What are the common types of fungal infections that occur under the skin. How are fungal infections diagnosed and treated. What preventive measures can be taken against fungal skin infections.

Understanding Superficial Fungal Infections

Fungal infections under the skin, also known as superficial fungal infections, are a common dermatological issue affecting people worldwide. These infections are primarily caused by organisms called dermatophytes, which have the unique ability to metabolize keratin – a protein found in skin, nails, and hair. This characteristic allows them to thrive on the surface of our bodies, causing various skin conditions.

Dermatophytes produce an enzyme called keratinase, which enables them to break down keratin and use it as a nutrient source. While these fungi can cause inflammation on the skin’s surface, they typically cannot penetrate deeper into the dermis, limiting their impact to the outermost layers of skin.

Common Types of Superficial Fungal Infections

• Tinea corporis (body ringworm)
• Tinea pedis (athlete’s foot)
• Tinea capitis (scalp ringworm)
• Tinea versicolor
• Oral thrush
• Candida diaper rash

These infections often present as red, itchy, and scaly patches on the skin. The specific appearance and location can vary depending on the type of infection and the causative organism.

Tinea Infections: The Ring-Shaped Culprits

Tinea infections, commonly referred to as “ringworm,” are a subset of superficial fungal infections that often produce characteristic ring-shaped patches on the skin. Despite the name, these infections are not caused by worms but by fungi belonging to the dermatophyte family.

The term “ringworm” comes from the appearance of the infection, which often forms circular patches with red, wavy borders that resemble worms. These infections can occur on various parts of the body and are highly contagious.

How Tinea Infections Spread

Tinea infections can be transmitted through several routes:

1. Direct skin-to-skin contact with an infected person
2. Sharing personal items (combs, brushes, towels) with an infected individual
3. Contact with contaminated surfaces (e.g., locker room floors, shower stalls)
4. Contact with infected animals

Understanding these transmission routes is crucial for preventing the spread of tinea infections, especially in communal settings like schools, gyms, and households.

Tinea Capitis: A Common Childhood Infection

Tinea capitis, or scalp ringworm, is particularly prevalent among children aged 3-9 years. It often manifests as a diffuse, itchy scaling of the scalp that can be mistaken for dandruff. In some cases, it may cause patches of hair loss, leading to bald spots on the scalp.

This infection is more common in urban areas with crowded living conditions. The spread of tinea capitis is facilitated by sharing personal items such as combs, brushes, hats, and pillows. Regular inspection of children’s scalps, especially in school settings, can help in early detection and prevention of outbreaks.

The Impact of Candida Infections on Skin Health

While dermatophytes are responsible for many superficial fungal infections, another group of fungi called yeasts, particularly those belonging to the Candida genus, can also cause significant skin issues. Candida albicans, the most common species in this group, is known to cause various infections, including oral thrush and diaper rash.

Oral Thrush: A Common Yeast Infection in Infants

Oral thrush is an infection caused by the overgrowth of Candida albicans in the mouth. It typically appears as white patches or “plaques” on the tongue and inside the cheeks, resembling milk curds. However, unlike milk residue, these patches cannot be easily wiped away, and attempting to do so may reveal a sore, reddened area underneath that might bleed.

This infection is particularly common in newborns and young infants, often occurring in the first few weeks of life. However, it can affect individuals of all ages, especially those with compromised immune systems or those taking certain medications.

Factors Contributing to Oral Thrush

• Immature immune systems in newborns
• Use of antibiotics or steroids, which can disrupt the normal oral microbiome
• Weakened immune system due to illness or medical treatments
• Dry mouth conditions
• Poor oral hygiene

The oral cavity’s natural defense mechanisms play a crucial role in preventing Candida overgrowth. The continuous shedding of epithelial cells (desquamation) and the presence of a balanced oral microbiome help maintain oral health and limit Candida colonization.

Candida Diaper Rash: More Than Just Irritation

Candida diaper rash, also known as napkin dermatitis, is a common fungal infection that occurs in the diaper area of infants and toddlers. While not all diaper rashes are fungal in nature, those caused by Candida tend to have specific characteristics that set them apart from typical irritation-related rashes.

Identifying Candida Diaper Rash

A Candida diaper rash typically presents with the following features:

• Bright red, slightly raised patches with well-defined borders
• Small red spots (satellite lesions) near the main rash
• Persistence beyond 3 days despite proper care
• Tendency to appear in the deepest creases of the groin and buttocks

It’s important to note that any diaper rash lasting more than three days may be indicative of a Candida infection and should be evaluated by a healthcare provider.

Causes and Risk Factors

Candida diaper rash can occur due to various factors:

1. Prolonged exposure to urine and feces
2. Warm, moist environment created by diapers
3. Recent antibiotic use (in the baby or breastfeeding mother)
4. Compromised skin barrier due to other skin conditions
5. Introduction of new foods in the baby’s diet

Interestingly, a Candida diaper rash can sometimes be accompanied by oral thrush, as the infection can spread from the gastrointestinal tract. In breastfeeding infants, this can potentially lead to a cycle of reinfection between the baby’s mouth and the mother’s nipples if not properly addressed.

Diagnosis and Treatment of Superficial Fungal Infections

Accurate diagnosis of superficial fungal infections is crucial for effective treatment. While many of these infections have characteristic appearances, clinical observation alone is not always sufficient for a definitive diagnosis.

Diagnostic Techniques

Healthcare providers may use several methods to confirm a fungal infection:

• Skin scraping: A sample of the affected skin is scraped off and examined under a microscope for fungal elements.
• Wood’s lamp examination: Some fungal infections fluoresce under ultraviolet light, aiding in diagnosis.
• Fungal culture: A sample is cultured to identify the specific fungal species causing the infection.
• KOH preparation: Skin samples are treated with potassium hydroxide to dissolve keratin, making fungal elements more visible under a microscope.

These diagnostic techniques help healthcare providers distinguish between different types of fungal infections and rule out other skin conditions that may present similarly.

Treatment Approaches

Treatment for superficial fungal infections typically involves antifungal medications. The specific treatment plan depends on the type and severity of the infection:

1. Topical antifungals: Creams, ointments, or powders containing agents like miconazole, clotrimazole, or terbinafine are often the first line of treatment for localized infections.
2. Oral antifungals: For more widespread or resistant infections, oral medications such as fluconazole or itraconazole may be prescribed.
3. Combination therapy: In some cases, a combination of topical and oral treatments may be recommended for optimal results.
4. Adjunctive treatments: These may include measures to keep the affected area dry, using medicated shampoos for scalp infections, or addressing underlying conditions that may contribute to fungal overgrowth.

It’s important to complete the full course of treatment as prescribed, even if symptoms improve, to prevent recurrence and the development of drug-resistant fungi.

Prevention Strategies for Fungal Skin Infections

While fungal skin infections are common, there are several strategies that can help reduce the risk of infection or reinfection:

Personal Hygiene Practices

• Keep skin clean and dry, especially in areas prone to sweating
• Change out of damp clothes, including swimwear, promptly
• Use breathable, moisture-wicking fabrics for clothing and footwear
• Avoid walking barefoot in public areas like locker rooms and pool decks
• Do not share personal items like towels, combs, or shoes

Environmental Controls

Creating an environment that is less conducive to fungal growth can help prevent infections:

1. Maintain good ventilation in living spaces to reduce humidity
2. Use antifungal powders in shoes and socks if prone to foot fungus
3. Regularly clean and disinfect high-risk areas like bathrooms and gym equipment
4. Keep pets clean and check them regularly for signs of fungal infections

Dietary and Lifestyle Factors

Some lifestyle choices may influence susceptibility to fungal infections:

• Maintain a balanced diet rich in nutrients that support immune function
• Limit sugar intake, as some fungi thrive on high sugar levels
• Manage stress, as chronic stress can weaken the immune system
• Get adequate sleep to support overall health and immune function

By implementing these preventive measures, individuals can significantly reduce their risk of developing superficial fungal infections and maintain healthier skin.

Special Considerations for At-Risk Populations

While superficial fungal infections can affect anyone, certain groups are at higher risk and may require special attention:

Immunocompromised Individuals

People with weakened immune systems, such as those with HIV/AIDS, undergoing chemotherapy, or taking immunosuppressive medications, are more susceptible to fungal infections. For these individuals:

• Regular skin checks should be part of routine healthcare
• Prophylactic antifungal treatments may be recommended in some cases
• Any skin changes should be promptly reported to healthcare providers
• Extra care should be taken to avoid environmental sources of fungi

Athletes and Fitness Enthusiasts

Those who engage in regular physical activity, especially in shared facilities, are at increased risk of certain fungal infections like athlete’s foot and jock itch. Preventive measures for this group include:

1. Using shower shoes in communal bathing areas
2. Thoroughly drying feet and other susceptible areas after bathing or swimming
3. Changing out of sweaty clothes and shoes promptly after exercise
4. Using antifungal powders or sprays in shoes and on feet regularly

Infants and Young Children

The developing immune systems and unique care needs of infants and young children make them particularly vulnerable to certain fungal infections. Parents and caregivers should:

• Change diapers frequently and keep the diaper area clean and dry
• Use barrier creams to protect against moisture in the diaper area
• Avoid sharing personal items like combs and hats among children
• Be vigilant for signs of oral thrush, especially in newborns and infants

By understanding the specific needs and risks of these populations, targeted prevention strategies can be implemented to reduce the incidence of superficial fungal infections.

