Fungal infections are the most common skin diseases and can affect all age groups. The incidence of the disease is constantly increasing due to the large use of antibiotics, an increased incidence of diabetes mellitus and diseases accompanied by a weakened immune system. This type of infection, in most cases has a mild course, but if left untreated, it can spread across other body parts or to other people. Fungi are microorganisms that are widespread throughout the world. About 40 species are pathogenic — harmful to humans and have greater medical significance. Classification of fungi is done based on the method of reproduction and their morphological characteristics.
Causative agents of fungal infection
Fungi that cause skin infection can be divided into three larger groups: * dermatophytes
How are fungal infections transmitted?
Fungi are transmitted from one person to another most often on swimming pools, in spas and in locker rooms. A person can also be infected when using common shoes, towels and clothing items. Often the infection is transmitted from man to man or from an infected animal (cat, dog) to a man by direct contact.
What conditions favour the development of fungal infections?
Increased body weight, impaired peripheral circulation, the presence of diseases such as diabetes mellitus, conditions with weakened immunity, as well as the use of immunosuppressive drugs favour the development of fungal infections.
What does a fungal infection look like?
The clinical picture depends on the type of fungus that is the causative agent of the lesions, as well as the location of the infection.
Pityriasis versicolor — a relatively common surface infection of the skin caused by a fungus of the genus Malassezia. These fungi are a part of the normal skin flora, but in states of increased sweating, during the warmer months, and when the immunity is weakened, they multiply more, leading to skin lesions.
Lesions are usually present on the back, chest, neck and upper parts of the arms in the form of clearly shaped round, brownish or whitish fields with tiny scales.
Dermatophytes are fungal infections caused by so-called dermatophytes. Dermatophytes There are several forms of infection:
* Tinea capitis (scalp ringworm)
* Tinea barbae (beard ringworm)
* Tinea faciei (facial ringworm)
* Tinea cruris (jock itch)
* Tinea pedis (Athlete’s foot)
* Tinea manuum Tinea capitis — fungal infection of the scalp. More often it is seen in children in the form of independent oval inflamed patches on the scalp covered with tiny greyish scales. The hairs in these places are shortened, i.e. broken off a few mm above the skin.
In the case of deeper infections, painful, swollen inflammatory patches with pus develop, and pus is easily squeezed when pressure is applied. The hairs are broken off or fall out. Regional lymph glands are enlarged. Often, secondary bacterial infections can develop. Tinea barbae— fungal infection of the beard and moustache areas of the face. The symptoms are inflamed red pimples or pustules around the hairs, accompanied by excretion of pus and the appearance of scabs. The entire area of the beard area can be inflamed. The hairs fall out spontaneously or can be easily pulled out. Tinea faciei (facial ringworm)— larger or smaller oval, reddish patches with an raised edge and covered with scales appear on the face. Tinea cruris (jock itch)— fungal infection in the groin area. It occurs more often in warmer areas, in people with higher body weight due to sweating and in people wearing diapers. Usually it develops when the infection from the nails or feet spreads, as well as when staying in locker rooms and public pools. It is characterised by clearly shaped, reddish plaques on the groin that are slightly scaling and have a pronounced edge. They spread towards the thighs and external genitalia. They are accompanied by itching. Tinea pedis (Athlete’s foot) — a common fungal infection of the foot that often affects athletes and people wearing occlusive footwear. Common places where this condition can be acquired are around swimming pools and in locker rooms, spas or it can be transmitted by infected family members. Most often, the lesions are present between the toes with itching, scaling, cracking and redness. From there, the infection can easily spread to other parts of the foot or body. On the soles and on the toes, redness, deep-seated blisters, scaling and cracks appear. Sometimes only thickened skin is present, which easily cracks. Tinea manuum — represents the presence of fungal infection on the hands. It is characterised by redness and more or less pronounced scaling. Sometimes blisters and pustules develop on inflamed, reddish skin.
Onychomycosis — is a fungal infection of the nails. This type of infection is quite common and it is considered that about 8% of the population suffers from onychomycosis.
Risk factors that favour the development of the disease are impaired peripheral circulation, smoking, diabetes mellitus, the use of immunosuppressive drugs, malignant diseases, frequent nail injuries, especially in athletes. Usually the first changes in the form of thickening of the nail plate and yellowish discoloration are seen on the distal and lateral parts of the nail, later spreading towards proximal parts. At an advanced stage, the nail plate is very thickened, brittle, breaks easily and has a yellowish-brownish discoloration. If left untreated, onychomycosis is a constant source of infection.
In addition, altered and thickened nails can cause pain when walking and contribute to the development of bacterial skin infection.
Candidiasis is a skin and/or mucous membrane infection caused by yeasts of the genus Candida.
Factors that favour the development of this infection are frequent use of antibiotics, immunosuppressive drugs, diabetes mellitus, endocrine disorders, increased body weight, malignant diseases, as well as moist and warm environment. Infection can be localised in the skin folds: under the breast, in the groin area, in the arm pits and around the genitals. It is characterised by red, macerated plaques with peripheral scaling, with the presence of pustules on the edges of a rash. Itching and fine scaling are present. The infection often affects the skin between the fingers and toes and is characterised by redness, painful fissures and erosions. Paronychia is a skin infection around the fingernail and toenails, in the form of redness and painful swelling of the skin folds from which pus comes out when pressure is applied. Later, infection of the nail plate may develop.
How is fungal infection diagnosed?
Diagnosis of fungal skin infection is made based on mycological examination of the scraping of the skin lesion or nail plate.
Fungal infection treatment
Fungal infections are treated with topical and systemic antifungals, recommended by a dermatologist. Treatment is long-lasting and relapses are frequent, especially with fungal infection of the nails.