FUNGAL INFECTIONS


What is Dermatophyte infection?

  • • Dermatophyte infection is a superficial fungal infection of skin, hair and nails. It is also known as ringworm. In Hindi it is termed as Daadand in Telugu it is termed as Thamara (తామర).

How can one get a Dermatophyte infection?

  • • Ringworm occurs when aperson gets infected with Dermatophytes which is a superficial fungus. This fungus lives off human keratin and that is why the infection can occur on the skin, hair and nails.

How does the infection spread? What are the predisposing factors for development of Dermatophyte infection?

  • • Dermatophyte infection is transmitted by direct skin contact with infected person and by sharing objects of daily use (fomites).
  • • Dermatophyte infection is more common in tropical climate.
  • • High temperature, humidity and occlusive atmosphere predisposes to development of Dermatophytosis.
  • • Certain diseases like diabetes mellitus, HIV infection or patients taking steroids or anticancer drugs are high risk for development of Dermatophytosis.
  • • Poor hygiene, increased sweating, self- medication or use oftopical steroids, steroid- antifungal combinations, infection in family members are contributory factors.

How does Dermatophyte infection appear? Which areas of the body are affected?

  • • Dermatophyte infection presents with severe itching and skinlesions in the form of circular red areas with raised border andcentral clearing. The infection clears in the centre andextends towards the periphery.
  • • The folds of the body are the most common sites affected,especially the groins (hence termed jock itch), the armpits,areas below the breasts. The infection can extend onto theabdomen, buttocks and thighs.
  • • The palms, soles, web spaces of fingers and toes maypresent with itchy and scaly lesions.
  • • Nails may be infected and act as a source for recurrentDermatophytosis. The nails may show discoloration or totaldamage of the nail plate can be seen. Toe nail infections arecommon in elderly and diabetic patients.
  • • Hair infection and appears as scaly patches with loss of hairor severe infections with pus filled lesions may be seen. Hairinvolvement is common in children.

What should one do if he/she gets Dermatophyte infections?

  • • Consult a dermatologist since it can be cured easily ifdiagnosed early and treated with appropriate antifungals.

Are there any laboratory tests to diagnose Dermatophytoses?

  • • Diagnosis is usually done by dermatologist based on clinicalfeatures. If needed, scrapings from the skin or clippings ofthe nail and hair can be subjected to laboratory tests toconfirm the diagnosis and identify the causative fungus bymicroscopy and culture.

What is the treatment for Dermatophytoses?

  • • Various topical and systemic antifungals are available fortreatment.
  • • Topical antifungal agents include terbinafine clotrimazole, miconazole, eberconazole, luliconazole, ketoconazole etc.
  • Oral antifungals include agents such as fluconazole, itraconazole, terbinafine and griseofulvin. Oral antihistaminicssuch as cetirizine, levocetirizine are also prescribed to reduce the itching.
  • • Dose, duration and type of medicine is decided by the dermatologist based on severity of the disease, and presence of other diseases such as kidney/liver disease, pregnancy as it can alter the choice of medicine.

Are there any side effects of treatment?

  • • Topical steroid- antifungal combinations are commonly overthe counter prescriptions used as self- medication due to theinstant relief.The commonly used combination products include a mixture of antifungals, steroids and antibiotics. These creams when applied may temporarily make you feel better with the relief of symptoms, because of the steroid component, but the fungal infection never clears out and over a period of time there are steroid related side effects on the skin like thinning, stretch marks and light coloured patches. Hence it is important that creams for ringworm should not be purchased over the counter without a valid prescription or on the recommendation of friends/neighbours/family members/non allopathic-non dermatology professionals.
  • • Use of oral antifungals can have adverse effects on liver and it can also have certain interaction with medication for diabetes. Hence inform your dermatologist about the medicines you are taking before he prescribes you any medicines. The dermatologists may also order some blood tests before prescribing and while you are on those medicines.

Can Dermatophytoses recur?

  • • Yes, Dermatophytoses can recur. Various factors cancontribute to recurrences-inadequate treatment, improperadherence to treatment, improper or inadequate treatmentof close contacts or family members, resistance toantifungal drugs, use of topical steroid antifungals and self-medication.

What are the self-care measures to prevent Dermatophyte infection and recurrences?

  • • Few simple measures can be adopted to prevent the infections and recurrences.

Do’s

  • • Take and apply your medicines regularly and for the adequate duration.
  • • The topical antifungal needs to be applied on the entire affected area plus two centimeters outside on the normal skin.
  • • Take bath after activities which result in excessive sweating.
  • • Pat yourself dry carefully after taking bath.
  • • Dry the clothing especially undergarments inside out in the sun.
  • • Towels, undergarments, napkins, handkerchiefs should be washed in hot water, sundried, ironed and then worn.
  • • Change your socks regularly.
  • • Avoid wearing tight undergarments. In males, boxer shorts are preferably to the conventional V shaped underwear.
  • • Cotton loose clothing is preferred. Avoid jeans/jeggings/ leggings and other tight clothing.
  • • It is important that all contacts including the family members and people having similar conditions in the work place are treated correctly and completely for the fungal infections. If your contacts are left untreated, you may contact the infection again.

Dont’s

  • • Don’t self-medicate.
  • • Do not buy creams OTC/on the recommendation of chemists/neighbours/friends/family members. It is advisable to see a dermatologist for skin issues.
  • • Don’t use steroid containing cream, it is poison for your skin.
  • • Don’t share your towel, use public bath, clothing with others.