Emerging Trends in Fungal Infection Management

The field of dermatology and mycology is continuously evolving, leading to new approaches in the management of superficial fungal infections. Some emerging trends include:

Novel Antifungal Agents

Researchers are developing new antifungal compounds to address issues of drug resistance and to improve treatment efficacy. Some promising areas include:

• Nanoparticle-based antifungal delivery systems for enhanced penetration
• Natural compounds with antifungal properties, such as essential oils
• Combination therapies that target multiple aspects of fungal growth and survival

Microbiome-Based Approaches

Understanding the role of the skin microbiome in preventing fungal overgrowth is leading to new therapeutic strategies:

1. Probiotic-based treatments to restore a healthy skin microbiome
2. Prebiotic formulations to support beneficial microorganisms on the skin
3. Microbiome transplantation techniques for recurrent fungal infections

Advanced Diagnostic Tools

Improved diagnostic techniques are enhancing the speed and accuracy of fungal infection identification:

• Molecular diagnostic methods for rapid species identification
• AI-assisted image analysis for more accurate clinical diagnosis
• Point-of-care testing devices for quick, in-office fungal detection

These advancements promise to improve the management of superficial fungal infections, potentially leading to faster diagnoses, more targeted treatments, and better outcomes for patients.

A review on its clinical manifestations, diagnosis, and prevention

The above three infections are discussed in detail below.

Superficial fungal infections

These infections are common all over the world (but specifically based on geographic distribution) and are caused by fungi called dermatophytes, which produce keratinase. This allows them to metabolize and live on human keratin, i.e., on skin, nails, and hair. They cause inflammation superficially but cannot invade deeper into the dermis. The common superficial fungal infections caused by Tinea worm are body ring worm by Tinea corporis, athlete’s foot by Tinea pedis, etc.[4,5,8,10] Such infections are red, itchy, and scaly. The diagnosis and confirmation should be based on clinical observations. The procedure which is followed is to scrape the lesion and observed under the microscope, and in case of Wood’s lamp (UV) colonies will fluoresce.

Another important superficial infection is cause by the yeast Malassezia furfur. [12] It does not even get into the keratin – more superficial than the dermatophytes. It digests the top layer of lipids and affects adolescents and adults to cause the superficial infection called Tinea versicolor – round, hypo-, and sometimes hyperpigmented patches. It never penetrates into the skin but can, especially nosocomially, infect the blood by contaminating lipid IV solutions.

Some of the types of superficial fungal infections that occur frequently in children are discussed below.

Oral thrush

It is an infection of the yeast fungus, Candida albicans, which occurs on the surface of the tongue and inside the mucus of the cheeks. It appears as white patches known as “plaques” which resemble milk curds.[13–15] One way to distinguish candida plaques from milk curds is that if the surface of the plaque is scraped away, a sore and reddened area will be seen underneath, which may sometimes bleed. It occurs most commonly in babies, particularly in the first few weeks of life. [16–18] Outbreaks of thrush in older children may also be the result of an increased use of antibiotics and steroids, which disturbs the balance of microbes in the mouth. This causes an overgrowth of Candida, which results in thrush.[19,20]

The stratified squamous epithelium of the oral mucosa forms a continuous surface that protects the underlying tissues and functions as an impervious, mechanical barrier. The protection so provided is dependent on the degree of keratinization and the continuous desquamation or shedding of epithelial cells. Indeed, the latter mechanism is considered to play a pivotal role in maintaining a healthy oral mucosa and in limiting Candidal colonization and infection. The interaction between Candida spp. and the commensal microbial flora is perhaps the next critical mechanism modulating oral Candidal colonization. The commensal flora regulates yeast numbers by inhibiting the adherence of yeasts to oral surfaces by competing for sites of adherence as well as for the available nutrients.

Candida diaper rash

It is sometimes called napkin dermatitis, a rash which occurs in the buttocks. Nappy rash will occur when the skin is sensitive and there is a presence of a trigger factor which includes prolonged exposure to urine and being unwell or thrush.[21–23] It tends to be in the deepest part of the creases in the groin and buttocks. The rash is usually red with a clearly defined border and consists of small red spots close to the large patches. In general, any diaper rash that lasts for 3 days or longer may be candidiasis.[24–26] A Candida skin infection can come from the upper gastrointestinal tract, the lower gastrointestinal tract, or exposure from a care provider. A Candida diaper rash can be accompanied by Candida infection of the mouth (thrush). A breastfeeding infant with a thrush infection may inadvertently infect the mother’s nipple/areola area. If such an infection is suspected, simple topical medications may be prescribed by her doctor. [27,28]

Tinea infection (ringworm)

It is a skin infection caused by fungi. It is called “ringworm” because the infection may produce ring-shaped patches on the skin that have red, wavy, worm-like borders. Some of the ways of catching Tinea is by direct skin-to-skin contact with an infected person, by sharing items with an infected person, or by touching a contaminated surface (such as floors in shower and locker rooms).[4]

Some of the more common types of Tinea infections that occur in children are discussed next. Tinea capitis results in a diffuse, itchy, scaling of the scalp that resembles dandruff. It can cause patches of hair loss on the scalp. It is especially common among children aged 3–9, particularly children who live in crowded conditions in urban areas. Scalp ringworm spreads via contaminated combs, brushes, hats, and pillows.[8,9] Tinea corporis means “ringworm of the body”; it involves the nonhairy skin of the face, trunk, arms, or legs. This would produce the classic ring-shaped patches with worm-like borders which may occur singly or in groups of threes and fours. It can occur in persons of all ages.[8]

Tinea pedis (athlete’s foot) produces area of redness, scaling, or cracked skin on the feet, especially between the toes. The affected skin may itch or burn, and the feet may have a strong odor. It is often acquired by walking barefoot on contaminated floors.[5]

Tinea versicolor or more commonly known as “white spots” is caused by a fungus known as Malassezia furfur. This fungus is present on the skin of most of the people but will only cause infection in some of them. This infection is common round the year in hot and humid climate. It occurs more often in older children and young adults.[10]

The infection causes a rash which may appear on the back, neck, upper chest, shoulders, armpits, and upper arms. The skin rash consists of peeling, oval patches with sharply defined borders, and pimple-like bumps. The patches appear white or black on dark-skinned people and are usually pink or tan on the more fair-skinned. More often than not, it does not cause itching unless the person is hot or sweaty. The patches may be more prominent after the skin has been exposed to the sun, because the patches do not tan [].[11]

Clinical presentations of some frequently observed fungal infections: (a) Tinea capitis due to Trichophyton tonsurans; (b) onychomycosis due to Trichophyton rubrum; (c) chronic oral candidiasis; (d) chromoblastomycosis; (e) histopathological appearance of an aspergilloma. (f) Cutaneous lesions in a patient with disseminate candidiasis.[8] (Reproduced with permission from Richardson et al.)[29

Subcutaneous fungal infections

If get a chance to introduce through the human skin, these fungi have the biological ability to grow in subcutaneous tissue and sometimes can cause significant human disease. They can grow up lymphatic and into bones or joints if in the way. These infections are far more common in the developed world. There are a variety of species that cause them: in India, Africa, and the Far East, generally speaking, they cause mycetoma (Madura foot). Individuals walking barefoot may get a splinter or injury to the foot and be inoculated, and slowly the bones of the foot and the ankle joint can be destroyed.[30]

Different types of subcutaneous fungal infection are discussed next.

Sporotrichosis

This infection is caused by the dimorphic fungus Sporothriz schenkii, which is characterized by the development on the skin, in subcutaneous tissue and in lymph nodes, of nodules which soften and break down to form indolent ulcers. The fungus is a saprophyte found widely on plants, thorns, and timber. Infection is acquired through thorn pricks or other minor injuries. Rare instances of transmission from patients and infected horses and rats have been recorded. It needs a splinter or a thorn to introduce it into human tissue – it can only live inside the body. It travels along lymphatics and causes a combination of pyogenic and granulomatous reaction. It manifests itself as a set of ulcerating nodules along a hard cord as it slowly grows up the lymphatics. It moves from distal to proximal and can lead to bone and joint destruction. It can become disseminated almost exclusively in immunocompromised individuals. The classic clinical presentation of this is with individuals with outdoor encounters: gardeners, golfers, hunters, etc. The culture mount of this fungus show fine branching hyphae and pear-shaped conidia borne in rosette like clusters at tips at lateral branches and singly along sides of hyphae.[31,32]

Chromoblastomycosis

This infection is caused by soil-inhabiting fungi of family Dematiaceae family. They enter the skin by traumatic implantation. The lesion develops slowly around the site of implantation. The most common fungi responsible are the Fonsecaea spp. – F. pedrosoi, F. compactum, F. dermatitidis, Phialophora spp – P. verrucosa and Clostridium spp. – C. carrionii. Infections caused by F. pedrosoi and P. verrucosa have been reported to disseminate to other areas, especially brain. Its clinical manifestations are raised and crusted lesions of the skin. Histological, the lesions show the presence of the fungus as round or irregular, dark brown, yeast-like bodies with septate called sclerotic cells, which can be diagnosed in KOH mounts or in sections and by culture on Sabouraud’s agar.[33]

Chronic mucocutaneous candidiasis

It is caused by Candida spp. (predominantly C. albicans). Various manifestations include white fissures, lesions, hyperkeratotic, granulomatous, and vegetative lesions, autosomal recessive trait associated with endocrine disorders, e.g., hypoparathyroidism.[34,35]

Systemic fungal infections

After superficial and subcutaneous comes systemic fungal infection. These are less common but more serious. They can be divided broadly into two types namely (a) endemic infections and (b) opportunistic infection.

