncontrolled use of antibacterial agents, immunosuppressants by the population, the growth of diseases associated with impaired immunity and various endocrinopathies, fungal infections have become widespread.

Classification of fungal infections

There is a classification of H.D. Sheklakov:

• Keratomycosis (versicolor versicolor, piedra, etc.)
• Dermatophytosis (epidermophytosis, trichophytosis, microsporia, rubromycosis, etc.)
• Candidiasis (superficial candidiasis of the skin and mucous membranes, visceral candidiasis)
• Deep mycoses (sporotrichosis, chromomycosis)
• Pseudomycosis (erythrasma, actinomycosis).

However, in many countries of the world, the classification of fungal diseases according to the localization of the pathological process is adopted:

• Tinea pedis – mycosis of the feet.
• Tinea corporis – mycosis of the smooth skin of the trunk.
• Tinea cruris – inguinal mycosis.
• Tinea capitis – mycosis of the scalp.
• Tinea unguim – onychomycosis.
• Tinea manum – mycosis of the hands.
• Tinea barbae – mycosis of the face.

The source of infection in case of a fungal infection can be either a sick person or animal, as well as objects of everyday use contaminated with fungi, products of agricultural vital activity.Often, with a fungal infection, a person himself acts as a direct carrier and host of an infection that occurred as a result of a general decrease in immunity and developed from a conditionally pathogenic flora that is normally present on the skin and does not cause a disease under the condition of healthy immunity. Thus, the presence of a fungal infection on the skin may be indicative of a general health disorder in the patient. Fungal diseases are often associated with a disease such as diabetes mellitus.

Skin lesions in a fungal infection can be both localized and widespread, the severity of subjective symptoms can range from the complete absence of any subjective symptoms, to severe itching and soreness of the lesion sites that disrupt the patient’s usual lifestyle, leading to a decrease in the quality of human life.

Microscopic and cultural methods are used for laboratory diagnostics of fungal infections, in addition, PCR diagnostics are used.

The largest specific gravity in the daily practice of a dermatovenerologist was received by various candidiasis, lesions of the skin and nail plates with yeast fungi of the genus Candida. With this fungal infection, folds large on the human body and small folds on the hands and feet can be affected, the lesion can be widespread, often the manifestation of candidiasis of the anogenital zone. Often with candidiasis, the nail plates suffer, and onychomycosis develops. The second in frequency of seeking medical help are epidermophytosis with lesions of large skin folds, and the third – rubrophytosis with a predominant lesion of the skin of the feet.Fungal infections, accompanied by damage to the hair, are still quite common in the human population: trichophytosis and microsporia.

The presence of a long-term current fungal infection in humans is the basis for a comprehensive examination of the patient, aimed at studying the reasons for the decrease in skin immunity. Timely therapy with antifungal drugs should be carried out taking into account the identified concomitant pathology that led to the development of a fungal infection in the patient.

URO-PRO: treatment of fungal infections

Long-term successful experience in the management of patients with various fungal infections by specialists dermatologists in the Uro-Pro clinic, individual selection of drug therapy and development of measures to localize the infection, active participation in solving treatment problems with mutual cooperation of the doctor and the patient, is a guarantee of the patient’s complete recovery, with reducing the risk of re-infection with a fungal infection.When choosing a drug treatment, we proceed, first of all, from the concept of the expediency of prescribing, taking into account the possible risk associated with the use of various chemotherapeutic drugs. All medicines used by us in the treatment of fungal infections are certified and have undergone strict clinical control. Taking into account the totality of the patient’s clinical symptoms, the doctor selects medicines and treatment tactics that will not only contribute to the treatment of skin pathology, but will serve to strengthen the general health of the patient in every possible way, and therefore will serve as the basis for improving the quality of his life.Complex rational therapy of fungal pathology is the basis of your health and the health of your loved ones!

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90,000 Treatment of microses (skin fungi) in Moscow at the Family Doctor clinic

Mycoses is a collective definition that includes fungal diseases.Most often, such an infection affects areas of the skin, mucous membranes, nails. Mycosis is transmitted through direct contact with an infected person, as well as the use of general hygiene items, shoes, clothing. Patients with diseases of the feet and hands often visit clinics of mycoses in Moscow. These are chronic ailments, often exacerbated in the summer.

Symptoms of mycoses

Today, the most common disease is mycosis or foot fungus.It affects people of all ages. The main symptoms of the disease include the following:

• redness, swelling of the skin between the fingers;
• the appearance of skin cracks;
• peeling, itching;
• thickening of the skin of the fingers, feet;
• unpleasant smell from the feet;
• sweating feet
• the appearance of skin rashes.

Onychomycosis is just as common.This is a nail fungus that can also affect the feet and fingers. In some cases, pathology is observed for a long time on one nail plate. This usually occurs as a result of injury. The main symptoms include thickening, yellowing, or a brownish tint to it. As the disease progresses, the nail becomes more fragile, brittle, and easily crumbles.

Damage to the scalp leads to flaking of the skin, dandruff, itching, redness. Mycosis of smooth skin – pityriasis versicolor – manifests itself as small spots on the skin of the back, armpits, chest, shoulders.

Hazard and Problems

It is important to contact the clinic dealing with the treatment of mycoses in Moscow as soon as possible. These diseases are treated by a mycologist, a dermatologist. Fungal infection in the absence of proper treatment is dangerous in that it is the entrance gate for the attachment of a secondary, bacterial infection. And in this case, more serious, expensive and long-term treatment with several types of drugs will be required.

