Fungal Infection
Dermatophyte infections are general worldwide, and dermatophytes are the common problems of fungal infection of the skin, hair, and nails. These infections begin to various clinical manifestations, such as tinea pedis, tinea corporis, tinea cruris. Tinea is also known as ringworm.
The clinical features, diagnosis, therapy, and treatments of the skin’s Fungal infections will be reviewed here. Dermatophyte infections of scalp hair (tinea capitis), beard hair (tinea barbae), and nails (tinea unguium) are discussed in detail separately.
GENERAL PRINCIPLES
Dermatophytes are filamentous fungi in the species Trichophyton, Microsporum, and Epidermophyton. Dermatophytes metabolize and subsist upon keratin in the skin, hair, and nails.
The primary clinical subtypes of Fungal infections are:
Tinea corporis – Infection of body, surfaces other than the feet, groin, face, scalp hair, or beard hair.
Tinea pedis – Infection of the foot
Tinea cruris – Infection of the groin
Tinea capitis – Infection of scalp hair
Tinea unguium (dermatophyte onychomycosis) – Infection of the nail
Additional terms used to describe less common presentations are tinea faciei (infection of the face), tinea manuum (infection of the hand), and tinea barbae (condition of beard hair).
Tinea corporis, tinea cruris, tinea pedis, tinea faciei, and tinea manuum infections are typically superficial, including just the epidermis.
Tinea capitis and tinea barbae are characterized by infection of terminal hairs. Occasionally, dermatophyte infections penetrate the hair follicle and dermis, causing a condition called Majocchi’s granuloma.
Treatments for fungal Infection (Tinea)
Topical or systemic antifungal medicines with antifungal activity are effective treatments. Most superficial cutaneous fungal infections can be controlled with topical therapy with agents such as azoles, allylamines, butenafine, ciclopirox, and tolnaftate. Oral treatment with agents such as terbinafine, itraconazole, fluconazole, and griseofulvin is used for extensive or refractory cutaneous infections and infections extending into follicles the dermis (e.g., Majocchi’s granuloma) or involving nails. Patients should not be treated with oral ketoconazole because of the risk for severe liver injury, adrenal insufficiency, and drug interactions.