Skin Fungus

Candida can both colonize (be present without causing disease) or infect any body surface. "Mucosa" refers to those body surfaces that are adapted to continuous or near-continuous exposure to moisture. Examples would be the mouth and the vagina.

Piedra refers to colonization of the hair shaft that results in firm, irregular nodules. If the nodule is dark, the infection is Black Piedra and is due to Piedraia hortae. These nodules will be firmly adherent to the shaft and cannot be readily detached. The nodule is the ascomycete fruiting body of the fungus, know as an ascostroma. If the nodule is white, the infection is White Piedra and is due to Trichosporon beigelii. These nodules are a loose aggregate of hyphae and arthroconidia. They are easily detached from the hair shaft by rubbing along its length.

Synonyms

Ringworm of the body

Definition

The key characteristic of Tinea corporis is that the fungus involves the glabrous (relatively hairless) skin. The infection is limited to the stratum corneum of the epidermis. Vellus hair (the fine hair present on glabrous skin) may be invaded, and the hair follicle may serve as a reservoir for the fungus. Tinea pedis,Tinea manuum, and Tinea cruris refer to Tinea corporis that is limited to the foot, hand, and groin, respectively. There is otherwise little special about them. History lesson: The term tinea has an interesting origin. A worm of a moth would sometimes grow on a woolen blanket. The resulting round holes were similar to the rounded lesions seen on the skin of patients. The genus name for the moth was Tinea, and thus this name was used as part of the Latin binomials naming these infections.

Epidemiology

Transmission of tinea corporis may occur from direct contact with infected animals (especially cats and dogs), infected humans, or contaminated fomites such as furniture and clothing. Like many other fungal skin infections, warmth and humidity favor the occurrence of this infection. Therefore, tropical and subtropical regions have a higher incidence of tinea corporis.

Tinea imbricata is an unusual form of Tinea corporis caused by T. concentricum. This form of Tinea is characterized by ring-like growth in overlapping circles that may have an autosomal dominant genetic predisposition. This may explain its geographic restriction to certain regions of the Far East, South Pacific, and South and Central America.
source-doctorfungus.org

The symptoms and appearances of a fungal skin infection depend on the type of fungus causing it and the part of the body affected.

They can cause rashes with a variety of different appearances. Some are red, scaly and itchy, whereas others can produce a fine scale similar to dry skin. The fungus may infect just one area of the body, or there may be several infected areas.

Fungal infections of the scalp or beard can lead to hair loss. Fungal rashes can sometimes be confused with other skin conditions, such as psoriasis and eczema.

Some common fungal infections are listed below.

Dermatophyte infections
Most basic fungal skin infections are caused by dermatophytes - a type of fungi that cause skin, nail and hair infections. They are common, affecting between 10 and 20% of people at some point in their life. They include:

Athlete's foot (Tinea pedis)
This is a very common infection that occurs in one in five adults. It's often caused by a combination of fungi and bacteria. It causes scaling and sogginess of the skin, commonly of the web spaces between the toes. Sometimes the skin becomes pale and can be itchy. The infection is often picked up from contaminated skin fragments in public places, such as swimming pools and shower facilities.

Nail infections
Onychomycosis is the name for any fungal nail infection. Tinea unguium (ringworm of the nails) is a common infection. The nails become malformed, thickened and crumbly. Not all nails affected like this are caused by fungal infections, but it is a common cause. Toenail infections are commonly linked with athlete's foot. Fingernails can be affected too.

Ringworm of the groin (Tinea cruris)
This is called "jock itch" because it occurs in sportspeople. It causes an itchy, red rash in the groin and surrounding area and is commonly seen in men who have been sweating a lot. Often you also have athlete's foot, and scratching your feet followed by the groin may spread the infection.

Ringworm on the body (Tinea corporis)
This affects the body, often in exposed areas like the abdomen or on limbs, causing red patches. They are scaly at the edge with clear skin at the centre. The patches spread out from the centre. It can be caught from domestic animals.

Ringworm of the scalp (Tinea capitis)
This tends to affect young children and can cause hair loss with inflammation in the affected area. It is usually spread from person to person. Most people infected by this fungus don't actually develop the symptoms, but become carriers who can spread the infection to others, sometimes for years.

Yeast infections
Other fungal skin infections are caused by yeast infections. For example:

Intertrigo
Intertrigo is a yeast infection of skin folds caused by Candida albicans. It affects areas of the body that have skin touching skin such as the armpits, groin, and under heavy breasts or fat folds, where the environment is warm and moist.

