Mycosis
What is it?
Cutaneous mycoses are infections sustained by pathogenic fungi, developing at the skin; more specifically, these infections typically affect the keratinized layers of the epidermis and the skin adnexa (nails, hair and hair). The fungi responsible for the occurrence of skin mycosis are defined as dermatophytes and basically belong to three different genera: Microsporum, Epidermophyton and Trichophyton.
There are many factors that can promote the occurrence of these mycoses. Among these, we mention:
- a decreased efficiency of the immune system
- the use of antibiotics that can destroy the bacterial flora of our body favoring the occurrence of fungal infections;
- diabetes, since high blood sugar levels can promote the proliferation of certain types of fungi that are found in different areas of the body and that are not normally pathogenic, but can become so when they proliferate excessively.
Finally, poor personal hygiene can also contribute to the development of skin fungus.
Which are the symptoms?
The symptomatology of fungal skin infections varies depending on the location (skin surface, hair, nails, etc.), while the virulence of the microorganism and the predisposition of the host determine the severity.
Typically, skin fungi cause patches on the skin that are white or reddish, asymptomatic or mildly itchy, with a scaling, slightly raised edge.
In some fungal infections, the lesions are whitish at first, then tend to become darker over time.
Most of the time, there is little or no inflammation, but occasionally, when the inflammation is more severe it results in damage to the structures involved, manifesting as a sudden vesicular or bullous disease (usually, on the feet) or as a large soft lesion of the scalp resulting in areas of alopecia (kerion).
Other symptoms associated with the presence of skin fungi include burning sensation, sudden-onset vesicles and fissures (especially on the feet), nail thickening, and dandruff-like scalp flaking.
- Itching
- Burning
- Scaling
How is it diagnosed?
At the time of the dermatological examination, fungal infections of the skin present a rather typical clinical picture, which enables the diagnosis in a few minutes.
In cases where doubts remain, the dermatologist can take biological material (scales, hairs or nail fragments), through scarification or swabs, from the site of mycosis, and then observe it under the microscope or submit it to a test.
For the differential diagnosis, the physician can also use the Wood's lamp, which is able to detect a typical fluorescence (e.g. golden yellow of Malassezia, greenish for dermatophytes, etc.) and exclude these infections from dermatoses not caused by mycetes.
Once the type of skin fungus responsible for the clinical symptoms has been identified (by culture examination), the physician can prescribe a specific therapy.
Suggested exams
How is it treated?
Since these are infections sustained by pathogenic fungi, the drugs used for the treatment of skin mycoses are antifungals. Usually, for the treatment of this type of mycosis, it is preferred to use topical antifungal drugs. However, in case topical therapy is not effective, the doctor may decide to resort to the administration of systemic antifungals. Miconazole, clotrimazole, econonazole, ketoconazole, are the topical products that are most frequently prescribed; itraconazole, fluconazole, terbinafine and griseofulvin are used orally instead. It must be remembered that to promote healing, proper personal hygiene - as well as the hygiene of clothing and footwear - are fundamental factors.
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