(a) Endemic infections infect all types of people, including those with a normal immune system. Although very much like TB, they cause disease only in specific circumstances. A huge number of individuals are infected, but only a few get diseased. As these infections have a number of properties in common, we should think of them as a group: histoplasmosis, coccioidomycosis, and blastmycosis.[36] Such infections are caused by dimorphs. They grow as molds in soil and reproduce there by sporulation. When they enter in a human, which happens exclusively via the respiratory route, they become yeasts. They also have a restricted geographic distribution and finally, and most importantly, they all cause disease with symptoms almost indistinguishable from TB.[37]

Various types of endemic fungal infections are elaborated next.

Histoplasmosis. It is an intracellular infection of the reticuloendothelial system caused by dimorphic fungus Histoplasma capsulatum. This fungus reacts like soils with high nitrogen content so it is found in the Ohio-Mississippi Valley, the Caribbean, and Central and South America. It is particularly endemic to chicken coups and caves due to the nitrogen in bird and bat droppings. It is caused by inhaling spores, which change into yeast in the lungs, phagocytosed by macrophages, and are disseminated hematogenously. After about 6 weeks, one can be tested for histoplasmin antigen derivative (just like TB), which is useful for diagnosing exposure but worthless for diagnosing disease. Clinically, histoplasmosis also mimics TB; almost everyone who is infected with this organism has latent disease. Very few people get sick, unless there is something else going on and can cause problems for those with an immature immune system or immunocompromised.[38] For people with abnormal lungs, histoplasmosis can cause pneumonia if inhaled into nonperfused areas. It can cause a chronic, cavitating nodular infection very similar to TB. Histoplasmosis can remain latent and reactivate many years later, for example, with AIDS. This can then disseminate and cause disease in virtually every organ of the body. To differentiate between TB and histoplasmosis, one can use sputum or blood smears, and purified protein derivative (PPD).[39]

Coccioidomycosis. This is an infection caused by fungus Coccidiodes immitis. This fungus is probably the most virulent and prefers to live in hot dry weather (Arizona, Cali, Mexico, Central, and South America). Infection is acquired by inhalation of dust containing arthrophores of the fungus. This fungus is dimorphic, occurring in the tissue as yeast and in culture as the mycelial form. The tissue form a spherule, 15–75 μm in diameter, with a thick doubly refractile wall and filled with endospores. Unlike histoplasmosis, this dimorph turns into a spherule not yeast in the human lung. A spherule is a giant seedpod full of thousands of yeast particles called endosperms; thus, it can infect very efficiently (explains virulence). There is also a skin test for Cocci called coccidiodin. Like histoplasmosis, in this case spores are aerosolized and inhaled. When compared the sequence of events in TB and histoplasmosis, it was found that they are almost similar. However, unlike TB and histoplasmosis, the primary infection with Cocci can have symptoms because one is getting such a huge load of organisms, with the endospores disseminating in the lungs. One gets a self-limited, flu-like syndrome (sometimes called Bali fever). However, in some people it does disseminate (more commonly in pregnant women, immunocompromised, and darker skinned people) and causes skin, bone, and CNS disease.[40]

Blastomycosis. The fungus Blastomyces dermatiditis causes this disease. This fungus is a dimorph that lives in a soil as a mold and becomes yeast in the human being upon inhalation. It likes organic debris and humidity: woodlands, beaver dams, marshes, and peanut farms (for some unknown reason) and are usually found at mid-Atlantic, Carolinas, and Mississippi Valley. It is picked up from aerosolized spores. In its yeast form, blastomyces is much bigger than histoplasma and has broad-based buds and a small capsule. The pathogenesis is basically the same as the others. The one big difference is that no one has yet discovered a characteristic protein for a skin test. We usually do not have any idea how many people have been exposed and how many to develop disease with blastomyces. We do know that with a fraction of people (immuncompromised), the disease can go on to become disseminated or can stay in the lungs to cause a TB-like disease. It likes cool surfaces so it tends to cause a lot of skin disease (skin lesions that look and behave like skin cancer), bone disease, and urinary tract disease in men.[36,39]

(b) Opportunistic systemic fungal infections occur primarily when some aspect of the normal host defense is compromised. Such infections are life-threatening and are associated with high rates of death. Because of the growing population of immunocompromised individuals, the frequency of systemic fungal infections is increasing significantly.[40] Patients with hematological malignancies, such as myeloid and lymphocytic leukemias, are at particularly high risk of infectious complications. Infections can occur when the patient develops neutropenia of long duration caused by the hematological malignancy itself or the treatment administered. For example, patients receiving bone marrow transplants are given immunosuppressive drugs (e.g., corticosteroids or cyclosporine) to prevent or treat rejection. Intensive myelosuppressive chemotherapy also causes neutropenia in patients.

Approximately 20–50% of patients who die from hematological malignancies have evidence of invasive fungal infections at autopsy. The death rate is even higher in patients with mixed Aspergillus and Candida tissue infections. Solid organ transplant recipients who receive immunosuppressive medications to limit the risk of rejection also have an increased susceptibility to systemic fungal infections. Fungal infections occur in 5–45% of all solid organ transplant patients and are a primary cause of morbidity and mortality.[41,42] Burnt patients are another population at high risk; the wound site is susceptible to colonization by opportunistic fungi such as Candida, but nowadays this is generally well managed and Candidiasis in burnt patients may originate in the gastrointestinal tract or from intravenous catheters. [43] Changes in medical procedures have contributed to the increased incidence of systemic fungal infections. The skin and mucosal surfaces normally prevent micro-organisms entering the body, but, if these barriers are compromised, for example, during surgery or when in dwelling catheters are used, fungal cells are able to invade. Myelosuppressive chemotherapy may also cause mucosal lesions, allowing the invasion of fungi. Allogeneic bone marrow transplant recipients face the additional risk of developing graft-versus-host disease, which can damage the mucosal surfaces and normally requires an increase in immunosuppressive therapy.

In lung transplant recipients, the donor organ can also be a reservoir for pathogenic fungi, which may have been dormant or harmless in the donor but can be a source of post-transplantation infection in the immunosuppressed recipient. Previous fungal infection may predispose high-risk patients to subsequent systemic infections because fungi can remain dormant for some time and become reactivated when the patient is immunosuppressed. [44,45] High-risk patients with damaged mucosal surfaces caused by bacterial or viral infections may be at a higher risk of infection by Candida spp. A high level of colonization by Candida in the gastrointestinal tract and oral cavity may also increase the threat of systemic Candidal infection in patients at high risk. An additional contributory factor is the use of antibiotics, which disrupt the microbial flora, allowing colonization by fungi. Antibiotic therapy also leads to increased survival of patients who are predisposed to fungal infection. Immunocompromised patients readily acquire fungal infections from their environment if standard safety procedures are not followed. For example, Aspergillus spp. is airborne fungi and may be propagated through ventilation systems. The risk of infection can be greatly reduced by the use of high-efficiency particulate air (HEPA) filtration.[46] Transmission of Candida from the hands of medical professionals is also an important cause of nosocomial infections. Hand washing is therefore vital, but unfortunately the rigorous compliance necessary to reduce infection is not always present.[47] Other patients at risk include those with medical conditions that compromise the immune system, the most notable being advanced HIV immune dysfunction or AIDS. Because of the extreme degree of immunosuppression in the patient group, fungal infections can be unusually virulent and persistent. Between 60% and 90% of individuals with progressive HIV disease develop at least one fungal infection during the course of the disease.[48] Among the most frequently occurring fungal infections in this group are candidiasis, cryptococcosis, and less frequently aspergillosis,[49] although, in specific geographical regions, endemic mycoses are important (e.g., coccidioidomycosis, penicilliosis with Penicillium marneffei, and histoplasmosis).[50] Individuals with chronic granulomatous disease (CGD), an inherited abnormality of the neutrophils that serve as an important defense against fungi, are also predisposed to infection. Various types of opportunistic systemic fungal infections are described next.

