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Dermatomycosis: Causes, Symptoms and Treatment

Dermatomycosis is a fungal infection of the skin caused by various types of fungi. It commonly presents with redness, scaling, and itching on affected skin areas.

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Things worth knowing about "Dermatomycosis"

Dermatomycosis is a fungal infection of the skin caused by various types of fungi. It commonly presents with redness, scaling, and itching on affected skin areas.

What Is Dermatomycosis?

Dermatomycosis refers to an infectious disease of the skin caused by fungi. The term derives from the Greek words derma (skin) and mykes (fungus). Fungal skin infections are among the most prevalent skin conditions worldwide, affecting people of all ages and backgrounds.

Depending on the area of the body involved and the causative organism, dermatomycosis can take several different forms. In addition to the skin surface, hair, nails, and mucous membranes may also be affected.

Causes and Pathogens

Dermatomycosis is caused by various groups of fungi. The most important pathogens include:

Dermatophytes (e.g., Trichophyton, Microsporum): The most common cause of dermatomycosis, predominantly affecting skin, hair, and nails.
Yeasts (e.g., Candida albicans): Typically cause infections in warm, moist areas such as skin folds or the oral mucosa.
Molds (e.g., Aspergillus): Less common overall, but particularly relevant in immunocompromised individuals.

Risk factors that predispose an individual to dermatomycosis include:

Weakened immune system (e.g., due to diabetes mellitus, HIV, or immunosuppressive medications)
Excessive sweating and persistently moist skin areas
Tight, non-breathable clothing or footwear
Skin injuries or abrasions
Direct contact with infected people, animals, or contaminated surfaces (e.g., in swimming pools or locker rooms)

Symptoms

The symptoms of dermatomycosis vary depending on the location and the causative organism. Common signs include:

Redness and inflammation of the skin
Scaling and peeling of the outer skin layer
Itching (pruritus) and burning sensations
Blistering or weeping skin lesions
In nail infections: discoloration, thickening, and brittleness of the nails (onychomycosis)
In scalp infections: patchy hair loss (tinea capitis)

Common Forms of Dermatomycosis

Tinea Pedis (Athlete's Foot)

Tinea pedis, commonly known as athlete's foot, is the most frequent form of dermatomycosis. It predominantly affects the spaces between the toes and causes itching, scaling, and skin fissures.

Tinea Corporis (Ringworm of the Body)

Tinea corporis affects smooth skin on the body and typically presents as ring-shaped, red, scaly patches that expand outward over time.

Tinea Unguium / Onychomycosis (Nail Fungus)

Onychomycosis is a fungal infection of the nails, leading to yellowish-white discoloration, thickening, and brittleness. Toenails are more frequently affected than fingernails.

Tinea Capitis (Scalp Ringworm)

Tinea capitis affects the scalp and hair follicles, occurs most commonly in children, and may cause patchy, circular hair loss.

Candidiasis (Yeast Infection)

Candidiasis, caused by Candida species, typically affects moist skin areas such as the groin, armpits, or corners of the mouth, presenting with redness, itching, and whitish deposits.

Diagnosis

The diagnosis of dermatomycosis is established through:

Clinical examination: The physician evaluates the characteristic appearance of the skin lesions.
Direct microscopy (native preparation): Skin scrapings, hair, or nail clippings are examined under a microscope for fungal elements.
Fungal culture: Collected material is cultured on special growth media to identify the causative organism.
Wood lamp examination: Ultraviolet light is used to detect certain fungal infections through specific fluorescence patterns.

Treatment

Treatment depends on the causative organism, the extent of infection, and disease severity:

Topical Therapy

Superficial dermatomycosis is typically treated with antifungal creams, gels, or solutions. Commonly used active ingredients include:

Clotrimazole
Miconazole
Terbinafine
Ciclopirox

Treatment duration generally ranges from 2 to 4 weeks depending on the agent and organism involved.

Systemic Therapy

Extensive, deep, or treatment-resistant infections, as well as nail or scalp involvement, typically require oral antifungal medication (e.g., terbinafine, itraconazole, fluconazole).

Prevention

To reduce the risk of dermatomycosis, the following measures are recommended:

Regular and thorough washing and drying of skin, especially in skin folds and between toes
Wearing breathable footwear and moisture-wicking socks
Avoiding walking barefoot in public facilities such as pools or gyms
Using personal towels and hygiene items

References

World Health Organization (WHO): Fungal diseases and their burden. Geneva, 2022. Available at: https://www.who.int
Nenoff P. et al.: Dermatophytosis - Diagnosis and Therapy. Journal of the German Society of Dermatology, 2019; 17(5): 1-15.
Hay R.J.: Fungal infections. In: Griffiths C. et al. (eds.): Rook's Textbook of Dermatology. 9th ed. Wiley-Blackwell, 2016.

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