FUNGAL INFECTIONS

Fungal Infections - Skin & Nails
Fungal infections are referred to as “tinea” in the medical literature or as “ringworm” in laymen’s terms. A fungal infection may occur anywhere on the body or face and is typically noticed as a raised red, flaky ring. Fungus is commonly found on the feet and presents as scaly or red feet and thickened, yellow nails. Certain fungal strains are transmitted by touching or playing with an affected animal.  Often these strains of fungus from animals behave more dramatically, causing more redness, irritation, or flaking of the skin.
 
The diagnosis of fungal infections is typically made clinically given the characteristic ring-like appearance of the skin.  A simple skin test performed by scraping off some of the flaky skin painlessly also confirms the diagnosis.  This skin test, called a KOH, helps to demonstrate the fungus under the microscope.  In rare cases, a skin biopsy confirms a fungal infection.  This typically occurs when the rash is unusual, or has been partially treated by a topical steroid.  For toenail fungus, a nail clipping can used to perform a fungal culture or PAS stain to confirm the presence of a fungal infection.
 
Fungal infections of the skin can usually be treated with topical prescription medications. Rarely, oral medication is needed for significant fungal infections. Toenail infection requires oral prescription medication for a chance of cure.  A newer topical nail lacquer is to be approved which may offer an alternative to oral medication like terbinafine (Lamisil) for the treatment of toenail fungus.
 
Subtypes of fungal infections are described below:
TInea capitis is a fungal infection of the scalp sometimes referred to as scalp ringworm.  This often involves the hair shaft and follicles.  Tinea capitis is most common in children.  The fungus is most often a species called Trichophyton tonsurans although pets can carry different fungal stains that can cause severe reactions.  Tinea capitis can cause hair loss, inflammation of the scalp, and loss of hair shafts called black-dot ringworm.  If the condition becomes inflamed and the scalp swollen, an extremem version of scalp rinworm called kerion can result.  Treatment consists of several months of oral antifungal medications including griseofulvin.


Tinea barbae is a fungal infection of the beard area.  It results in painful, red, pus-filled bumps along the jawline and mustache area.  Treatment consists of oral medication.


Tinea faciei is a fungal infection of the face.  Mild cases of tinea faciei respond well to topical treatment.  This fungal infection is sometimes confused with eczema,   and often the fungal infection has first been treated with a steroid which may lead to temporary improvement.  Definitive antifungal treatment is necessary to cure the skin rash.


Tinea corporis also known as tinea circinata is a fungal infection of the body.  Fungus from the hands or feet may be transmitted to other areas of the body, or contact with a pet or farm animal may cause the skin eruption.


Tinea incognito describes a fungal infection that has been partially treated with topical steroid, allowing it to flourish down follicles on the skin.  Sometimes referred to as Majocchi’s granuloma, the fungal infection often appears as pus bumps on the skin.  Treatment requires oral medication.


Tinea cruris is often referred to as jock itch and is a fungal infection in the groin area.  Fungus from the feet is often transmitted from pulling on underwear to the groin region, causing red, itchy, scaly patches.  Topical treatment is often adequate to treat this fungal infection.


Tinea manis refers to a fungal infection of the hands.  Often only one hand is involved, sometimes along with both feet.  The palms appear red and scaly, almost like a contact dermatitis. Topical or oral medication is needed to treat the fungus.


Tinea pedis is the medical term for athlete’s foot, or a fungal infection of the feet.  Scaly feet are a common feature of fungal infection, and underlying redness of the skin is often present.  A look between the toes often reveals broken down skin called maceration.  Treatment requires continuous use of a topical antifungal medication.


Tinea versicolor is not a fungal infection but is caused by a yeast. 

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