Superficial Fungal Infections
September 10, 2000 - 0:0
Dermatophyte Infections (Ringworm) Part 1 Superficial infections caused by dermatophytes fungi that invade only "dead" tissues of skins or its appendages (nails, hair). Fomites are probably not responsible for transmission of infection. Some dermatophytes produce only mild or no inflammation, in such cases, the organism may persist indefinitely, causing intermittent remissions and exacerbations of a gradually extending lesion with a slightly raised border.
In other cases, an acute infection may occur, typically causing a sudden vesicular and bullous disease of the feet; or an inflamed logy lesion of the scalp may occur, which is due to a strong immunologic reaction to the fungus and is usually followed by remission or cure. Since clinical differentiation of the related dermatophytes is difficult, these infections are conveniently discussed according to the sites involved. Diagnosis is confirmed by direct microscopic examination or by culture.
Ringworm of the body is usually caused by a trichophyton. This infection is caused by direct contact with active lesions of sick person or animal over the trunk, stomach, limbs or neck.
The characteristic lesions have raised borders, expand peripherally, and tend to clear centrally. For small to moderately sized lesions, one of the antifungal creams or lotions should be rubbed in at least 7 to 10 days after lesion disappear. For extensive or resisted ringworm of the body, the most effective therapy is oral tablet.
This infection usually responds readily to specific antifungal medication, but may be extensive and resistant to treatment in persons with debilitating systemic disease. Ringworm of the feet, athlete's foot is particularly common. This infection begins in the 3rd and 4th enterdigital spaces and later involve the planter surface of the arch. The lesions often are macerated or may be vesicular. Acute flareups, with many vesicles and bullae, are common during warm weather. Infected toenails become thickened and distorted.
Oral therapy, the most effective treatment for mycologically proven ringworm of the feet should be started even though it may have little immediate effect on the acute infection. It is useful in chronic infections and in preventing active exacerbations, but cure may require therapy for many months and is especially difficult if the toenails are involved. Good foot hygiene is essential. Interdigital spaces must be dried after bathing, macerated skin rubbed away and a bland, drying dusting powder applied.
Light permeable footwear is recommended, especially during warm weather; many patients benefit from going barefoot. Ringworm of the nails, toenail involvement is common in long standing ringworm of the feet; infections of fingernails are less common.
In other cases, an acute infection may occur, typically causing a sudden vesicular and bullous disease of the feet; or an inflamed logy lesion of the scalp may occur, which is due to a strong immunologic reaction to the fungus and is usually followed by remission or cure. Since clinical differentiation of the related dermatophytes is difficult, these infections are conveniently discussed according to the sites involved. Diagnosis is confirmed by direct microscopic examination or by culture.
Ringworm of the body is usually caused by a trichophyton. This infection is caused by direct contact with active lesions of sick person or animal over the trunk, stomach, limbs or neck.
The characteristic lesions have raised borders, expand peripherally, and tend to clear centrally. For small to moderately sized lesions, one of the antifungal creams or lotions should be rubbed in at least 7 to 10 days after lesion disappear. For extensive or resisted ringworm of the body, the most effective therapy is oral tablet.
This infection usually responds readily to specific antifungal medication, but may be extensive and resistant to treatment in persons with debilitating systemic disease. Ringworm of the feet, athlete's foot is particularly common. This infection begins in the 3rd and 4th enterdigital spaces and later involve the planter surface of the arch. The lesions often are macerated or may be vesicular. Acute flareups, with many vesicles and bullae, are common during warm weather. Infected toenails become thickened and distorted.
Oral therapy, the most effective treatment for mycologically proven ringworm of the feet should be started even though it may have little immediate effect on the acute infection. It is useful in chronic infections and in preventing active exacerbations, but cure may require therapy for many months and is especially difficult if the toenails are involved. Good foot hygiene is essential. Interdigital spaces must be dried after bathing, macerated skin rubbed away and a bland, drying dusting powder applied.
Light permeable footwear is recommended, especially during warm weather; many patients benefit from going barefoot. Ringworm of the nails, toenail involvement is common in long standing ringworm of the feet; infections of fingernails are less common.