The waste products of fungi can provoke severe allergic diseases, and the disease itself depletes the immune system.As a result, bronchial asthma, persistent dermatitis, and vasculitis may develop.

A fungal infection that accompanies diabetes mellitus or other disease greatly complicates treatment and can cause serious complications.

A fungus of the skin or nails causes serious psychological discomfort: the symptoms of the disease are visible to the naked eye, visiting swimming pools, gyms or other public places in the presence of an ailment will not work, especially if a doctor’s certificate is required there.In addition, a sick person is a danger to others: he can be a source of infection for loved ones, including children.

Mycoses, which were not cured in time, entail a number of consequences, including physical ones: thickening, deformation of the nails greatly complicates walking and wearing shoes, interferes with normal physical activity. Constant itching, burning sensation cause discomfort both during the day and during a night’s sleep.

Professional restrictions can become a real problem: a person with a fungus is prohibited from working in the service sector, catering.

Getting rid of the fungus is real. Modern methods of treatment allow you to completely recover from mycosis, restore the normal structure of the skin, mucous membranes, nails. Remember that a healthy nail grows 2 mm per month. The sooner you start therapy, the sooner you will forget about the problem.

Features of treatment

Modern clinics of mycoses in Moscow practice an individual approach to therapy: the selection of a treatment method is carried out taking into account the severity of the case, the characteristics of the patient’s health, and the duration of the disease.

The basis of therapy is antifungal drugs. However, before prescribing them, the doctor will refer you for a thorough diagnosis. The following health assessment methods may be required:

• scrapings of skin, nails – to determine the type of fungus;
• laboratory blood tests – to assess the state of the immune system;
• biochemical blood test – to determine the state of the liver and make the right decision about whether antimycotics will need systemic action.

At risk for the development of fungal diseases are people whose relatives are sick with mycosis, as well as those who often visit public baths, swimming pools, gyms with showers, etc. It is necessary to contact a dermatologist or mycologist when the first unpleasant symptoms appear, this will prevent the development of complications and shorten the treatment time.

The specialist will prescribe systemic and local antifungal agents. Taking drugs inside is required in relatively severe cases, as a rule, local treatment with ointments, creams, sprays, varnish with antimycotic components is sufficient.

Therapy can take from several weeks to several months. In some cases, the use of keratolytic agents is required to soften the nail plate and remove it painlessly.

The doctor will also be sure to give recommendations regarding the hygiene and handling of shoes and clothes. This is important for the prevention of self-infection, as well as infection of family members.

A visit to a mycoses clinic in Moscow is an optional measure, a qualified dermatologist of a multidisciplinary medical center will cope with the tasks.When choosing the latter, take into account such a factor as the possibility of passing all the necessary tests in one place – this will save time and money.

For the treatment of fungal diseases, you can contact the Family Doctor clinic. Our specialists have many years of successful experience in the treatment of mycoses, and they have at their disposal advanced equipment and extensive laboratory facilities for making an accurate diagnosis.

To make an appointment at a convenient time for you, call the unified contact center in Moscow +7 (495) 775 75 66, fill out the on-line registration form or contact the clinic’s registry.

Cost

dermatovenerologist, oncologist, cosmetologist, Ph.D.

dermatovenerologist, cosmetologist, trichologist

dermatovenerologist

dermatovenerologist

dermatovenerologist, trichologist, cosmetologist, Ph.D.

dermatovenerologist, trichologist, Ph.MD, associate professor

90,000 Fungal skin diseases: symptoms and prevention

Today, fungal skin diseases are an urgent problem for many people. The impetus for the development of mycosis can be not only walking barefoot in public places or poorly fitted shoes, which provide an optimal climatic environment for fungus (fever and sweating of the feet), but also a weakening of the immune system, as well as endocrine diseases of the pancreas (diabetes mellitus) or the thyroid gland.

Fungi are everywhere – in the air, in the soil, on the skin of every person. A healthy body is in symbiosis with a fungus. But as soon as the conditions change, and the fungus immediately breaks “neutrality.” How to protect yourself from fungal infection, what to do in case of infection and how long to treat the consequences of mycosis Beauty HUB asked the expert.

– Yaroslav, tell us what a fungal skin disease is and how it manifests itself.

– Fungal skin lesions are diseases caused by parasitic fungi that, when in contact with the skin, retain the ability to grow rapidly and aggressively.Fungal skin diseases can be divided into four large groups.

1. Keratomycosis – diseases in which fungi parasitize in the superficial parts of the stratum corneum of the epidermis and do not cause acute manifestations of inflammation, and, therefore, rarely cause itching and discomfort. Often manifested by various spots on the skin of the back, chest, shoulders. The color of the affected area can be from pale pink to dark brown, while there may be slight peeling of the skin and intermittent itching.

2. Dermatomycosis – diseases in which parasitic fungi grow in deeper layers of the skin and can affect hair and nails (onychomycosis). This group of fungal infections is highly contagious (infectious). The rash may be accompanied by allergy-like blisters near the primary lesion. Clinical signs: redness of smooth skin, skin folds, color from pink to bright red. In places of inflammation, hair may fall out; the affected nails change shape, exfoliate, turn yellow, brown, and an unpleasant odor may appear.

