Fungal Infections of the Skin

Fungal infections of the skin are among the most common infectious conditions encountered in dermatology practice. Fungi can affect the scalp, body, groin, hands and feet, and the nails. Although the signs vary by location, the most common are itching, redness, scaling, cracking, ring-shaped expanding rashes and, in the nails, thickening, discolouration and brittleness.

Fungal infections can spread through contact with infected people or animals, shared personal items, and gyms, swimming pools and communal areas. Hot and humid environments, heavy sweating, conditions affecting the immune system, and some conditions such as diabetes can increase the risk of developing a fungal infection.

Not every itchy or scaly skin lesion is a fungal infection. Eczema, psoriasis, rosacea and many other skin conditions can mimic a fungus; fungal infections, in turn, can be confused with different skin conditions. Making the correct diagnosis is therefore very important in avoiding unnecessary or incorrect treatments.

The diagnosis is made by dermatological examination and KOH (potassium hydroxide) examination. In the KOH examination, a superficial sample taken from the skin, hair or nail is assessed under the microscope, and fungal elements can be demonstrated within a short time. In some patients, a fungal culture or additional investigations may also be needed.

Treatment is planned according to the location and extent of the infection and the causative fungus. In some patients topical treatments alone are sufficient, while in widespread or stubborn infections, certain types of athlete's foot, and scalp and nail fungus, oral antifungal medications may also be needed. With the correct diagnosis and appropriate treatment, fungal infections can be treated successfully.

Because fungal infections can be confused with some types of eczema, corticosteroid-containing creams are sometimes used without the advice of a dermatologist. These creams can temporarily suppress a fungal infection and provide short-term improvement in symptoms; however, they can then cause the infection to spread, change its appearance and delay diagnosis. For this reason, making the correct diagnosis before starting treatment is very important in long-standing or recurrent rashes.