Pityriasis versicolor
This yeast infection causes increased dark patches on pale or untanned skin and light patches on tanned or darker skin. Another name for this condition is tinea versicolor (versicolor means "of various colours"). Teenagers and young adults are most often affected in the UK.

Thrush (Candida albicans)
The fungus Candida albicans is present in most people, and lives in the mouth and digestive system. It usually lives in harmony with us and rarely causes problems. However, in certain situations, such as during illness or when using antibiotics, the fungi multiply and cause thrush symptoms.

Thrush can affect the mouth and tongue, areas lined with a mucus membrane such as the vagina, and moist, folded skin. Thrush infection often looks like small white patches, which leave a red mark when rubbed off. In adults, vaginal thrush can cause itchiness and a thick, white discharge. For more information, please see Related topics.

Thrush sometimes affects men, causing a painful red rash on the head of the penis (glans). It also commonly affects newborn babies in the mouth (oral thrush). The white patches may be mistaken for breast or formula milk. It isn't usually serious, but babies with thrush in their throats may stop feeding properly. Babies may also develop thrush in the nappy area.

A number of things can make fungal infections more likely. You're more at risk from fungal infections if you:

have recently taken a course of antibiotics
have been taking oral steroids
have diabetes
are obese
are African-Caribbean
have a history of fungal infections have a weakened immune system caused, for example, by cancer or AIDS
Moist skin encourages fungal infections. This means fungal infections are more likely when skin isn't dried properly after sweating or bathing, or when it is covered with a material that doesn't allow sweat to evaporate. Damage to the skin surface, such as a cut or graze, can also encourage fungi to grow.

Fungal infections inside the body can cause more serious health problems than those on the skin. These infections only affect people whose immune systems aren't working properly - either as a result of another illness such as AIDS, or because of immunosuppressant medicines, such as those taken after having an organ transplant.

How do fungal infections spread?
Fungal infections can be spread between humans. For example, athlete's foot is thought to be spread in communal areas, such as gyms and swimming pools. Contact with bed sheets or towels can also spread fungal infections.

It's also possible to catch fungal infections from animals such as cats or dogs, and, more rarely, cattle. Ringworm is occasionally caught this way. source- http://hcd2.bupa.co.uk/fact_sheets/html/fungal_skin_infections.html

Personal Hygiene

Use anti-perspirants and talcum powder to keep high-risk areas dry.

If you're susceptible to athlete's foot, use an anti-fungal powder (see Recommended Products section) and anti-fungal socks.

In high humidity, keep clothing loose and light; avoid knits and less breathable synthetic materials.

Avoidance

Don't share towels or clothes.

Wear thongs or other footwear in public locker rooms, pools, and showers.

Always wear a thick T-shirt or sweatshirt and long shorts or sweat pants while sharing exercise equipment.

Wipe off vinyl surfaces with a dry towel before using exercise equipment.

There are situations where self-treatment of fungus infections is inappropriate:

Spread of athlete's foot into the toenail beds. (toenails can't be successfully treated with OTC products)
Bacterial secondary infections of athlete's foot (indicated by spreading redness or swelling from the original site, extreme tenderness, foul odor, and yellow or cloudy drainage from a weeping area between the toes).
Large areas impractical to treat with topical creams (prescription tablets treat the entire body).
Recurrent infections despite appropriate treatment (other underlying medical problems or medication side-effects could be the real culprits).

Ringworm has nothing to do with worms, so then what is ringworm? It is a fungal infection of the skin. It gets its name because it appears as red rings on the skin. The centers are white and may appear to be blisters. The blisters may or may not ooze.

Ringworm can affect all parts of the body. However, it affects different parts of the body in different ways.

When it affects the scalp or beard areas, it may initially look like large pimples. As the infection progresses, bald patches may appear.

When ringworm affects the foot, it is often called athlete's foot. How do you get ringworm of the foot? It is often picked up in places like gyms and locker rooms, which is why it's referred to as athlete's foot.

What is ringworm of the fingernails and toenails like? It can resemble other types of nail fungus. It causes the nails to become yellow and brittle. They may even begin to crumble.

So how do you get ringworm? You get it by contact with a person or animal that has it. You can also get it though contact with an object that has been in contact with a person or animal that has it.

Education about what is ringworm will help to prevent spreading the infection. Ringworm is spread through direct contact with an infected person or animal, or by contact with an object or surface that was in contact with an infected person or animal. It can be spread by domestic animals such as pets. It is highly contagious.