3. Fungal diseases that cause Malassezia and Candida can be distinguished into separate groups. These representatives can normally “live” on the skin and mucous membranes of a person (saprophytes). But under certain conditions (antibiotic therapy, decreased immunity , violation of hygienic care) can acquire pathogenic properties and cause diseases such as candidiasis (mucous membranes of the mouth, genitals, rarely smooth skin, nails), seborrheic dermatitis, folliculitis, reticular papillomatosis.Diseases can be accompanied by severe discomfort (itching, burning). Visual signs: skin and mucous membranes are red, irritated.

– Where is the most common infection of the fungus and how is it transmitted?

– Unfortunately, everyone can become infected with a fungus, because we have a large number of social contacts, we are constantly surrounded by many people. Sick people carry a fungal infection, therefore, it is more likely to become infected when visiting the pool, saunas, water parks, baths, beauty salons, hairdressers, etc.e. The likelihood of getting sick increases in the elderly, with diabetes mellitus, diseases accompanied by impaired blood circulation in the extremities, which can lead to violations of the barrier properties of the skin.

– How to treat onychomycosis? Is it possible to fix the problem on my own or only under the supervision of a doctor?

– Diagnosis and treatment of onychomycosis should only take place under the supervision and supervision of a physician. At the same time, it is important to correctly carry out the diagnosis, which the patient cannot carry out on his own due to the lack of knowledge and experience in this area, as well as the appropriate equipment.

As for the treatment, it all depends on the location of the lesion, the depth of the lesion of the skin, the area. Treatment requires a systematic and precise implementation of prescriptions. Otherwise, a positive result will not be achieved, and the disease may become topical. In the treatment of onychomycosis, various dosage forms are used: creams, ointments, special kits, etc. A systemic approach includes the need to take antifungal pills. At the consultation, the dermatologist must explain in detail and justify the principles of treatment and the importance of its correct implementation.

– How long does it take to recover from a fungus?

– Depending on the location of the lesion, the area and depth of penetration of the fungal infection, treatment takes from several weeks (21 days) to several months (3-9 months).

– What can you recommend to prevent this disease? Your top tips for your patients.

– My main advice is to live a fulfilling, happy life. And stick to these simple rules.

1. Observe personal hygiene.
2. Use personalized bath accessories.
3. Do not measure shoes on bare feet in stores, clothes on the body without underwear.
4. Have your own set of manicure and pedicure tools.
5. If you are concerned about something, seek the help of a dermatologist.

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Mitsetoma

Mitsetoma usually appears as
chronic foot disease, but can affect any part of the body.Infection,
most likely due to the penetration of some species
fungi or bacteria in the subcutaneous tissue due to trauma.

Typically, the disease affects young people, especially men, aged 15-30 in developing countries. People with low socioeconomic status and manual workers such as farmers, laborers and pastoralists are most susceptible to this disease.

Mycetoma has numerous adverse medical, health and socioeconomic consequences for patients, communities and health authorities.There are no exact data on the incidence and prevalence of this disease. However, early diagnosis and treatment are important to reduce morbidity and improve treatment outcomes.

Mitsetoma was first recorded in the middle of the 19th century in the Indian city of Madurai, and therefore this disease was originally called “Madura foot”.

Distribution

Mycetoma pathogens are common throughout the world, but endemic in tropical and subtropical regions of the so-called “mycetoma belt”, which covers the Bolivarian Republic of Venezuela, Chad, Ethiopia, India, Mauritania, Mexico, Senegal, Thailand and Sudan Yemen.

Transmission of infection

Transmission of infection occurs as a result of penetration of the pathogen into the human body during minor wounds or penetrating injuries, usually pricks. There is a clear association between mycetoma and people walking barefoot and manual workers.

Clinical features

Mycetoma is characterized by a combination of painless subcutaneous tumor-like formations, numerous fistulas and secretions with granular formations.Mycetoma usually spreads to adjacent skin, deep structures, and bones, causing destruction, deformity, and loss of function that can be fatal. Mycetoma mainly affects the limbs, back and gluteal region, but any part of the body can be affected. Due to the slow progression of the disease, its painless nature, the fact that people are not aware that they are sick, and the lack of medical and healthcare facilities in endemic areas, many patients seek medical help in the late stages of the disease, when the only only amputation can be a treatment option.A secondary bacterial infection often develops with lesions that, if left untreated, can cause severe pain, disability, and fatal sepsis (severe infections of the whole body). The infection is not spread from person to person.

Diagnostics

The diagnosis of mycetoma is established on the basis of the clinical picture and identification of infectious agents that can be detected by direct examination of granular formations secreted from fistulas.Samples with clinical material can be obtained from any open fistulous discharge by means of diagnostic fine needle aspiration puncture (DTAP) or surgical biopsy. Although microscopic examination of granular formations helps to identify pathogens, culture (sowing) is important for their further identification, but even in this case, errors in classification are possible. Polymerase chain reaction (PCR) is one of the most reliable methods of identification, but this study is expensive and does not have standardized procedures.Serologic diagnostic tests are not used. Imaging methods such as X-ray examination, ultrasound examination, magnetic resonance imaging and computed tomography are used to assess the prevalence of the lesion and to plan the tactics of clinical management of the patient.