Invasive candidiasis/candidaemia. It is caused by C. albicans and other nonalbicans Candida spp. Its clinical manifestations are prolonged antibiotic-resistant fever, often associated with weight loss, abdominal pain, and hepatic and/or spleen enlargement. CT scan may reveal small radiolucent lesions in liver or spleen in patients with chronic invasive candidiasis (hepatosplenic candidiasis).[55⁵⁶]

Invasive aspergillosis. It is caused by Aspergillus spp. The commonest human disease caused by aspergilli is otomycosis. Its clinical manifestations are prolonged antibiotic-resistant fever, histopathological appearance of nonpigmented, septate hyphae with dichotomous branching. CT scan shows characteristic halo and/or air crescent signs. In this, the fungus actively invades the lung tissue. Disseminated aspergillosis involving the brain, kidney, and other organs in fatal complication sometimes seen in debilitated patients on prolonged treatment with antibiotic, steroids, and cytotoxic drugs.

Diagnosis may be made by microscopic examination and by culture. The fungus grows rapidly on culture media. Identification of Aspergillus is easy based on growth characteristics and morphology. Aspergillus has septate hyphae. Asexual conidia are arranged in chains, carried on elongated cells called “sterigmata,” borne on expanded ends (vesicles) of conidiophores.[51] Meningitis is the most common clinical manifestation. Hematogenous spread may also occur, giving rise to widespread cutaneous lesions.[52]

Zygomycosis. It is caused by Rhizopus spp., Absidia spp., and Mucor spp. It may manifest as rhinocerebral, pulmonary, gastrointestinal, or cutaneous mucormycosis. Disseminated mucormycosis can follow, spreading most frequently to the brain, with possible metastatic lesions in the spleen, heart, and other organs.

Other invasive infections. It is caused by Malassezia spp. Its manifestations are characterized by catheter-associated sepsis related to hyperalimentation with lipid emulsions and pneumonia. Trichosporon spp. can cause infrequent disseminated disease which occurs in granulocytopenic patients, with fatal outcome. Bloodstream infections manifest as skin and lung lesions and give false positives in cryptococcal antigen tests. Infections due to Fusarium spp. can cause mycetoma, endophthalmitis, facial granuloma, osteomyelitis, and brain abscess. Disseminated disease in neutropenic patients has positive blood cultures and skin lesions.[52]

Not Sure What’s on Your Skin? It Could…

Unfortunately, there is often an overlap between the signs and symptoms of different skin conditions. The untrained eye might not be able to distinguish one skin problem from another, which is why it’s crucial to get diagnosed by a professional dermatologist. For instance, your doctor might tell you that the skin problem you’re facing is actually a fungal infection.

Here’s how you might become infected, how to identify fungal infections, and how to treat them.

What to Know About Fungal Infections

How Do You Contract Fungal Infections?

The only way to contract a fungal skin infection is to come into direct contact with fungi. Of course, there are many avenues through which one might brush up against a certain type of fungus. Fungi, such as mold, mildew, and yeast, mainly thrive in warm, damp environments (i.e. public pools, sweaty parts of the body like armpits, feet, groin area, etc.). If your bare skin is exposed in such an environment and touches a surface or another individual harboring fungi, the fungal spores can quickly find a new home on your dead skin cells (i.e. the outer layers of skin and nails) and multiply. To make matter worse, fungi can spread from one area of the skin to another via touching and scratching.

What Are the Signs of Fungal Infection?

Generally speaking, fungal infection symptoms include:

• Itching
• Irritation
• Redness
• Blisters
• Burning
• Scaly skin
• Swelling

These symptoms are also correlated with other skin conditions unrelated to fungal infection, such as eczema, psoriasis, rosacea, and more. One way to tell these different conditions apart is to consider their location. Though fungal infections can affect any area of your body, they are most often found in moist areas, as previously mentioned. So, if your symptoms primarily occur on your feet, groin area, underneath your armpits, and/or similarly damp, enclosed areas, you might be facing a fungal infection. Your dermatologist can help you determine the precise nature of your skin condition.

Common Fungal Infections To Look For

Our world is filled with millions of species of fungi, though only a select number commonly affects human skin. Some of the most prevalent fungal infections include:

• Athlete’s Foot (Tinea Pedis)
• Jock Itch (Tinea Cruris)
• Ringworm (Tinea Corporis) — fungal infections typically found on the arms, shoulders, face, and other areas of glabrous (smooth, hairless) skin
• Beard Ringworm (Tinea Barbae)
• Yeast Infections (Cutaneous Candidiasis)
• Fungal Nail Infections (Tinea Unguium)
• Tinea Capitis — fungal infections found on the neck and/or scalp

There are other types of fungal skin infections out there, and the ones listed above include variations that yield different symptoms and levels of severity.

How Do You Get Rid of Fungal Skin Infections?

Many fungal skin infections go away on their own, though it can take several weeks or months for this to happen without intervention. Additionally, some infections can spread and create further complications (i.e. bacterial infections). To prevent such problems, relieve symptoms, and speed up recovery, your dermatologist might recommend an over-the-counter or prescription-strength antifungal spray, cream, or ointment. Oral antifungal medication is often required to treat a severe, systemic, and/or persistent fungal skin infection. With proper treatment, most superficial fungal infections will improve within weeks. If results are lacking, you may need to try different treatment methods under the supervision of your dermatologist.

Ultimately, the best way to clear your skin from fungal foes is to avoid infection in the first place. While there’s no way to guarantee total prevention, certain measures can decrease your level of risk, such as:

• Practicing excellent skin hygiene
• Thoroughly cleaning and disinfecting bathtubs, showers, and floors
• Avoiding direct-skin contact in public places such as pools, saunas, and locker rooms
• Not wearing artificial fingernails
• Separating towels, sheets, and clothing from those around you who currently harbor fungal skin infections

Experiencing itchy, inflamed, reddened skin? Fungal infection might be the culprit. To know for sure, reach out to your dermatologist and/or the experts at Premier Dermatology Partners. Our specialists can help you find the right treatment options for your skin conditions. To learn more about our team and all the services we provide, contact us.

Fungal Infections Treatment | Vanguard Dermatology

Fungal infections are caused by fungi. Fungi are widespread in our environment and come from spore bearing plants that have no chlorophyll. They are commonly known as mold, mildew, and yeast. Because fungus is so prevalent, it is inevitable that a certain amount of fungi gets inhaled into the lungs or lands on the skin.

Fungus grows very rapidly in moist, dark places with little ventilation. A fungal infection occurs when fungi multiply and become inflamed. This can happen internally in the organs or on the outer layer of the skin and nails.

Fungal infections of the skin are often called ringworm or tinea. Microscopic fungi, called dermatophytes, thrive on dead tissue such as the outer layer of the skin and nails.

The most common types of fungal infections of the skin and nails are:

• Tinea barbae—along the beard and jawline
• Tinea capitis—occurs on the neck and scalp
• Tinea corporis—occurs on various parts of the body, such as the arms, shoulders and face
• Tinea cruris—known as jock itch, involves the groin area
• Tinea pedis—known as athlete’s foot
• Tinea unguium & tinea versicolor occur on the nails

WHAT CAUSES FUNGAL INFECTIONS?

Fungal infections occur because the mold, mildew or yeast spores are touched or inhaled and develop into an overgrowth in or on the body. Depending on the conditions, these infections can be superficial or serious. Under conditions of moisture, warmth and irritation, these fungi grow rapidly and may cause serious illness.

Superficial fungal infections can be caused by an overgrowth of existing fungi or can be the result of contact with an infected person or contaminated surfaces and objects. Fungal infections can be easily spread through bed sheets, towels, and clothing. They can also spread from one part of the body to another by scratching.

Fingernail fungus or tinea unguium has been linked to methyl methacrylate, which is a glue used for attaching acrylic fingernails. This condition can be quite serious and difficult to treat, because the environment between the real and artificial fingernail provides precisely the conditions in which fungus thrives.

Systemic fungal infections are often linked to the soil. Usually, they are contracted when fungi spores in the soil get inhaled when soil is dug up or blown around in the air. They can be a chronic problem for people with suppressed immune systems.

HOW TO TREAT FUNGUS

Superficial fungal infections are usually treated with over the counter or prescription antifungal creams or sprays. If the infection persists, an oral antifungal drug may be prescribed.

Systemic fungal infections are treated with oral antifungal medications.

Although fungal infections are usually not serious in healthy individuals, it is important to seek treatment because sometimes the infection can spread and complications such as secondary bacterial infections develop.

LONG TERM RESULTS

Most infections improve with treatment within several weeks. It is important to note, however, that many fungal infections do not respond to treatment. It can take prolonged periods and many treatment methods before there is any response.

PREVENTING FUNGAL INFECTIONS

Several important steps can be taken to prevent fungal infections. Practice good personal hygiene, skin should be kept clean and dry. Avoid artificial fingernails. Household sources of fungus such as showers, bathtubs, and floors should be maintained by cleaning regularly with warm water and a disinfectant.

If a member of the household has a superficial infection, be sure to keep sheets, towels and clothing separate and clean.

