Fungal infections are among the most common infections known to mankind. The reason for their pervasiveness lies in the fact that the predisposition factors which favor fungi have also become very common (e.g., obesity, antibiotics, diabetes).
The situation is made worse by the wearing of synthetic fabrics and shoes which do not ventilate well, as well as by perspiration and dampness. The spread of fungus is more common when there is a hormonal change – e.g., long-term use of contraceptives, pregnancy, diseases of the adrenal cortex. The quality of circulation is also significant – arterial constriction, post-thrombotic syndrome and lymphatic edema are all risk factors.
Fungal infections can develop anywhere on the skin. They can be spread by pets, in which case the symptoms appear on the area which is contact with the animal. Reddish-colored, round, fine-edged, flaking, itchy areas of 0.5-5 cm diameter develop, which are often surrounded by small blisters containing clear fluid. If left untreated, skin fungus can spread further, and large, itchy plaques with raised contours can result.
The symptoms of mycosis intertriginosa usually develop in the folds of the skin, primarily in the inguinal and underarm areas as well as under the breasts and in the folds of the abdomen. Fine-edged, reddish, flaky, itchy patches develop on the affected skin. Long-term symptoms of fine flaking, itchiness and cracks may be due to a fungal infection of the skin of the palm; these are usually one-sided.
Infection of the nail is more common on the foot. The nail can be cracked and the color may change to yellowish or yellowish-brown. Symptoms on the hand nails are similar, and can be associated with long-term infection of the nailbed.
In many cases, there is no need for complicated procedures. The dermatologist can usually diagnose the infection on the basis of the symptoms and will apply the appropriate treatment. In case of large areas of infected skin or stubbornly chronic conditions, there may be a need for closer examination: for instance, it may be necessary to eliminate diabetes or diseases associated with immune deficiency.
If necessary, a fungal test is carried out. The sample is taken using a sharp blade. It is usually easy to obtain a reasonable sample from the scaly, peeling skin or the residue under the nail without causing pain. Using various dyes, the elements of the fungus become visible under the microscope – an experienced professional can diagnose the type of fungus on this basis. A more exact diagnosis can be made on the basis of fungal culture.
Skin infections are caused by 4 classes of fungus. These are the so-called Dermatophytes, which use a special enzyme called keratinase to break through the keratin layer of the hair follicle, the nail or hair and to live as parasites in those areas. The dermatophytes consist of three types: Microsporum, Trichophyton, and Epidermophyton. These are the most typical agents of skin fungal infections. Rarely, the skin can also be infected by a mold, by a so-called dimporphous fugus (extremely rare) and by proliferous fungus, the most common of which is Canduda albicans. Malassezia furfur (Pityrosporum ovale) is associated with the maintenance and aggravation of seborrheas dermatitis and dandruff of the scalp.
There are a multitude of treatments available to dermatologists as many antifungal treatments have developed over the past decades. Generally, fungal infections are treated topically with ointments, creams, and alcohol solutions.
Fungal infections of the nails can be treated by a variety of agents. Azoles (Clotrimazol, Ketoconazol, Fluconazol, Itraconazol) are available, as are allilamine derivatives (Terbinafin). It is recommended that laboratory parameters also be monitored when using these pharmaceuticals. The length of time required depends on the extent of the symptoms, usually at least 3 months.