Treatment

The choice of treatment depends on the infectious agent. With the bacterial etiology of the disease, combined antibiotic therapy is used, and the treatment of mycetoma of the fungal type is based on the appointment of combined antifungal drugs and surgical intervention.Treatment is often unsatisfactory, has numerous side effects, is expensive and not readily available in endemic areas.

Prevention and control

Mycetoma is not a notifiable disease (which needs to be notified by law) and a global surveillance system for this disease is still under development. A mycetoma control program is currently only available in Sudan. Preventing this infection is difficult, but people living in or traveling to endemic areas should be advised not to go barefoot.

WHO and the global response

In order to build national capacity for mycetoma control, the Government of Sudan and WHO organized the First International Mycetoma Training Workshop from 10 to 14 February 2019 in Khartoum. This workshop, which brought together about 50 health workers from many mycetoma-endemic countries, provided a unique opportunity to share experiences and standardize practices in diagnosis, treatment and surveillance, drawing on the expertise and experience of the Mycetoma Research Center in Khartoum.

At the end of the seminar, the Sixth International Conference on Mycetoma (Khartoum, February 15-17, 2019) was held. The conference adopted the Khartoum Call for Action on Mycetoma, which appeals to a wide range of stakeholders to take concrete policy and public health measures to reduce the burden of mycetoma.

Opportunity

Developing a public health strategy for the prevention and control of mycetoma requires the collection of epidemiological data on the burden of the disease and investment in research and development so that cost-effective prevention can be achieved in resource-limited settings. diagnosis, early treatment and case management.

Currently, the best approach to reducing the incidence and disability associated with mycetoma is proactively identifying cases and early diagnosis and treatment of mycetoma with the tools available today. However, important public health measures are needed to address the mycetoma problem. Some of them are:

• Incorporation of mycetoma into national surveillance systems and establishment of a registry in countries where the disease is prevalent;
• Integration of mycetoma detection into the approach to the management of neglected tropical diseases with primary skin lesions, which will improve the early diagnosis of this infection;
• Improving access to diagnostics and medicines and improving clinical protocols for managing patients;
• Strengthening preventive measures (eg wearing shoes) to reduce the incidence of new cases;
• Raise awareness of mycetoma in affected communities and build the capacity of healthcare staff.

The Drugs for Neglected Diseases Initiative and other partners are currently investigating the safety and efficacy of phosravuconazole in the treatment of eumycetoma in Sudan. In addition to the expected increase in patient cure rates, if successful, adoption of this treatment method will shorten treatment times, improve adherence to therapy, and save financial resources.

Fungal diseases

FUNGAL DISEASES

Fungal skin diseases (dermatomycosis) are infections of the skin caused by fungi.

At present, about 50 species of fungi pathogenic for humans have been described. From a medical point of view (in dermatological practice), three species are of interest – dermatophytes, yeast-like fungi and molds.

Fungi can infect the stratum corneum, appendages of the skin, mucous membranes of the oral cavity and genitals, dermis, hypodermis, and other deep tissues (with deep mycoses).

The development of fungal skin lesions is due to the following factors: pathogenicity and virulence of the pathogen, the state of the human body, environmental conditions.

The diagnosis of fungal skin lesions in the overwhelming majority of cases must be confirmed by laboratory research methods: microscopic, allowing to establish the presence of the fungus, cultural (inoculation), identifying the fungus, in rare cases, histological examination is carried out. For a number of mycoses, fluorescent diagnostics are used.

Mycosis of the scalp

Mycosis of the scalp is a lesion of long hair with trichophytosis, microsporia and favus.

Trichophytia

Caused by anthropophilic fungi, zoophilic and geophilic.

Superficial trichophytosis of the scalp is characterized by the formation of several small rounded bald spots due to hair thinning. A close examination reveals that it is not associated with hair loss, but with hair breakage at various levels. Some hair breaks off at a height of 2-3 mm and looks like grayish hemp, others break off at the mouth of the hair follicle and look like black dots.The skin in the area of ​​the bald patches is slightly hyperemic and slightly flaky. The disease begins, as a rule, in childhood and lasts for years. At the same time, the bald spots slowly increase in size. During puberty, lesions can resolve on their own, and the hairline is completely restored.

Chronic trichophytosis of the scalp occurs almost exclusively in women. As a rule, it is a continuation of the superficial trichophytosis of childhood, which did not resolve during puberty.Clinical manifestations are so scarce that they remain unnoticed for decades and are detected only with a special examination of mothers and grandmothers, carried out in order to identify the sources of infection in children, in the form of black dots against a background of slight peeling (black dot trichophytosis). Blackheads represent hair stubs broken off at the orifices of the follicles. It is often possible to notice small atrophic scars.

Infiltrative-suppurative trichophytosis of the scalp is a painful, dense, sharply limited, tumor-like raised inflammatory infiltrate of a hemispherical or bumpy shape, on the surface of which pustules and broken hair are found.Over time, the infiltrate softens and becomes covered with purulent-hemorrhagic crusts. Upon their removal, small follicular holes are revealed, which creates a picture resembling a honeycomb (hence the old name of the disease – kerion). When the infiltrate is squeezed from the holes, like through a sieve, drops of pus are released. The affected hair is rejected with crusts and pus.

As a result of peripheral growth, the lesion can reach a fairly large size (6-8 cm in diameter). It is often accompanied by painful regional lymphadenitis, fever, and malaise.

Treatment: Consultation with a dermatologist is required for treatment.