6 fungal infections you need to be aware of

Of the thousands of species of fungi, there are only a few that can cause disease or discomfort in people.

Furthermore, invasive fungal disease is relatively rare in healthy persons because of our sophisticated immune systems. However, serious fungal diseases frequently occur in immunocompromised patients.

Compromised immunity

Uncontrolled HIV infection, for example, makes many people vulnerable to lethal fungal diseases.

Cancer treatments (e.g. chemotherapy) and diabetes can also compromise our immunity.

In addition, corticosteroids, immunosuppressants and prolonged courses of antibiotics can also make the body more susceptible to fungal infections.

According to Human Diseases Forum and Conditions, fungi can cause anything from minor skin conditions to life-threatening diseases. Opportunistic fungal infections include Aspergillosis, Candidiasis and Mucormycosis.

Fungi can produce two kinds of infections, i.e. systemic and superficial. Systemic infections affect internal organs (e.g. lungs, blood, heart, brain, kidneys and liver), while superficial infections affect the skin, nails and hair.

Common fungal infections

Fortunately superficial fungal infections are much more common and there are very few people who have not had to cope with at least one of the following at some stage of their lives:

1. Athlete’s Foot (Tinea Pedis) is a fungal infection of the feet with itching, scaling and redness. It can be caused by a number of different fungi, including Trichophyton, Epidermophyton and Microsporum.

2. Ringworm (Tinea Corporis) can appear in the form of a red or silver rash anywhere on the body. It is usually ring-shaped and is most commonly caused by the fungus Trichophyton rubrum. 

3. Tinea Capitis is ringworm that affects the scalp.

4. Onychomycosis is a fungal infection of the toenails or fingernails that can involve any component of the nail, including the matrix, bed or plate. It can cause pain, discomfort and disfigurement. Onychomycosis is caused by various fungal organisms, the most common being dermatophyte. Yeast and moulds also cause nail infections.

5. Tinea Versicolor or pityriasis versicolor is a common condition that causes small patches of skin to become scaly and discoloured. They can be darker or lighter than the surrounding skin, or even red or pink. The condition is caused by a yeast called Malassezia, which lives on the skin of most people without causing any problems.

6. Cutaneous Candidiasis can involve almost any skin area of the body, but mostly occurs in warm, moist, creased areas such as the armpits and groin. Candida is the most common cause of nappy rash in infants. Candida is also common in people who are obese or have diabetes. Antibiotics, steroid therapy and chemotherapy increase the risk of cutaneous Candidiasis.

Candida can also cause:

• Infections of the nails
• Infections of the corners of the mouth
• Oral thrush (a form of infection of the moist lining of the mouth)
• Vaginal yeast infections

^{Image credits: iStock}

Fungal Infections | The Office of Sharon Scherl MD

Fungi are single or multi-cellular organisms that cause skin infections. Fungi can be true pathogens, which cause infections in healthy people, or opportunistic pathogens, which cause infections in immune-compromised patients. A common type of fungus is yeast, which is already present in the human body, but when levels increase, can result in infection. Dermatophytes are fungal organisms that grow on the human body and infect the top layer of skin as well as nails or hair. There are different types of fungal infections, and each can appear in different areas of the body. Some symptoms include: rash, itchy blisters, cracking of the skin, and skin irritation.

Cause:

Fungal infections can be caused by a variety of conditions and medication-use.  Some risk factors for developing a fungal infection include the following:

• Antibiotics:
 Antibiotics decrease the amount of helpful bacteria living in the body. When these levels are decreased, fungi have an opportunity to invade and colonize.
• Corticosteroids:
 Cortisteroids are often used to reduce inflammation and treat other skin disorders. They sometimes lower immune responses, and thereby create favorable conditions for fungal growth.
• Medical Conditions:
 People suffering from diabetes and some forms of cancer are more prone to fungal infections.
• Compromised Immune System:  When immune systems are weakened, such as when a patient undergoes chemotherapy, or for those inflicted with Acquired Immune Deficiency Syndrome (AIDS), fungi have better opportunities to grow, causing more infections.
• Environmental Factors:
 Fungi grow and reproduce in moist areas. Sweaty shoes and clothes can therefore help increase fungi production and lead to infection.
• Heredity:
 Some people are genetically predisposed toward fungal infections. They are more likely to contract a fungal infection when exposed to infectious conditions.

Types:

• Tinea Pedis (“Athletes Foot”): Tinea pedis affects over 10% of the United State’s population each year, and 75% will contract it at some point in their lives. The fungus appears in between toes, characterized by skin becoming white, moist, and easily rubbed off. The tops may be red, dry and flaky. Tinea pedis generally occurs with hot, moist conditions, or if shoes are worn often and without socks.
• Tinea Cruris (“Jock Itch”): As with tinea pedis, moist, sweaty conditions around the groin, combined with poor circulation from tight clothing leads to fungal infection in this area. Intense itching and burning are the usual symptoms. Redness, flaking and peeling on the inner thighs and scrotum may also occur.
• Tinea Corpora (Ringworm): Tinea corpora is caused by a microscopic fungus, not a worm as the name implies. The infected area spreads out slowly from the central point, creating a slightly raised, red ring surrounding a less red, flaky, itchy area. This “ring” gives the infection it’s nickname. Tinea corpora can spread throughout the body, and may appear in multiple areas at once.
• Candidiasis: This infection is characterized by brown-red itchy discoloration on the skin, generally occurring where there are folds in the skin such as under the arms, in the rectal area, and beneath the breasts. This type of fungus also causes vaginal yeast infections.

Treatment:

Treatment for fungal infections is generally antifungal creams, which can be bought over the counter, such as 1% clotrimzole and 1% terbinafine. They are usually applied to the affected areas several times daily, and can take many weeks before all signs of the fungus vanish. If these creams fail, prescription antifungal creams such as econazole 1% may be recommended. For extreme cases, or when toenails are involved, oral terbinafine may be useful.

Prevention:

There are some measures you can take to prevent the skin from contracting a fungal skin infection. You should always keep clothes dry and clean, and wear loose-fitting clothes as much as possible. Avoid sharing hairbrushes, combs, and towels, as they may contain skin fragments with fungal colonies. Use alternative shoes every few days to avoid athlete’s foot. Natural fabrics that allow the skin to “breathe,” such as cotton, should be worn as well.

Conditions We Treat

Acne

Acne is the most common skin condition in the United States. Although it’s common, accurate information about acne can be scarce.

Who gets acne?

If

Acne Cyst

An acne cyst forms when the pore fills with dead skin cells oil, and bacteria. A cyst goes deep into the skin and can hurt

Actinic Keratosis (Also called a solar keratosis)

An actinic keratosis  or AK is a rough,dry, scaly patch or growth that forms on the skin

An AK forms when the skin is badly damaged by ultraviolet

Alopecia (Hair Loss)

Who experiences hair loss?

Millions of people experience hair loss. Some people see their hair re-grow without doing anything. Others need treatment

Atopic Dermatitis/Eczema

This is a common skin disease in children. 
Children often get atopic dermatitis (AD) during their first year of life. If a child gets AD during this

Atypical Mole (Dysplastic)

This type of mole can look like melanoma. It is not melanoma. But you have a higher risk of getting melanoma if you have any of the following:

4

Basal Cell Carcinoma

Basal cell carcinoma (BCC) is the most common form of skin cancer. More than two million cases of this skin cancer are diagnosed in the United States

Bed Bugs

Bedbugs are tiny insects that feed on human blood. They hide in dark places close to where humans sleep and usually crawl out to feed while people

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If a blocked pore stays open, it can look kind of black and is called a blackhead.

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Congenital Mole

When a person is born with a mole, the mole is called a congenital mole. Roughly, 1 out of every 100 people is born with a mole. These moles vary in

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Dry skin is common. It can occur at any age and for many reasons. Using a moisturizer often helps repair dry skin.

Sometimes people need a

Eczema

Eczema is a word that means irritated skin. Doctors don’t really know why some kids and adults get eczema, and others don’t. They think it might

Female Pattern Baldness

The most common cause of hair loss is a medical condition called hereditary hair loss. About 80 million men and women in the United States have this

Fungal Infections

Fungi are single or multi-cellular organisms that cause skin infections. Fungi can be true pathogens, which cause infections in healthy people, or

Genital Warts

Genital warts are warts that appear in the genital area. There can be 1 wart or a cluster of warts. People get these warts by picking up the human

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Herpes simplex is a common viral infection. If you’ve ever had a cold sore or fever blister, you picked up the herpes simplex virus. Most cold sores

Hives

Hives are welts on the skin that often itch. These welts can appear on any part of the skin. Hives vary in size from as small as a pen tip to as

Lichen Planus

Many people get lichen (LY-kin) planus (PLAN-us). This disease can develop on one or several parts of the body. It can appear on the skin or inside

Melanoma

Melanoma is a type of skin cancer. Anyone can get melanoma. When found early and treated, the cure rate is nearly 100%.

