Dermatophytosis: An Overview

Introduction

Dermatophytosis is a superficial fungal infection affecting the skin. Dermatophytosis is an infection of the skin, hair, and nails caused by a dermatophyte. One of the most common dermatophytes is the Trichophyton genus, and the less observed dermatophyte is the Microsporum or Epidermophyton genera. The common dermatologic diseases are tinea capitis, tinea pedis, and onychomycosis which may result from such an infection. The treatment of fungal infections caused by a dermatophyte is done with oral or topical antifungal agents. Itraconazole, Terbinafine, and Fluconazole are oral antifungals that are effective in treating superficial mycotic infections. According to the severity of the disease, topical antifungals are used in treating dermatophytosis.

What Is Dermatophytosis?

Dermatophytosis is also called tinea infection. Dermatophytosis is a fungal infection caused by dermatophytes known, a group of fungi that invade the dead keratin. Some of the species that invade human keratin and such species belong to the Microsporum, Epidermophyton, and Trichophyton genera. They tend to grow outwards, producing a ring-like pattern called a 'ringworm.' They usually affect different regions of the body. The treatment of dermatophytosis is done according to the severity of the infection. Some clinical classifications of dermatophytes organisms according to the infected site are given below.

• Scalp - caused by tinea capitis.

• Feet - caused by tinea pedis.

• Nail - driven by tinea unguium or onychomycosis.

• Beard - caused by tinea barbae.

• Groin - caused by tinea cruris.

• The body, including the trunk and arms, is infected by tinea corporis.

• Hands - caused by tinea manuum.

What Are the Causes of Dermatophytosis?

Dermatophytosis infection is up to the dead layers of skin but is aggravated by a moist and warm local environment. The spread of infection can be transmitted to humans by anthropophilic, in between people, geophilic, from the soil, and zoophilic from animals. The most common organisms causing dermatophytosis are given below.

• Trichophyton rubrum.

• Trichophyton tonsurans.

• Trichophyton interdigitale.

• Trichophytons mentagrophytes.

• Microsporum canis.

• Epidermophyton floccosum.

What Are the Signs of Dermatophytosis?

Dermatophytes typically grow only in keratinized tissues such as hair, nails, and the outer layer of skin; the fungus usually stops spreading where it contacts living cells and in inflamed areas. Many dermatophytes, which include anthropophilic species such as Epidermophyton floccosum or E. floccosum and Trichophyton rubrum, are limited to the skin, and the mucous membranes are not affected. The symptoms of dermatophytosis vary depending on the infecting organism and the affected site. Some of the symptoms of dermatophytosis are given below.

• In tinea capitis, the symptoms are characterized as widespread scaly and irregular lesions. In addition, the lesions will show redness called erythema and alopecia.

• Dry allopathic patches are present.

• In the case of tinea schoenleinii, the crust, which is yellow and shaped like a cup, will surround the hair follicles.

• In tinea corporis, the symptoms are observed in the trunk, extremities, and hairs. Sometimes the symptoms are kept in the wrist and ankles in adults.

• The lesions in tinea corporis are pink, erythematous, scaly, and annular, and the edge of the lesion is red and scaly with a clear margin.

• Papules and pustules are usually present in association with pruritus and are present on the border of the lesion.

• În tinea faciei and ținea barbae, symptoms include pruritus, burning, and itching sensation, and the symptoms of tinea faciei and tinea barbae are aggravated by sun exposure.

• A kerion (keer-ee-on) is an inflammatory, pus-filled abscess that occasionally leaks.

• Inflammatory changes are present.

• In the tinea pedis, the athlete's foot is present, characterized as dry, fissured, scaly, and moist macerated lesions in the feet.

• In the tinea pedis, the lesions are in moccasin form, known as the erythrosquamous chronic lesions.

Symptoms of ringworm or tinea, according to the site of involvement, are mentioned below.

• Feet, Caused by Tinea Pedis, or Athlete’s Foot: Symptoms include red, swollen, peeling, and itching on the skin, primarily observed in the toes. The sole and heel of the foot may also be affected by dermatophytes. In severe cases, blisters are present on the skin.

• Scalp, Caused by Tinea Capitis: Symptoms include scaly red itching and circular bald spots. The bald spot can grow in size, and numerous areas are involved in this type of infection. Scalp infection is more common in children, and adults are rarely affected.

• Groin, Caused by Tinea Cruris: Ringworm on the groin, also called "jock itch," looks like scaly, red spots, itchy, and is usually present on the inner sides of the thigh.

• Beard, Infected by Tinea Barbae: Symptoms present on the beard include a scaly, itchy chin and red spots on the cheeks. The upper neck is also affected. The red spots become crusted over or filled with pus, and the affected hair might fall out.

How to Diagnose Dermatophytosis?

The diagnosis of dermatophytosis is based on the history of symptoms and clinical examination.

Some of the various diagnostic measures for diagnosing dermatophytosis are mentioned below.

• Physical examination.

• History of symptoms.

• Microscopic examination, potassium hydroxide stain is used for examining tinea infection in the affected area.

• Ultraviolet light examination or wood lamp examination.

• A fungal culture is considered to be the confirmatory test for fungal infections.

What Is the Treatment for Dermatophytosis?

The treatment is done according to the severity of the infection. Topical and systemic antifungal medications are used for effective management. The treatment methods for treating dermatophytosis are mentioned below.

• Terbinafine.
• Itraconazole.
• Fluconazole.
• Griseofulvin.

Other preventive measures are mentioned below.

• Always keep the skin clean and dry.

• Wear shoes that freely allow air around the feet.

• Avoid walking barefoot.

• Always keep the fingernails and toenails clean.

• Socks and underwear must be changed regularly.

• Avoid sharing clothes with the infected person.

• Regular handwashing must be done.

• Pets should be kept clean.

• Athletes must avoid sharing shoes and socks.

Conclusion

Dermatophytosis is a fungal skin infection, also referred to as ringworm infection. Dermatophytosis affects different body areas, including the scalp, nails, hair, and neck. Dermatophytosis is most common in youngsters, and the symptoms include itching, erythema, and a scaly rash. The fungal culture diagnoses dermatophytosis, and the treatment is done according to the severity of the infection. Preventive measures are followed to avoid disease risk.