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Acne |  Aging Skin |  Fungal Infections | Ingrown Nails |  Photo Aging |  Rushes |  Rosacea |  Skin Cancer |  Sun Burns |  Scars | 

Fungal Infections

What is a fungal infection?

A fungus is a microscopic organism distantly related to plants. Some fungi can grow on the body – commonly affected areas include the skin, scalp, feet, the finger and toe nails, and also the moist linings of the mouth and vagina. The term ‘tinea’ is used for most fungal skin infections – these are also known as ringworm (on the body, limbs or scalp), athlete’s foot and jock itch (on the groin). The last part of this topic on fungal skin infections covers the yeast infection candidiasis (known as thrush). Ringworm, known in medical terms as tinea corporis, is actually not caused by a worm, but by a fungus. Tinea corporis refers to a fungal infection of the body or face, not including the beard area on men. Ringworm occurs more commonly in warm, tropical environments, affects men and women equally, and affects all ages equally.

Many fungal infections, or mycoses, of humans and animals affect only the outer layers of skin, and although they are sometimes difficult to cure, they are not considered dangerous. Athlete\'s foot and ringworm are among the common superficial fungal infections. Fungal infections of the mucous membranes are caused primarily by Candida albicans. It usually affects the mouth (see thrush ) and the vaginal and anal regions.
The fungi that affect the deeper layers of skin and internal organs are capable of causing serious, often fatal illness. Sporotrichosis is an infection of farmers, horticulturists, and others who come into contact with plants or mud. The disease affects the skin and lymphatic system and, in rare cases, becomes disseminated. Blastomycosis is caused by a yeastlike fungus that reproduces by budding. The North American variety, caused by Blastomycosis dermatitidis, occurs more often in men and seems to be limited to the central and E United States and Canada. Wartlike lesions appear most often on the skin, sometimes spreading to the bones and other organs. The South American variety of blastomycosis is caused by B. brasiliensis.
Among the fungi that infect the deeper tissues is Coccidioides immitis, which causes coccidioidomycosis , sometimes called valley fever, a lung infection that is prevalent in the SW United States. Cryptococcosis is another fungus disease that may be localized in the lung or disseminated, especially to the central nervous system. It has a worldwide distribution, affecting men twice as often as women. The causative agent ( Cryptococcus neoformans ) has been isolated in pigeon excretions. Histoplasmosis, which is caused by spores of the fungal genus Histoplasma, is a severe infection that shows varied symptoms. In acute cases ulcers of the pharynx and enlargement of the liver and spleen are present. In other forms tubercularlike lesions of the lung occur. In its benign form no symptoms may be present.
Fungal infections sometimes follow the use of antibiotics, which kill nonpathogenic as well as pathogenic bacteria , thereby providing a free field in the body for fungal invasion. Opportunistic fungal infection occurs when a fungus enters a compromised host, as in the case of such diseases as AIDS . Treatment for fungal infections includes systemic antifungal agents, such as amphotericin B, clotrimazole (Lotrimin) and miconazole (Monistat).

Fungal nails 

Many people have thickened, discolored toenails and fingernails. About 50% of these abnormal nails are due to a fungal infection of the nail bed, matrix, or nail plate. The medical terms for this type of fungal infection are onychomycosis or tinea unguium. Fungal infections of the nail affect up to 3% of the population mainly in developed countries. Men are more often affected than women and usually later in life, after the age of 40.

Appearance of Fungal Nail Infections
There are actually 4 different types of fungal nail infections classified by the part of the nail involved. The most common infection involves the end of the nail when the fungi invade the hyponychium. Initially, the nail plate splits from the nail bed, a process called onycholysis. The end of the nail then turns yellow or white and keratin debris develops under the nail causing further separation. The fungus grows in the substance of the nail causing it to become fragile and crumble. The fungal organism responsible for most fungal nail infections is Trichophyton rubrum.

Risk Factors for Fungal Nail Infections
The following are instances that either promote infection with fungi or encourage growth of fungi:

• Tight footwear promotes crowding of the toes keeps the toes warm and moist - a perfect environment for fungi to grow.

• Exercise can cause repeated minor trauma to the hyponychium allowing fungi to invade.

• Communal showers can expose the feet to fungi.

• Diseases that influence the immune system like AIDS and diabetes can make it easier for a fungal infection to start.

Diagnosis of Fungal Nail Infections
Not every thickened, discolored nail is a fungal infection. Other diseases that can cause thickened nails are psoriasis, eczema, and lichen planus. It is important that fungal nail infections are diagnosed properly because treatment is long-term and expensive. Fungal nail infections are diagnosed by taking a sample of the debris under the nail. The most fungal elements are found under the nail and closest to the skin, therefore the nail should be trimmed before a sample is taken. There are two tests used to diagnose a fungal nail infection - the KOH test and a fungal culture. The KOH test has the advantage that it can be quickly performed. A fungal culture takes 3 to 4 weeks to come back, but can identify the exact fungal organism if there is any question.