Microsporia

Caused by both anthropophilic and zoophilic fungi.

Mostly children are ill. During puberty, the disease usually resolves spontaneously. Microsporia is usually superficial. The infiltrative-suppurative form is extremely rare.

Microsporia of the scalp manifests itself in two ways.In cases where the causative agent is a zoophilic fungus, 1-2 large, rounded or oval, well-defined lesions are formed, all the hair in which is broken off at the same height (5-8 mm) and therefore looks as if trimmed. Broken hair is white due to the spore clutch and is easily pulled out. At the same time, the skin is densely covered with flour-like scales. Microsporia caused by an anthropophilic fungus is very reminiscent of superficial trichophytosis of the scalp, with the only difference that the hair breaks off (not all!) Higher and is white.

Treatment: Consultation with a dermatologist is required for treatment.

favus

Called T.schoenleinii. Infection occurs from a sick person or, which is extremely rare, from mice, cats and other animals. Of greatest importance is the transmission of infection through household items. The disease begins in childhood and continues in adults.

Specific to the favus is a crust-like, dry, bright yellow, saucer-like element called the scutula (scutellum).Initial scutulae do not exceed the size of a pinhead, growing and merging with each other, they can form continuous conglomerates. Over time, the scutules take on a grayish-white color.

When the scalp is affected, an ash-gray, dull hair is visible in the center of each scutula. Hair with favus does not break off, but it is relatively easy to pull out. The formation of air bubbles inside the hair is characteristic.

Simultaneously with the peripheral growth of lesions, their resolution occurs in the central part, which is accompanied by the development of cicatricial atrophy.Ultimately, persistent baldness affects the entire scalp. Only on the periphery of it there is a corolla of hair.

Treatment: Consultation with a dermatologist is required for treatment.

Mycosis of smooth skin is a disease characterized by fungal infections of the skin of the trunk and extremities, with the exception of large folds, palms and soles. The involvement of vellus hair is possible.

The most common diseases are T.rubrum, T.mentagrophytes, M.audouinii, M.canis.

Mycosis of smooth skin is represented by: rubrophytosis (mycosis caused by red trichophyton), trichophytosis, microsporia, favus.

Rubromycosis.

The skin of the buttocks, abdomen, back is involved, sometimes it becomes very common. In this case, there are rashes of scaly erythema with a bluish tinge and follicular nodules. Important signs are scalloped outlines of foci, discontinuity of their borders, grouping of nodules, the formation of arcuate, ring-shaped, garland-like figures from them along the periphery of erythemato-squamous lesions. In vellus hair, fungal elements are often found, located mainly inside the hair, which determines the duration of the course of the disease and its resistance to external antifungal therapy.

Thus, rubromycosis can simulate a wide variety of dermatoses and therefore presents great difficulties in establishing a diagnosis.

Treatment: Consultation with a dermatologist is required for treatment.

Trichophytosis.

Superficial trichophytosis of smooth skin is more common in children. It is characterized by the formation of a reddened, slightly edematous, clearly delineated, pityriasis-scaly spot, against the background of which small vesicles are visible, drying up into crusts.The spot has peripheral growth, eventually resolves in the center and takes on a ring-shaped shape. A new lesion may develop within the ring, resulting in a ring in the ring. In the case of the formation of several foci of trichophytosis, they merge into garland-like outlines.

Chronic trichophytosis of smooth skin is characterized by the formation of flaky, pinkish-purple spots with irregular, blurred boundaries. On their background, small red nodules may appear, located in groups or in the form of ring-shaped figures.The most common localization is the legs, buttocks, forearms, the extensor surface of the knee and elbow joints. The disease lasts for many years, which is associated with an imperceptible lesion of the vellus hair.

Infiltrative-suppurative trichophytosis of smooth skin is characterized by the formation of a round, well-defined inflammatory plaque of bright red color, towering above the level of the skin. On its surface, multiple pustules are visible, drying up into purulent crusts. The plaque gradually increases in size, but after a few weeks its peripheral growth stops and spontaneous resolution occurs.Pigmentation and (sometimes) punctate scars remain at the site of the former lesion.

Treatment: Consultation with a dermatologist is required for treatment.

Microsporia.

The microsporia pattern of smooth skin does not practically differ from superficial trichophytosis of smooth skin.

Treatment: Consultation with a dermatologist is required for treatment.

Favus.

The lesion of smooth skin, as a rule, accompanies the favus of the scalp, differing from it in the absence of cicatricial atrophy.The most common localization is the face, neck, limbs, scrotum, penis, but sometimes very common lesions are observed.

Treatment: Consultation with a dermatologist is required for treatment.

Mycosis of the feet.

Mycosis (epidermophytosis) of the feet – various clinical manifestations of lesions of the feet by dermatophytes.

Infection with epidermophytosis of the feet occurs through scales that get on the skin of a healthy person most often in baths, showers, swimming pools, gyms, as well as through impersonal slippers, sports shoes, hospital shoes, socks, footcloths.Sometimes infection is observed through direct contact in a shared bed.

The predisposing causes of infection are excessive sweating of the feet, wetting, pollution, abrasions, cracks, vascular disorders associated with prolonged overheating or hypothermia of the feet.

Skin changes in mycosis of the feet are manifested in the following clinical forms: erased, squamous, intertriginous and dyshidrotic.

The erased form is characterized by slight peeling in 3-4 interdigital folds.