Allowed to grow, melanoma

Melasma

Melasma (muh-LAZ-muh) is a common skin problem. It causes brown to gray-brown patches on the face. Most people get it on their cheeks, bridge of

Moles

Moles are common. Almost every adult has a few moles. Adults who have light skin often have more moles. They may have 10 to 40 moles on their skin.

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Molluscum (muh-luhs-kum) contagiosum (kən-tā-jē-ō-səm) is a common skin disease. It is caused by a virus. This virus easily spreads from person to

Nummular Dermatitis

People who get this skin problem often see distinct, coin-shaped (nummular) or oval sores on their skin. Nummular dermatitis often appears after a

Pityriasis Rosea

People of all ages and skin colors get pityriasis rosacea, but this skin disease is more likely to occur:

Between 10 and 35 years of age.
During

Poison Ivy Dermatitis

Many people get a rash from poison ivy, poison oak, and poison sumac. This rash is caused by an oil found in the plants. This oil is called urushiol

Rosacea

Rosacea (rose-AY-sha) is a common skin disease. It often begins with a tendency to blush or flush more easily than other people.

The redness can

Seborrheic Dermatitis

This is a very common skin disease that causes a rash. When this rash appears, it often looks like the one pictured above. The skin tends to have

Seborrheic Keratosis

Seborrheic keratoses tend to do the following:

Start as small, rough bumps, then slowly thicken and develop a warty surface
Have a waxy,

Shingles/Herpes Zoster

Anyone who has had chickenpox can get shingles. After the chickenpox clears, the virus stays in the body. If the virus reactivates (wakes up), the

Skin Cancer

Even the same type of skin cancer can look very different from person to person. This makes it hard to look at a picture and tell if you have skin

Tinea Versicolor

We all have yeast living on our skin. When the yeast grow out of control, a person can get a skin disease called tinea versicolor.  Yeast is a type

Warts

Warts are small, harmless growths that appear most frequently on the hands and feet. Sometimes they look flat and smooth, other times they have a

Fungal Infections – Johns Hopkins All Children’s Hospital

What do you think of when you hear the word fungus? Do you think of mushrooms? A mushroom is one type of fungus, but fungus also refers to a type of germ that lives on all of us.

This germ is harmless most of the time, but sometimes it can cause a problem called a fungal infection (say: FUN-gul in-FEK-shun). It sounds gross, but don’t worry or feel embarrassed. A lot of people get fungal infections, but they’re usually easy to treat because a fungus rarely spreads below the skin.

If you get one of these infections, before you know it, you’ll be saying bye-bye to fungi (say: FUN-guy).

What Is a Fungal Infection?

Fungi, the word for more than one fungus, can be found on different parts of the body. Here are some common types of fungal infections:

• Tinea (say: TIH-nee-uh) is a type of fungal infection of the hair, skin, or nails. When it’s on the skin, tinea usually begins as a small red area the size of a pea. As it grows, it spreads out in a circle or ring. Tinea is often called ringworm because it may look like tiny worms are under the skin (but of course, they’re not!).

  Because the fungi that cause tinea (ringworm) live on different parts of the body, they are named for the part of the body they infect. Scalp ringworm is found on the head, and body ringworm affects any other skin areas.

• Athlete’s foot is another type of fungal infection that usually appears between the toes but can also affect toenails and the bottom or sides of the feet.
• Jock itch is a fungal infection of the groin and upper thighs. You might think only men and boys get it, but girls and women can get it, too.
• Candida (say: KAN-dih-duh) is a yeast, similar to a fungus. It most often affects the skin around the nails or the soft, moist areas around body openings. Diaper rash in babies can be from one type of candidal infection, as can thrush (white patches often found in the mouths of babies). Older girls and women may develop another form of candidal infection in and around the vagina. This is called a yeast infection.
• Pityriasis versicolor (say: pih-tuh-RYE-uh-sis VUR-suh-kul-ur) is a mouthful to say. It’s a rash caused by a fungus that normally lives on human skin. It can appear over the chest, shoulders, and back, and is common in teenagers.

Why Do Kids Get Fungal Infections?

Lots of kids get fungal infections. Kids love to share and hang out together. Some of these infections are contagious (say: kon-TAY-jus), which means they easily spread from person to person. Close contact or sharing a comb or hairbrush with someone who has tinea can spread the fungus from one person to another. Because fungi need a warm, dark, and humid place to grow, public showers, pools, locker rooms, and even the warmth of shoes and socks can give fungi the perfect opportunity to strike.

Taking antibiotics can cause some kids to get a yeast infection. Antibiotics get rid of germs that make us sick, but they can also kill many of the harmless bacteria in our body. These harmless bacteria normally fight with the yeast for a place to live, but when antibiotics kill them, the yeast is free to grow.

Sometimes, a fungus may infect kids if they have an immune system disorder (this means their bodies can’t fight certain types of infections). This is rare, but it does happen.

How Do I Know If I Have a Fungal Infection?

Many skin problems look like a fungal infection so the best way to know for sure is to ask your doctor. Here are some signs you and a parent can look for:

• Athlete’s foot causes symptoms that include red, dry, cracked, and itchy skin between the toes. Some people also have red, scaly bumps filled with pus on the bottoms and sides of their feet.
• Jock itch appears as a rash with elevated edges in the groin area. It’s itchy and often feels like it is burning. It’s pretty common, especially if you play sports. Sweating and wearing athletic equipment can bring on this kind of rash.
• Ringworm of the head begins as a small bump or scaly patch that looks like dandruff. The pimple or patch becomes larger and the hair in the infected area can become brittle and break off. This can create scaly patches of baldness, but the hair will grow back. If you have ringworm on your arms, legs, or chest, you may see small red spots that grow into large rings.
• Candida yeast causes the skin in the infected area to itch. The skin also might be red and swollen.
• Pityriasis versicolor, also caused by a yeast, makes lots of round and oval-shaped flat, pale patches on the skin, especially the chest, upper arms, and sometimes the face and neck.

Farewell to Fungus!

Getting rid of a fungal infection is not too hard. Your doctor may decide to scrape a small amount of the irritated skin or clip off a piece of hair or nail and look at it under a microscope or do a culture.

Once your doctor knows what kind of infection you have, special antifungal creams and shampoos can help to get rid of it. Sometimes the doctor will prescribe a medicine to take by mouth. Make sure you take the medicine for as long as the doctor tells you.

Maybe fungal infections can’t be avoided altogether, but you can help yourself ward them off.

Walk away from athlete’s foot by:

• Washing your feet every day.
• Drying your feet completely, especially between your toes.
• Wearing sandals or shower shoes when walking around in locker rooms, public pools, and public showers.
• Wearing clean socks. If they get wet or damp, be sure to change them as soon as you can.
• Using a medicated powder on your feet to help reduce perspiration (sweating). Ask a parent first.

You can ditch jock itch by:

• Wearing clean cotton underwear and loose-fitting pants.
• Keeping your groin area clean and dry.

Prevent beastly yeast infections by:

• Changing out of wet swimsuits instead of lounging around in them.
• Wearing clean cotton underpants.

Say bye-bye to pityriasis by:

• Trying not to let your skin get too hot or sweaty.
• Using an anti-dandruff shampoo to wash your skin once a month.

There may always be a “fungus among us,” but we can make it a lot tougher for them to invade and grow!

Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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How to Heal a Fungal Infection: Holladay Dermatology & Aesthetics: Dermatology and Aesthetic Specialists

If you’ve ever had a common cold or a sinus infection, you know how bacteria and viruses can affect your health. But fungi, the lesser known pathogen, causes its fair share of damage as well, including allergies, asthma, and blood issues. But the most common fungal conditions are infections of the skin and nails.

It’s important to learn the signs of a fungal infection so you can stop it before it progresses. It’s also important to have an expert dermatologist who can help you determine exactly what type of fungal infection you have and get you started on the right treatment. 

Dr. Robert Topham at Holladay Dermatology & Aesthetics here in Holladay, Utah, diagnoses and treats all kinds of fungal infections and can help you navigate the complex world of skin care. Here’s what you need to know about fungal infections.

Facts about fungi

Fungi are organisms that live in soil, water, vegetation, animals, and humans. Some fungi decompose dead matter and play an important role in the life cycle of an ecosystem. Other fungi (about 300 of the millions of fungus types) are parasitic and cause disease and infection.

Many forms of fungus are harmless, such as the yeast in bread and beer and the mushrooms on your salad or burger. However, if a harmful type of fungus invades your body, it can affect your health, particularly your skin and nails.

Types of a fungal infection

Fungal infections of the skin and nails typically fall into one of four categories: athlete’s foot, yeast infections, jock itch, and ringworm.

1. Athlete’s foot

Fungi love warm, wet environments, which is why they thrive between the toes of sweaty athletes. In fact, it’s so common in the sports world that the medical term for this type of fungal infection, tinea pedis, is widely known as athlete’s foot. 

It begins as an itchy, scaly rash that may sting and burn. Although it typically originates between your toes, it spreads quickly and can affect your whole foot. It can even infect your hands if you touch and scratch your infected feet.

