Tinea (Fungal) Infections of the Skin 2017-11-05T20:27:12+00:00

Introduction

Tinea, often called ringworm due to the circular nature of the rash, is a common type of fungal infection on the skin. In 2010, fungal infections of the skin were the 4th most common disease worldwide affecting 984 million people. Inhalation of fungal spores or localized colonization of the skin may initiate persistent infections. For example, fungi tend to colonize in wet and warm areas of the body such as between the toes, genital region, under the breast, and armpits. It is worth mentioning that fungi tend to live only in the topmost layer of the epidermis (i.e., stratum corneum) and do not penetrate deeper yet fungal infections on one part of the body can cause rashes on other areas of the body that are not infected. For example, a fungal infection on the foot may cause an itchy, bumpy rash on the fingers. These eruptions (dermatophytids, or identity or id reactions) are allergic reactions to the fungus. They do not result from touching the infected area. Evidence has shown that people who are obese, as well as those that are diabetic, have a higher propensity for contracting a fungal infection.

Causes

Most tinea infections are due to either dermatophytes (e.g., Tinea pedis, Tinea corpora; see below) or yeast. (e.g., Candida & Malassezia globosa which causes tinea versicolor: see below). A dermatophyte is one of three genera of the fungus species; for example, Epidermophyton (causes Tinea pedis and Tinea cruris), Microsporum (causes Tinea corporis), and Trichophyton (causes tinea unguium).

Symptoms

Symptoms will vary depending on the location as well as the type of species that colonizes on the body. Consequently, each fungal infection is classified based on the site of the infection on the body as well as the type of species causing the infection. Fungal infections will begin with the name tinea proceeded by a specified name based on the location. For example, Tinea pedis (foot), Tinea unguium (nails), Tinea manuum (hand), Tinea cruris (groin), Tinea corporis (body), Tinea capitis (scalp), Tinea faciei (face), Tinea barbae (beard), and Tinea versicolor (various colors); which is characterized by a skin eruption on the trunk and proximal extremities, hypopigmentation macule in area of sun induced pigmentation. Excluding tinea versicolor, most tinea infections are marked by an Itching-, burning-, cracking-, and scaly-like lesion that may appear as concentric rings often with a bright center.

Diagnosis

We may diagnose a fungal infection by examining the clinical appearance of your skin. We will look for any irritation, redness, or a scaly rash in the area that is affected. We may order a skin scraping to quantitatively confirm if a fungal infection is occurring. A skin scraping is performed by scraping off a small amount of skin that is placed in a culture medium or examined under a microscope.

Treatment

Fungal infections are typically treated with antifungal drugs, usually with antifungal medications that are applied directly to the affected area (called topical drugs). Topical medications may include creams, gels, lotions, solutions, or shampoos. It is worth mentioning that antifungal drugs may also be taken by mouth. In rare cases, a corticosteroid may be prescribed to reduce the inflammation and itching. Lifestyle changes such as keeping the area dry is suggested in clearing a fungal infection.