The squamous form is characterized by small-lamellar peeling on the sole and in the interdigital folds, more often in 3 and 4. Sometimes a crack forms in the depth of the fold. Subjectively – slight itching.

The intertriginous form develops in the interdigital folds of the feet, often from epidermophytosis squamous. The first signs in the form of skin redness and maceration of the stratum corneum appear in the 3rd and 4th folds. As a result of the rejection of the macerated epidermis, erosion is exposed, bordered by a white collar of the swollen stratum corneum.Gradually, the process spreads to the plantar surface of the toes and the adjacent part of the sole. Patients complain of itching and pain that makes it difficult to walk.

Dyshidrotic epidermophytosis is localized on the soles, mainly on the arch of the feet, and is characterized by the eruption of itchy vesicles (vesicles) the size of a pea, with a thick cover. They can be single and multiple, grouped. Over time, the vesicles either shrink into crusts or break open with the formation of erosions.When they merge, a continuous erosive focus is formed against the background of redness, which has clear outlines and is bordered by the collar of the stratum corneum. After the healing of the lesions, the phenomena of squamous epidermophytosis remain, with an exacerbation of which dyshidrotic vesicles reappear.

For rubromycosis, the following manifestations are most characteristic: the skin of the palms and soles is rough, dry, thickened due to diffuse hyperkeratosis, often reaching the formation of callosities with deep painful cracks.Mucous peeling in the skin grooves is very characteristic.

Treatment: Consultation with a dermatologist is required for treatment

Mycosis of nails.

Mycosis of nails (onychomycosis) is a lesion of the nail plates by fungi.

Onychomycosis is often considered a minor disease that does not require timely treatment. However, it should be emphasized that it can significantly worsen the patient’s quality of life, since it leads to the destruction of the nail, a feeling of anxiety, anxiety, depression, and impaired performance.In addition, onychomycosis can cause the following complications: impaired peripheral microcirculation, exacerbation of recurrent thrombophlebitis, erysipelas, bacterial infection, sensitization of the body.

There are four types of onychomycosis: distal subungual onychomycosis, proximal subungual onychomycosis, white superficial onychomycosis, and total dystrophic onychomycosis.

Distal subungual onychomycosis occurs most frequently. Fungi penetrate into the distal areas of the nail bed from the stratum corneum of the surrounding skin and affect both the fingernails of the hands and the toenails, the latter being 4 times more frequent.This disease is characterized by a thickening of the nail plate and, in some cases, its separation from the nail bed.

Proximal subungual onychomycosis occurs mainly in immunocompromised patients, especially in HIV-infected patients. The pathogen first affects the nail plate and infects the proximal part of the nail bed.

White superficial onychomycosis is a rare form of the disease. The causative agents of this disease penetrate into the surface layers of the nail plates, which become white and crumble.

Total dystrophic onychomycosis can result from distal or proximal onychomycosis, when the entire nail plate is affected.

Treatment: Consultation with a dermatologist is required for treatment.

MYCOSIS CAUSED BY YEAST-LIKE FUNGI.

A) Superficial candidiasis (skin candidiasis).

Candidiasis is a disease of the skin, mucous membranes, nails and internal organs caused by yeast-like fungi of the genus Candida.Superficial candidiasis includes lesions of the skin, visible mucous membranes, and nails.

Superficial candidiasis is usually caused by Sandida albicans. The causative agent belongs to a conditionally pathogenic microflora and is found in the folds of the skin, on the mucous membrane of the oral cavity and vagina, in the intestines. Its pathogenicity is determined by the virulence and state of the organism of a particular person.

The following provoking factors in the development of candidiasis are distinguished:

1.long-term use of antibiotics, glucocorticosteroids and cytostatics;

2. malignant tumors, lymphoproliferative diseases;

3. HIV infection;

4. diabetes mellitus;

5. endocrine dysfunctions;

6. high humidity and ambient temperature, microtrauma;

7. early childhood and old age.

Candidiasis of the mucous membranes

Candidiasis of the mucous membranes (“thrush”) is observed most often in the oral cavity, less often in the vagina (vulvovaginal candidiasis).The process begins with the appearance of a white crumbly plaque, resembling semolina, against the background of redness. A film gradually forms, which at first is easily removed, and then compacted, acquires a dirty gray color and firmly adheres to the surface of the mucous membrane (after its removal, bleeding erosion remains). Thrush is common in newborns. Vulvovaginitis is accompanied by excruciating itching and tiny vaginal discharge. Yeast-like fungi can be sexually transmitted.Candidal balanoposthitis is characterized by maceration of limited areas of the glans penis and the inner layer of the foreskin, followed by the formation of erosions. Diabetes mellitus plays an important role in the development of balanoposthitis and vulvovaginitis: sugar excreted in the urine serves as a good breeding ground for yeast-like fungi.

Treatment: Consultation with a dermatologist is required for treatment.

Candidiasis of the corners of the mouth

Candidiasis of the corners of the mouth (Candida seizure) occurs more often in people who have a habit of licking their lips or sleeping with their mouth open, from which saliva flows out, moisturizing the corners of the mouth.The lesion is an erosion surrounded by a collar of the swollen stratum corneum. A crack appears deep in the fold. The honey-yellow crusts that form around streptococcal erosion are absent in yeast lesions.

Treatment: Consultation with a dermatologist is required for treatment.