2. Yeast infections

Under normal circumstances, small amounts of yeast in your body are harmless, but if it multiplies, yeast causes infections called candidiasis.

If the yeast grows in your mouth and throat — a condition called thrush — you’ll notice pain when swallowing, white or yellow patches in your mouth, cracks at the corners of your mouth, and a red, sore throat and mouth.

Yeast can also affect the genitals, especially in women. The vaginal environment is perfect for yeast growth. Symptoms of infection include itching, burning (especially when you urinate), inflammation, and a discharge that resembles cottage cheese.

Diaper rash is a form of yeast infection that occurs when a baby’s skin is in contact with a wet diaper for prolonged periods. 

Toenails are another notorious place for a yeast infection. If you have a nail injury, diabetes, a weakened immune system, or a circulatory problem, yeast can easily set up camp in your nails and cause them to become thickened, yellow or brown in color, cracked, and crumbly.

3. Jock itch

Technically called tinea cruris, jock itch is another fungal infection common to athletes who sweat a lot. 

Although not usually a serious condition, it can be extremely bothersome, as it causes reddened patches on the groin, buttocks, and inner thighs that can be painful and itchy. 

4. Ringworm

Ringworm, or tinea corporis, is a misnomer, as the culprit is fungus, not a worm of any type. It got its name from the shape of the red rash or lesion it causes. Jock itch is technically a type of ringworm.

The classic ringworm symptom is a rash that forms a ring shape with red edges, but it may also present with blisters or red, itchy raised patches of skin. Ringworm can attack your body anywhere, including your scalp.

Healing a fungal infection

The best way to avoid fungal infections and manage a current one is to adjust your daily habits:

• Dry yourself thoroughly after showering or swimming
• Wear loose clothing, especially on hot, humid days
• Don’t sit around in a wet bathing suit 
• Change damp socks and undergarments

If you contract a fungal infection, there are many over-the-counter lotions and ointments that may reduce your symptoms for a while, but if you find them ineffective, Dr. Topham can prescribe a stronger treatment to get rid of the fungus for good. 

He recommends two powerful antifungal medications: FungiFoam® and Formula 3®. These topical solutions contain tolnaftate, an ingredient found in many antifungal products, but in prescription strength. FungiFoam and Formula 3 also contain jojoba oil, which is known for its ability to kill certain yeasts and fungi, including those that cause candidiasis. 

Fungal infections can be tough to get rid of, but Dr. Topham can help. If you have symptoms of a fungal infection and it’s not getting better, schedule an appointment today. Call us at 801-272-4408. 

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Versicolor versicolor

Fungal diseases of the skin and nail plates – a common disease that causes a lot of cosmetic inconvenience to patients. It is important to note that the problems are associated not only with cosmetics, if a person suffers from diabetes mellitus, then the affected nail plastics and the concomitant fungal infection on the skin can, together with other factors and changes in the vessels, lead to a serious condition – diabetic foot syndrome.The diabetic foot is manifested by long-term non-healing ulcers, pain in the feet, and often ends with amputation. Also, patients with fungal diseases are a source of infection for others. Before prescribing treatment, the doctor must confirm the diagnosis of a fungal infection by laboratory methods. This is due to the fact that some diseases may be similar to mycosis. For example, with psoriasis of the nail plates and with mycosis of the nails, the external manifestations will be the same. In our clinic, a laboratory study of skin scales from the skin of the affected areas and nail plates is carried out to detect elements of the fungus.Only after confirming the diagnosis, it is possible to determine the treatment option.

Treatment of fungal diseases of the skin and nails is carried out according to certain rules – external therapy will be effective only for skin lesions, damage to hair, nail plates requires the appointment of drugs in capsules or tablets inside. Such systemic therapy of mycoses has been well studied in world practice and has shown high efficacy and safety . At the same time, it is important not to forget about the processing of shoes and leather of the feet.However, the slow growth of nails does not allow getting a result in a short time – it takes 6 to 12 months for a healthy nail plate to grow back. In some cases, it is proposed to remove nail plastics – this is traumatic and can lead to damage to the growth zone of the nail and regrowth of the deformed plate, although fungi will not be found there. We are opposed to such tactics and only use modern treatment options.

Treatment of fungal infections of the skin and its appendages in St. Petersburg

Fungal diseases are infectious lesions and can develop in all layers of the skin, nails, hair, and also affect bones and internal organs.According to the World Health Organization, every fifth inhabitant of our planet suffers from some kind of fungal disease.

Diagnostics and treatment

If signs of a fungal disease appear, consult a doctor immediately. Only an experienced dermatologist will be able to make the correct diagnosis based on examination, tests and laboratory diagnostics.

The treatment program for each patient is selected individually and necessarily includes the following stages:

• External treatment – elimination of external symptoms of the disease using highly effective antifungal ointments, creams, solutions, varnishes.
• General treatment, which consists in eliminating the internal causes of the disease and the causative agent of the fungus. It includes immunostimulating therapy, drug therapy, and the use of antifungal drugs.
• Elimination of the consequences and complications of mycological disease

Most common fungal diseases and their symptoms

Versicolor versicolor

Symptoms: The disease manifests itself as non-inflammatory spots of various shades from white to brown, scaly and itchy.The spots can merge, forming large foci of irregular shape. Most often, lichen is localized on the skin of the neck, chest, back and abdomen. The causative agent of this disease is the yeast-like fungus Pityrosporum orbiculare, which normally lives on human skin and does not cause any inconvenience. The development of the disease is affected by a decrease in nutrition and immunity, severe sweating, seborrhea, and various pathologies of internal organs. During treatment, it is necessary to examine all family members, disinfect clothes and bed linen.The disease can be transmitted through household items, a shared towel, clothing.

Epidermophytosis of feet

Symptoms: fungal disease of the feet, affecting the skin of the foot, interdigital folds, plantar surface of the toes and human nail plates. It appears as scaly patches and blisters that cause itching. In 20-30% of patients with mycosis of the feet, nail damage occurs, in which the nail plate becomes dull, yellow spots appear, and the nail peels off from the nail bed.The causative agent of athlete’s foot is Trichophyton mentagrophytes var. interdigitale. The disease is very common, among the main causes of infection is the wearing of shoes and socks of an infected person on a bare foot. Contribute to the appearance of diseases of microtrauma on the leg, diaper rash,
abrasion, dry skin. Most often, infection occurs in a bath, pool or sauna, when skin particles of an infected person get on a wet foot. To prevent the development of epidermophia, it is recommended to always wear slippers in the bath or pool, never wear someone else’s shoes on bare feet.

Athlete’s groin

Symptoms: a fungal disease affecting large folds of the skin, mainly in the groin area. At the first stage of the disease, inflammatory spots of pink color appear, rounded, accompanied by itching, burning and soreness. When the spots merge, they form a lesion, on which bubbles, micropustules, erosion and desquamation develop. The disease is most often localized in the groin and intergluteal region, but can spread to the inner thighs, elbow folds, scalp.Epidermophytosis of the groin area is caused by the fungus Epidermophyton floccosum. Infection occurs mainly by contact, as well as through things and household items of a sick person. Increased sweating, impaired carbohydrate metabolism, and poor personal hygiene contribute to the development of the disease. Most often, men suffer from epidermophytosis.

Ringworm (mycosporia)

Symptoms: a fungal disease of the hair and skin caused by a fungus of the genus Mycosporum.Getting on the skin, the fungus begins to multiply, forming bright pink spots with inflammatory nodules, erosion, crusts. When localized in the scalp, the fungus grows deep into the hair follicle, affecting the hair and cuticle. Most often, children are sick with ringworm. Cats are carriers of the disease, and an outwardly healthy street cat can be carriers of the fungus. The disease is very contagious, skin lesions occur through contact with an infected animal or with objects on which there is an infected wool.

Skin candidiasis

Symptoms: the causative agent of candidiasis are yeast-like fungi of the genus Candida (albicans, glabrata, tropicalis, etc.) affecting the skin, mucous membrane and internal organs. The clinical manifestations of the disease are different and depend on the localization and state of the body’s defense system. Most often, candidiasis begins with the abundant appearance of bubbles, when opened, areas of crimson erosion, inflammation and swelling of the skin appear. Most often, candidiasis affects large folds of the skin – the groin and intergluteal regions.With development on the mucous membrane of the genital organs, itching, erosion and tiny whitish discharge occur.

Fungal infections (mycoses of the skin and mucous membranes, nails)

Fungal infections (mycoses) are diseases that are caused by different types of microscopic fungi.

Mycoses of the skin and mucous membranes, nails are the most common among all human fungal diseases. Systemic mycoses (damage to several body systems) are predominantly found in persons with immunodeficiency.Most often these are HIV-infected, patients after organ transplantation, cancer patients, etc.

The main causative agents of mycoses of the skin: mushrooms Trichophyton Trichophyton rubrum, Trichophyton mentagrophytes, var. interdigitale, Epidermophyton Epidermophyton floccosum and Candida Candida .

