Fungal Infections

Description

This is a contagious fungal infection of the foot caused by Trichophyton mentagrophytes and T. rubrum most
commonly.

Signs and Symptoms

• Itching of the foot
• Burning or stinging lesions with scaling borders between the toes
• Vesicular eruptions with white scaling between the 4th or 5th toes or the instep of the sole
• May be accompanied by vesicles on the palms and sides of fingers called ‘id’ reaction. The vesicles do not
contain fungus and get better when the fungus is treated

Investigations

Scrape the scales from the infected site and put on a glass slide with a drop of 20% KOH. On microscopy
branching, fungal hyphae are seen.

Treatment

Supportive
• Keep feet dry all the time
• Wear open footwear
• Wear cotton socks, if need be, Change socks daily
Pharmacological
• Miconazole 2% cream, topically twice daily for 3 to 4 weeks
• Continue treatment for 2 weeks after the symptoms have cleared.
• Oral antifungals can be used, e.g. Griseofulvin and Terbinafine for more severe or unresponsive cases

Description

This is a condition which can be acquired from animal (Trichophyton verrucossum, Microsporum canis) or
human contact (T. rubrum). It is characterised by itchy lesions appearing as scaly greyish patches with raised
borders. It can affect any part of the body, with the most commonly affected parts being the arms, groin,
buttocks, waist and the area under the breasts

Treatment

Supportive
• Maintenance of general hygiene
• Avoid sharing of personal items such as towels and clothes
Pharmacological
• Miconazole cream 2%, topically twice daily for 2 to 6 weeks.
• Terbinafine 250mg O.D. oral for about 4 weeks
OR
• Griseofulvin 500mg O.D. oral up to 2 weeks after lesions disappear. On average 4 weeks administration

Description

This is a fungal infection of the scalp which is especially common in children. It is caused by Trichophytonspecies – violaceum in Africa and Asia, T. rubrum in Europe. Non-inflammatory invasion of the hair shaft can occur due to Microsporum audouiini transferred by contact with barber shears, hats or M. canis from pet

Signs and Symptoms

• Diffuse scaling of the scalp with no hair loss
• Circular scaly patches in the scalp with associated alopecia (hair loss)
• In severe cases, a boggy swollen mass with discharging pus and exudates called Kerion is due to animal fungus

Investigations

Remove scales and broken hairs with a blunt scalpel and put it on a slide with Potassium Hydroxide 20%. The hair shaft is seen under the microscope full of fungal spores

Treatment

Supportive
• Maintenance of good general hygiene
• Avoid sharing of personal items such as towels and clothes
• Antifungal shampoo can be used as adjuvant treatment.
Pharmacological
Griseofulvin:
• Adults: 500mg orally daily as a single dose or in divided doses (in severe infection dose may be doubled,
reducing when the response occurs)
• Children: l0mg/kg body weight daily as a single dose or in divided doses continue till two weeks after the
lesions disappear and hair is growing

Description

This is an infection of the skin caused by Candida albicans a yeast fungus which is a normal commensal
occupying the gut. Under certain circumstances such as diabetes or other endocrine diseases or
immunosuppressive states, it becomes pathogenic. The infection usually occurs in the skin folds such as,
around the groin area, under the breasts, in the nail folds and axilla. In chronic or severe cases suspect HIV/AIDS

Signs and Symptoms

Moist, white curd-like papules and plaques form which are easily scraped off leaving red and raw-looking
patches with clear edges

Investigations

Scrape off white patch and place on a glass slide with a drop of Potassium hydroxide (KOH). Hyphae and
yeast are seen

Treatment

Supportive
• The patient should be advised to keep the skin dry
• Long-term antibiotic use should be avoided
Pharmacological
• Miconazole cream 2%, topically twice daily.
• Continue treatment for 14 days after lesions have healed.
• For nail infections, apply under occlusive dressing.
• Patients not responding to topical applications should be referred to a specialist.

Description

Pityriasis versicolor, also known as tinea versicolor, is a common fungal infection of the skin caused by
Malassezia yeasts. It typically presents as small, discoloured patches on the skin, often on the chest, back, shoulders, and upper arms. These patches can vary in colour from white, pink, tan, to brown, and may be slightly scaly or itchy. Pityriasis versicolor thrives in warm, humid climates and is more common in adolescents and young adults

Treatment

Pharmacological
• Topical antifungal creams or lotions containing substances like ketoconazole, terbinafine. These
medications work to eliminate the fungus causing the infection.
• Antifungal shampoos containing ketoconazole or selenium sulfide, which are effective in treating tinea
versicolor on the scalp and hairline.
• 6-20% salicylic acid cream, a keratolytic
• Oral antifungal medications such as fluconazole or itraconazole may be prescribed for severe or
widespread cases of tinea versicolor that do not respond to topical treatments.
• Medicated cleansers or soaps containing antifungal agents may also be recommended for daily use to help
prevent recurrence of the infection