You can prevent the spread of ringworm by avoiding contact with infected people and animals. Keep common areas such as gyms and locker rooms clean. Do not share personal items such as towels, hats, and hairbrushes.

Make sure you complete the entire course of treatment as recommended for ringworm, even if the symptoms subside. Failure to complete the entire treatment often results in the ringworm coming back.

See your doctor if your ringworm does not report to treatment, or if it spreads to other areas of your body. Your doctor may do a scraping of your skin to determine if you have ringworm or something else.

Psoriasis is a chronic skin disorder characterized by round, dry, scaly patches or plaques. This affliction is non-contagious, and it is more commonly found among those between the ages of 20 and 50 years.
Seborrheic Dermatitis is a chronic skin condition marked by scaling and inflammation of the skin.
Granuloma annulare is a skin disease that produces raised bumps or protrusions, and they assume a ring-like formation, much like ringworm. However, unlike ringworm, no itching or scaling is present.
Eczema is often mistaken for ringworm due to the similar dry, scaly patches it produces.
Vitiligo is characterized by a patchy loss of skin color. In its early stage, it is commonly mistaken for ringworm.
Drug reactions and allergy or hypersensitivity to prescription medication or drugs can cause rashes that are comparable to ringworm.
When considering a course of treatment, it is best to remember that while other diseases look like ringworm, they may not be ringworm at all. For this reason, you should seek a professional medical opinion and receive a definite confirmation of your condition. A reliable ringworm cure won't necessarily be effective against another kind of skin disorder, for although other diseases look like ringworm, they often require different methods of treatment.
source- www.quickcare.org

To prevent against infection and re-infection of ringworm, keep your body clean and dry. This strategy is important because the fungus that is responsible for ringworm grows favorably under moist conditions. Consider also the following preventive measures:
Use your own personal grooming items and be sure to wash and dry them after each use.
Wear loose clothing in order to minimize sweat and body moisture.
Wear shoes at all times in locker rooms or other public areas.
Shower daily and use a medicated shampoo for your hair on a regular basis.
Avoid infected animals, since they are common carriers of the fungi that cause ringworm.

Mycoses caused by members of the family Mucorales (and sometimes the family Entomophthorales) are generally acute and rapidly developing in debilitated patients. The disease is associated with the acidotic diabetics, malnourished children, and severely burned patients. It is also seen with leukemia, lymphoma, AIDS, and use of immunosuppressive therapy such as corticosteroids. The infection typically involves the rhino-facial-cranial area, lungs, gastrointestinal tract, skin, or less commonly other organ systems. The fungi show a predilection for vessel (arterial) invasion resulting in embolization and necrosis of surrounding tissue. Suppurative pyogenic reactions develop. Infections are typically acute and fulminant. Rhinocerebral disease in acidotic patients usually results in death, often within a few days

Study Confirms Common Assumption: and Athlete's Foot Spread Within Close Quarters

By Jennifer Warner
WebMD Health News

Reviewed By Louise Chang, MD
on Friday, September 29, 2006

Sept. 29, 2006 -- Moms and football coaches had it right all along. A new study confirms that foot infections like athlete's foot and toenail fungus do spread from person to person among families and probably others sharing close quarters.

Although it has been commonly thought that athlete's foot and toenail fungus spread from person to person, researchers say it's the first time they've been able to provide evidence for it.

Using high-tech molecular biology techniques, researchers were able to trace the spread of the same tiny organisms, called dermatophytes, responsible for the common foot infections within families.

"Doctors have never been able to caution patients with certainty that toenail fungus or athlete's foot can spread from one family member to another," says researcher Mahmoud Ghannoum, PhD, of University Hospitals Case Medical Center, in a news release.

"What we can see from the current findings is the value of treating toenail fungus and athlete's foot to try to prevent its spread from person to person."

Foot Infections Spread Within Families

Researchers say more than 35 million people are affected by toenail fungus, which causes the affected toenails to become discolored, brittle, thickened, and flaky.

The infection is known as tinea pedis, and is caused by a group of tiny organisms called dermatophytes -- the same fungus responsible for athlete's foot. That common foot infection causes a rash on the skin of the foot and affects 10% of the population.

Researchers studied 57 families in which at least one member had toenail fungus and/or athlete's foot. Of these families, 19 had at least two members who were infected.

Using a combination of microbiology and DNA matching techniques, researchers were able to confirm that identical infection-causing dermatophytes were present in 42% of affected family members.