Infection with fungi occurs through direct contact with the patient, through shoes, clothes, when using general hygiene products (washcloths, manicure tools), when visiting gyms, baths, saunas, swimming pools.The main factor of infection is the presence of abrasions and cracks in the skin, which occur with increased sweating, dryness, and poor circulation in the limbs. People with diabetes mellitus, immune disorders, blood diseases; long-term antibiotics, glucocorticosteroids, cytostatics are especially susceptible to the development of mycoses.

Most often, microscopic fungi cause damage to the skin of the feet and large skin folds (axillary, inguinal and others).

Main symptoms and complaints

When infected with fungi, ring-shaped inflammatory foci appear on the skin and in the folds, with clear boundaries and a raised roller along the edges.On the surface there may be small scales, bubbles. If large folds are affected, there may be a weeping and macerated surface. It is often observed in the groin areas, scrotum, armpits, under the breast.

Fungal disease of the feet is manifested by peeling on the skin in the interdigital spaces, soles, thickening of the stratum corneum and lateral surfaces of the feet, cracks.

With onychomycosis (“nail fungus”), yellowish and whitish stripes are formed in the thickness of the nail, the nail plate thickens, crumbles, the edges of the nail become serrated.Thinning of the nails is sometimes observed, and detachment of the nail from the bed may occur.

Itching is the main complaint of fungal skin diseases. When the surface is macerated (especially in the folds), a burning sensation occurs. Fungal infections develop slowly and have a long course. An exacerbation usually occurs in the summer. It is important to remember: the use of ointments and creams containing hormones in the composition causes a deterioration in the condition and is strictly contraindicated in mycoses.

Among the fungal diseases of the scalp, the most common microsporia , which is caused by fungi of the genus Microsporum. Microsporia is a highly contagious disease. On the territory of Russia, fungi Microsporum canis are widespread, often infect animals (cats, dogs, rabbits, hamsters, guinea pigs). Human infection occurs through contact with a sick animal. The incidence peaks are May-June and September-November. Most often children are ill, not only because of the ardent love for animals, but also because of the peculiarities of the structure of the skin – more delicate than that of adults. The symptom of microsporia is the appearance of foci of a round or oval shape, with raised clear boundaries, covered with scales or crusts.When the scalp is affected, the hair in the focus is broken off.

Yeast-like fungi are the cause of candidiasis. Urogenital candidiasis – e is an inflammatory disease of the genitourinary tract caused by fungi of the genus Candida . It is believed that 70-75% of women at least once during their life get sick with vulvovaginal candidiasis (“thrush”). The main symptoms in women are abundant white cheesy or creamy discharge from the genital tract, itching and burning in the external genital area.Relapses of the disease often occur against the background of a decrease in immune defense, the use of antibiotics, and a change in sexual partner. In men, manifestations of urogenital candidiasis can be redness and swelling on the genitals, with a white coating on the surface of the rash.

Candida can affect the mucous membranes of the mouth, most commonly in young children. Eroded elements with a white coating appear on the mucous membrane, accompanied by a burning sensation, discomfort when swallowing.

Diagnostics

To confirm a fungal disease of the skin, folds and nails, microscopic examination of skin flakes, nail plates is used, with microsporia – skin flakes and broken hair.

Mycelium-forming ( trichophytons, epidermophytos and others) fungi are difficult to cultivate on artificial nutrient media. It takes a long time – up to a month to get the result of microbiological research (inoculation).

In contrast, yeast-like fungi (candida) are well cultivated. Microbiological research (inoculation) is often used to diagnose and determine the sensitivity of yeast-like fungi to antifungal drugs.

In case of damage to the oral cavity and respiratory tract:

Ear swab:

Detachable eyes:

With urogenital candidiasis:

In case of candidiasis of the genitourinary tract, it is also possible to pass an analysis by the real-time PCR method with the determination of candida species that are resistant to standard therapy.

With oral candidiasis, the PCR method can also confirm the diagnosis in a short time.

In some severe, common cases of fungal disease, treatment includes long-term oral systemic antifungal medications (for example, up to several months with nail damage). In such cases, before starting treatment, it is necessary to assess the general clinical parameters of blood and urine, biochemical parameters of the blood.

Sources

1. Clinical guidelines of the Russian Society of Dermatovenereologists and Cosmetologists “Mycosis of the hands, feet and trunk”, 2016
2. Clinical guidelines of the Russian society of dermatovenerologists and cosmetologists “Microsporia”, 2016

Crimean scientists have invented a new way to detect skin fungus – Rossiyskaya Gazeta

According to the authors of the article, today it is possible to recognize skin fungus using tests that require a lot of time.Another way is fluorescent diagnostics: illumination of the affected areas of the skin with a UV lamp (the infected area of ​​the skin will glow when illuminated with ultraviolet light). Moreover, different fungal skin diseases glow in different ways, and a special table with diseases and the corresponding glow colors allows you to determine the infection.

In the publication, scientists note that the human eye may not see the glow of the affected skin area. For example, if the area of ​​the infected skin area is very small or, due to the physiology of his vision, the doctor may attribute the fungal disease to the wrong color of the glow.In this regard, the authors of the article argue that it will be possible to quickly diagnose skin fungus using “computer vision” – image processing.

“The creation of such technologies is largely due to the emergence and development of pattern recognition, which are based on invariants of moments of intensity,” said Alexander Volyar, head of the Department of General Physics at Kazan Federal University. – Moments of intensity will be used to detect and further analyze the infected areas of the skin. It is planned that a high-quality selection and calculation of moments will allow fixing even small-sized affected skin areas with clearly defined boundaries, which will increase the accuracy of diagnosing skin diseases in real time, and will also contribute to the rapid and high-quality treatment of patients.

The color and shade of the disease glow will be determined by the lightness, saturation and color tone. Lightness and saturation will help to establish how a given color differs from monochromatic (pure) radiation, which in turn will determine the degree of attenuation (dilution) of a given color with white and distinguish pink from red, blue from blue. The color tone will allow you to distinguish between the main colors (red, green, blue).

According to scientists, to determine the color of the glow of a fungal disease, the primary colors are planned to be divided into shades in terms of brightness: from dark to light.Each gradation of brightness is assigned a digital value. This defines a three-dimensional color coordinate space, within which each color is represented by a point.

The created device is supposed to be used for express diagnostics of fungal skin diseases in schools and kindergartens. Also, its algorithm is effective in face recognition systems at public events.

According to the creators, the results of the study can be of great importance for the development of theoretical questions and the solution of problems in the use of modern singular optics and computer technologies in the field of medical diagnostics.

Fungal diseases (fungus, mycosis, candidiasis) of the skin and nails – article on the topic Dermatology

In the department of dermatology of the “International Center for Health Protection” diagnostics and selection of therapy for skin mycoses are carried out.
Fungal skin diseases (dermatomycosis) are infections of the skin caused by fungi. Currently, about 50 species of pathogenic fungi 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.
Etiology: fungi can infect the stratum corneum, skin appendages, mucous membranes of the oral cavity and genitals, dermis, hypodermis, and other deep tissues.
The development of fungal skin lesions is due to: pathogenicity and virulence of the pathogen, the state of the macroorganism, environmental conditions.

Diagnostics

The diagnosis of fungal skin lesions, in the overwhelming majority of cases, must be confirmed by laboratory research methods: * microscopic, * cultural, * rarely histological, * sometimes luminescent.

Classification of dermatomycosis

There are different types of classifications: by localization, by the type of pathogen and other characteristics.

Classification No. 1

There are 4 groups of mycoses and a group of pseudomycoses.
Mycoses:
1) keratomycosis (versicolor versicolor)
2) dermatomycosis (epidermophytosis, trichophytosis, microsporia, favus)
3) candidiasis
Pseudomycosis: erythrasma, actinomycosis

Classification No. 2

1.mycoses due to dermatophytes:
* mycosis of the scalp (trichophytosis, microsporia, favus)
* mycosis of the beard and mustache
* mycosis of smooth skin (rubromycosis, trichophytosis, microsporia, favus)
* mycosis of large folds of the body
* mycosis of feet
* mycosis of hands
* mycosis of nails (“nail fungus”)
2.mycoses due to yeast-like fungi:
* superficial candidiasis
* candidiasis of mucous membranes
* candidiasis of the corners of the mouth
* intertriginous candidiasis (yeast intertrigo)
* candidal paronychia and onychia
* pityriasis versicolor
3.mycoses caused by molds

Basic recommendations for the treatment of mycoses

1.treatment of fungal diseases should be carried out only after laboratory confirmation of the diagnosis
2.in case of skin lesions, any antifungal agent for external use is used 1-3 times a day until the disappearance of clinical manifestations, then once a day for 2-4 weeks to prevent relapse of the disease.
3.In case of lesions of the appendages of the skin, use general therapy
4.It is compulsory to carry out preventive measures

Prevention of mycoses

– identification of sources of infection
– elimination of ways of infection spread
–prophylactic and sanitary-educational work

Treatment of fungal diseases of the skin and nails is a complex and time-consuming process.