Intertriginous candidiasis

Intertriginous candidiasis (yeast intertrigo) in its clinical picture practically does not differ from intertriginous streptoderma.Interdigital erosion is very characteristic of yeast lesions of the skin, which usually develops between the III and IV fingers of the hands of housewives dealing with vegetables and fruits, workers of confectionery, fruit and vegetable and similar industries. In the interdigital fold and on the adjacent lateral surfaces of the fingers, maceration and rejection of the stratum corneum occurs, due to which erosion of a cherry-red color is formed, bordered by a white collar of a swollen horn.

Treatment: Consultation with a dermatologist is required for treatment.

Candidal paronychia and onychia

The process begins with the posterior nail fold, goes to the lateral, and then spreads to the nail plate. The rollers become swollen, bright red, sharply painful. Often it is possible to squeeze out a drop of pus from under the rear roller. The adjacent part of the nail plate becomes cloudy and crumbles to form a hole.

Treatment: Consultation with a dermatologist is required for treatment.

B) Pityriasis versicolor versicolor.

Pityriasis versicolor is characterized by the defeat of only the horny substance of the epidermis, the absence of inflammation and very little contagiousness.

Excessive sweating is a predisposing cause of the development of mycosis.

The disease is localized mainly on the trunk, mainly on the chest and back, less often on the neck, the outer surface of the shoulders, and the scalp.The lesion of the skin begins with the appearance of small spots of various shades of brown (hence the name – versicolor versicolor). The spots increase in size, merge with each other, forming more or less large foci with finely festooned outlines. On their surface, there is a barely noticeable pityriasis peeling associated with the loosening of the stratum corneum by the fungus. The disease lasts for months and years. In sunburned people, the lesions appear lighter than healthy skin (pseudo-leucoderm).This is due to the fact that under the influence of the sun they are resolved, however, through the loosened stratum corneum, the skin receives an insufficient dose of insolation for sunburn. It must be remembered that white patches on the neck and upper chest and back can be a manifestation of syphilis.

Treatment: Consultation with a dermatologist is required for treatment.

90,000 Skin infections – ProMedicine Ufa

Skin infections are classified as bacterial, viral, fungal and parasitic. These include diseases such as: scabies, warts, herpes, fungal diseases, lichens, etc.

For the development of the disease, the pathogen alone is not enough. For its vigorous activity and reproduction, certain conditions are necessary, for example, a weakening of the immune system. If a person has a strong immune system, the disease may not exist.

Reasons

Infection is one of the leading causes of skin diseases. The infection multiplies, causing an inflammatory response. In addition, any infection releases toxins into the body, which disrupt the work of the filter organs.The toxins released by infections are the primary and aggressive allergens. The presence of infections in the body significantly increases the allergic component. The organs responsible for detoxification (liver, kidneys, lymphatic system), with a huge amount of toxins, will cease to cope with their work, to fully perform their functions. In fact, skin diseases are a pathological pathway for the percutaneous elimination of toxins from the body.

Types of skin infections and their symptoms

Scabies is a characteristic symptom of itching at night, which prevents sleep and is very annoying.Scabies can also be recognized by small itchy pimples and a gray line extending from them – this is the tick’s move.

Warts. In fact, they are a benign tumor caused by the human papillomavirus (HPV). Warts are of several types: common, genital warts, plantar, flat and senile warts. This disease is very common. It is a skin growth, usually small. Although sometimes they can merge and grow to an impressive size.

Herpes. In this case, we are talking about herpes type 1. There are also other types of herpes viruses, but they no longer belong to skin diseases, but rather affect internal organs.

So, the herpes simplex virus type 1 (or herpes simplex virus) is an infection that lives in almost all of us. According to statistics, 9 out of 10 people on earth are infected with herpes. First symptoms: small sores can be seen on the lips or near the nose. In the first hours, the skin begins to swell and sore a little, causing discomfort.Symptoms of an exacerbated herpes virus, in addition to skin manifestations, may resemble a common cold – weakness, fever, etc.

Fungal diseases. Fungi, which, getting on the skin, hair and nails of a person, cause their change, a huge number. You can become infected with a fungal infection, like other skin diseases, upon contact with a carrier (including animals), when using general hygiene items, shoes, as well as in saunas and swimming pools, that is, where it is warm and damp, especially if there are mechanical damage to the skin.

Symptoms of fungal diseases can include: itching, burning, redness, peeling, oozing, cracking, flaking of scales, the formation of round plaques with a flaky raised rim, a change in the color and texture of the nail, the appearance of clearly defined foci on the hairy surface of the skin, in which hair becomes dull, brittle and eventually fall out, the appearance of black spots, severe seborrhea or dandruff.

Leeshai. These are diseases that can also be caused by viral microorganisms and fungi.Infectious varieties include ringworm, pink, multicolored (or pityriasis). A common symptom of these conditions is a rash in the form of scaly, discolored plaques of very different sizes that cause itching.

Erythema multiforme exudative. Infectious disease with an acute course. The seasonal form develops more often in spring or autumn. It is caused by an infection against the background of colds.

Toxicoallergic form occurs due to intoxication of the body with medications or after vaccination (more often in children).

Both forms are characterized by skin eruptions in the form of pinkish spots or slightly raised papules. In their middle, vesicles filled with serous and sometimes bloody contents may appear. The disease is also accompanied by general malaise, fever. Pain in the throat and joints is often felt.