Researchers say matching the DNA of the same dermatophytes among members of the same household clearly indicates each family member had the identical strain of dermatophyte, which confirms that the infection was transmitted from one family member to the other, either directly or indirectly.

Questionnaires completed by the participants showed the likelihood of the spread of the foot infection within a household was tied to the strain of fungus and whether anyone in the family had nail discoloration or scaling of the skin on the side of the foot and/or a past history of toenail fungus and athlete's foot.

"This study raises questions we will look at in the future," says Ghannoum. "For instance, why did the infection spread among some families but not others, and why did some members of a household become infected while others did not? When we can answer these questions, we will be closer to knowing how to eradicate these very common and highly persistent infections."

The results of the study were presented today at the 46th ICAAC annual meeting of the American Society for Microbiology in San Francisco. Novartis Pharmaceuticals funded the study. Novartis is a WebMD sponsor.

Patches of thick, inflamed skin covered with silvery scales form here and there on the patient's body, often on the elbows, knees, other parts of the legs, scalp, lower back, face, palms, and soles of the feet. They usually itch or feel sore, and the more of the patches there are, generally, the worse the person suffers.

And because psoriasis is a genetic condition that causes inflammation by striking at the immune system, it can have other health effects. An estimated 10 percent to 30 percent of people with psoriasis also develop psoriatic arthritis, which causes pain, stiffness and swelling in and around the joints, according to the National Psoriasis Foundation.

Psoriasis sufferers also have higher rates of cardiovascular disease and other systemic health problems, said Dr. Jennifer Cather, a Dallas dermatologist and a member of the Baylor University Medical Center's Division of Dermatology.

"Often patients think psoriasis is just a rash, [but] it is a systemic inflammatory disease with far-reaching affects," Cather said. "Patients should be aware of that and understand that controlling that systemic inflammation can help with other diseases."

That's a message doctors are looking to share during August, Psoriasis Awareness Month.

Until recently, there was little that could be done about the systemic damage done by psoriasis. Sufferers used topical creams to ease their itches or aches, or underwent expensive ultraviolet light treatments that disrupted the surface spread of psoriasis but did not address the underlying problems within the immune system.

But the past few years have seen the development of a new wave of drug treatments known as biologics. These medications do what previous treatments could not - go after the root of the problem by influencing the immune system.

"It's really changed the way we can treat psoriasis," said Dr. Lawrence Green, assistant professor of dermatology at George Washington University School of Medicine in Washington, D.C. "It really has made life much more tolerable for patients."

Psoriasis occurs when the body's immune system is somehow mistakenly triggered, which speeds up the growth cycle of skin cells, according to the National Psoriasis Foundation. Normal skin cells mature and fall off the body in 28 to 30 days. A psoriatic skin cell takes just three to four days to mature and move to the surface, and, instead of falling off, the cells pile up and form lesions.

According to the National Institutes of Health, as many as 7.5 million Americans have psoriasis.

Biologics are made from human or animal proteins, and they treat psoriasis by going after the overactive immune cells causing the disease.

"They are based on natural processes," Green said. "They're similar to chemicals or compounds we already have in our system. They help lessen immune responses. They help soak up or diminish the extra inflammatory compounds."

Currently, five biologics are approved by the U.S. Food and Drug Administration for treatment of psoriasis, and three of those five are approved for psoriatic arthritis. Biologics are effective, and they also are more affordable than ultraviolet therapy, the other leading treatment for dealing with medium-to-severe cases of psoriasis, according to dermatologists.

Ultraviolet light kills the immune cells in the skin that are causing the problem, Cather said. The problem is, a person must come in three to five times a week for treatment, racking up hundreds of dollars in co-payments.

Biologics, by comparison, are self-administered through injection. The patient usually must inject the medication somewhere between twice-weekly to once every other week, Cather said.

Patients undergoing biologic therapy need to have periodic re-evaluations by their dermatologist to check for the development of new symptoms, including infections and potential cancers, according to guidelines issued earlier this year by the American Academy of Dermatology.

Tinea favosa is usually considered a variety of Tinea capitis because it classically involves the scalp, however, this mycotic infection may also involve glabrous skin and nails.
Favus is characterized by the occurrence of dense masses of mycelium and epithelial debris forming yellowish cup-shaped crusts called scutula. The scutulum develops at the surface of a hair follicle with the shaft in the center of the raised lesion. Removal of these crusts reveals an oozing, moist, red base. After a period of years, atrophy of the skin occurs leaving a cicatricial alopecia and scarring. Scutula may form on the scalp or the glabrous skin.