Ostiofolliculitis or staphylococcal impetigo. The causative agent is often Staphylococcus aureus. The main cause of the disease is violation of hygiene rules, excessive sweating.It is characterized by the appearance on the skin of small semicircular rashes filled with purulent contents. Their size is about the size of a pinhead. There is a hair in the center of the abscess.

Accompanied by painful sensations in the area of ​​the rash dislocation. In the absence of adequate treatment, the infection can spread deep into the epidermis, provoking the development of folliculitis, the appearance of boils.

Pyoderma. A wide group of pustular diseases caused by bacteria: streptococci, staphylococci and pathogenic fungi.
The main symptom is follicles appearing mainly on the face, back, chest, armpits and scalp. If you do not seek help from a doctor in a timely manner, there is a high risk of developing sepsis, a life-threatening condition.
Actinomycosis. Bacterial skin disease with a chronic course.
The main symptom is the appearance of a dense, lumpy neoplasm (infiltrate) under the skin, which consists of several nodules that have fused together. The skin in this area acquires a bluish-reddish tint.With the development of the disease, the infiltrate breaks through, forming fistulas from which purulent contents are released.

Thrush or yeast stomatitis – often diagnosed in newborns or debilitated children. It is characterized by the appearance of a white film (plaque) on the oral mucosa.

Diagnostics

In the diagnosis of skin diseases, it is especially important to detect hidden infections that prevent the immune system from functioning properly. The condition of internal organs is also assessed, the disruption of which can cause skin diseases.

Therefore, an examination for skin diseases consists of a carefully verified list of tests and examination by doctors of other specialties (for example, a cosmetologist-dermatologist), which are designed not only to detect skin diseases (often this can be done with the naked eye), but to identify the true causes of all available in the body of disorders. With such a systematic approach, the treatment carried out is enough to save the patient from skin disease for a long time, and often for a lifetime.

Treatment

Therapy of infectious diseases is carried out in a comprehensive manner.Conventionally, all treatment is divided into several stages, which depend on the established diagnosis and the individual characteristics of the organism of each patient.

Various methods of treatment are used: medications, including antibiotics of different groups. They also use homeopathic remedies, phyto and physiotherapy methods. In certain cases, cryotherapy procedures are effective. Depending on the disease, ultraviolet blood irradiation may be needed. In addition, drugs are prescribed that improve the functioning of internal organs, strengthen the immune system.

For external use, use certain ointments, gels, talkers and creams. As an additional treatment, effective folk remedies are used.

Treatment is usually carried out on an outpatient basis, although in especially severe cases, the patient is indicated for referral to a hospital.

Treatment of fungal diseases

Fungal diseases are widespread, they are transmitted by contact with a sick person or by sharing hygiene and household items.Fungal infections can be contracted in swimming pools, saunas, and other humid public places. Fungal diseases most often affect the skin and nails, the most common fungal infection is mycosis of the feet . If you notice the appearance of longitudinal stripes of a white-yellowish color on the nail plates, you must immediately consult a doctor, most likely this is a fungal infection. The sooner you consult with a specialist about the treatment of fungi, the less damage and discomfort this disease will cause you.We offer reliable diagnostic techniques, modern medicines allow effective treatment of fungi.

In case of fungal skin diseases, the condition of the skin also changes: it begins to peel off, acquires a reddish tint, itching appears between the fingers. If the course of fungal skin diseases is long, then small bubbles form on its surface, which then flock into larger bubbles, then the lesions can take the form of rounded inflamed spots – all these processes are accompanied by a general deterioration in well-being, high temperature, and enlargement of lymph nodes.With a fungal disease of the scalp, hair is also affected, which begins to break off at the roots. If fungal diseases are characterized by a pronounced inflammatory process, then hyperemic, well-defined lesions covered with purulent crusts can be observed.

Fungal infections, depending on the location, are divided into:

• keratomycosis, parasitizing in the upper layer of the epidermis, affecting hair and nails. For example, pityriasis versicolor is a fungal skin disease characterized by the appearance of spots on the chest, neck, back, shoulders;
• dermatophytosis, acting in the deeper layers of the epidermis, – cause an intense inflammatory reaction, affecting the appendages of the skin.For example, microsporia and mycoses of the feet;
• deep mycoses, causing damage to muscles, bones and internal organs, mucous membranes and even the nervous system;
• candidiasis affecting mucous membranes, internal organs. It is these microorganisms that cause genital fungal diseases. Also, this pathogen provokes fungal diseases of the throat.

Treatment of fungal infections

Cracks, abrasions, chicks, wearing tight shoes, vascular diseases, varicose veins, decreased immunity – all this is a fertile ground for the occurrence of fungal diseases.Fungal skin diseases can manifest themselves in different ways: it can be light peeling of the skin, and extensive itchy rashes, which can be accompanied by an unpleasant odor.

Self-treatment of fungal diseases is categorically not recommended, since this can only aggravate the course of the disease. In order to reduce the risk of the disease and subsequently not carry out radical treatment of fungal diseases of the feet and other infectious lesions, it is necessary to observe preventive measures: use individual shoes when visiting a bathhouse, swimming pool, handle manicure and pedicure tools with high quality, do not share personal things and hygiene items.

If the treatment of fungi is not started as soon as possible, then the infection will progress rapidly, moving on to other nails, skin and further, up to damage to internal organs.