Skin Disorders
Bookmark and Share
   Acquired Melanocytic Nevocellular Nevi
   Acral Lentiginous Melanoma
   Acute HIV Syndrome
   Acute Lymphangitis
   Acute Sun Damage
   Adult T Cell Leukemia
   Adverse Cutaneous Drug Reactions
   Alopecia Areata
   Androgenetic Alopecia
   Aphthous Ulcer
   Bacillary Angiomatosis
   Bacterial Infections
   Basal Cell Carcinoma
   Basal Cell Nevus Syndrome
   Behcet's Syndrome
   Benign Cutaneous Neoplasms
   Capillary Hemangioma of Infancy
   Cat-Scratch Disease
   Chronic Lupus Panniculitis
   Chronic Venous Insufficiency
   Clark Melanocytic Nevus
   Congenital Nevomelanocytic Nevus
   Crest Syndrome
   Cutaneous Candidiasis
   Cutaneous Larva Migrans
   Cutaneous Lupus Erythematosus
   Cutaneous and Mucocutaneous Leishmaniasis
   Cutaneous Pseudomonas Aeruginosa Infections
   Cutaneous Reactions to Arthropod Bites
   Cutaneous T Cell Lymphoma
   Desmoplastic Melanoma
   Disseminated Coccidioidomycosis
   Disseminated Cryptococcosis
   Disseminated Gonococcal Infection
   Disseminated Intravascular Coagulation
   Drug Hypersensitivity Syndrome
   Drug-Induced Acute Urticaria
   Drug-Induced Pigmentation
   Eosinophilic Folliculitis
   Erysipelas and Cellulitis
   Erythema Infectiosum
   Erythropoietic Protoporphyria
   Exanthematous Drug Reactions
   Exfoliative Erythroderma Syndrome
   Extramammary Paget's Disease
   Eye Stye
   Fixed Drug Eruption
   Gangrenous Cellulitis
   Genital Candidiasis
   Giant Cell Arteritis
   Glucagonoma Syndrome
   Graft Versus Host Disease
   Hand-Foot-and-Mouth Disease
   Herpes Gestationis
   Herpes Simplex Virus: Genital Infections
   Herpes Simplex Virus Infection
   Herpes Simplex Virus: Infections Associated Systemic Immunocompromise
   Herpes Simplex Virus
   Herpes Zoster
   HIV Associated Lipodystrophy Syndrome
   Human Papillomavirus: Mucosal Infections
   Human Papillomavirus: Squamous Cell Carcinoma In Situ
   Human Papillomavirus
   Hypersensitivity Vasculitis
   Hypertrophic Scars and Keloid
   Impetigo and Ecthyma
   Infectious Exanthems
   Infectious Folliculitis
   Infective Endocarditis
   Infestations of the Skin
   Kaposi's Sarcoma
   Kawasaki's Disease

Home :: Dermatophytoses


Dermatophytes are a unique group of fungi that are capable of infecting nonviable keratinized cutaneous epithelium including stratum corneum, nails, and hair. Dermatophytic genera include Trichophyton, Microsporum, and Epidermophyton. The term dermatophytosis thus denotes a condition caused by dermatophytes. It can be further specified according to the tissue mainly involved: epidermomycosis (epidermal dermatophytosis), trichomycosis (dermatophytosis of hair and hair follicles), or onychomycosis (dermatophytosis of the nail apparatus). The term tinea should be reserved for dermatophytoses and is modified according to the anatomic site of infection, e.g., tinea pedis. "Tinea" versicolor is better called pityriasis versicolor in that it is caused by Pityrosporum yeast and not dermatophytes.

Causes of Dermatophytoses

Dermatophytes synthesize keratinases that digest keratin and sustain existence of fungi in keratinized structures. Cell-mediated immunity and antimicrobial activity of polymorphonuclear leukocytes restrict dermatophyte pathogenicity.

  • Host factors that facilitate dermatophyte infections: atopy, topical and systemic glucocorticoids, ichthyosis, collagen vascular disease
  • Local factors favoring dermatophyte infection: sweating, occlusion, occupational exposure, geographic location, high humidity (tropical or semitropical climates)

The clinical presentation of dermatophytoses depends on several factors: site of infection, immunologic response of the host, species of fungus. Dermatophytes (e.g., T. rubrum) that initiate little inflammatory response are better able to establish chronic infection. Organisms such as M.canis cause an acute infection associated with a brisk inflammatory response and spontaneous resolution. In some individuals, infection can involve the dermis, as in kerion and Majocchi's granuloma.


Topical antifungal preparations

These preparations may be effective for treatment of dermatophytoses of skin but not for those of hair or nails. Preparation is applied bid to involved area optimally for 4 weeks including at least 1 week after lesions have cleared. Apply at least 3 cm beyond advancing margin of lesion. These topical agents are comparable. Differentiated by cost, base, vehicle, and antifungal activity.

  • Imidazoles Clotrimazole (Lotrimin, Mycelex), Miconazole (Micatin), Ketoconazole (Nizoral), Econazole (Spectazole), Oxiconizole (Oxistat), Sulconizole (Exelderm)
  • Allylamines Naftifine (Naftin), Terbinafine (Lamisil)

Systemic antifungal agents

For infections of keratinized skin: use if lesions are extensive or if infection has failed to respond to topical preparations. Usually required for treatment of tinea capitis and tinea unguium. Also may be required for inflammatory tineas and hyperkeratotic moccasin-type tinea pedis.

  • Terbinafine 250-mg tablet. Allylamine. Rarely, nausea; dyspepsia, abdominal pain, loss of sense of taste, aplastic anemia. Most effective oral antidermophyte antifungal; low efficacy against other fungi.
  • Azole/imidazoles Itraconazole and ketoconazole have potential clinically important interactions when administered with astemizole, calcium channel antagonists, cisapride-coumadin, cyclosporin A, oral hypoglycemic agents, phenytoin, protease inhibitors, tacrolimus, terfenadine, theophylline, trimetrexate, and rifampin.
  • Griseofulvin Micronized: 250- or 500-mg tablets; 125 mg/teaspoon suspension. Ultramicronized: 165- or 330-mg tablets. Active only against dermatophytes; less effective than triazoles. Adverse effects include headache, nausea/vomiting, photosensitivity; lowers effect of crystalline warfarin sodium. T. rubrum and T.tonsurans infection may respond poorly. Should be taken with fatty meal to maximize absorption. In children, CBC and LFTs recommended if risk factors for hepatitis exist or treatment lasts longer than 3 months. Not used in Europe.

Apply powder containing miconazole or tolnaftate to areas prone to fungal infection after bathing.

More Skin Disorders
   Langerhans Cell Histiocytosis
   Leg Ulcers
   Lentigo Maligna
   Leukemia Cutis
   Livedo Reticularis
   Localized Infection
   Lupus Erythematosus
   Lyme Borreliosis
   Lymphogranuloma Venereum
   Lymphomatoid Papulosis
   Malignant Melanoma of the Mucosa
   Mammary Paget's Disease
   Mastocytosis Syndromes
   Merkel Cell Carcinoma
   Metastatic Cancer to the Skin
   Molluscum Contagiosum
   Mycobacterium Fortuitum Complex Infection
   Mycobacterium Marinum Infection
   Mycobacterium Ulcerans Infection
   Necrobiosis Lipoidica
   Neisseria Gonorrhoeae Infections
   Nodular Melanoma
   Nodular Vasculitis
   Nongenital Herpes Simplex Virus Infection
   North American Blastomycosis
   Oral Hairy Leukoplakia
   Oropharyngeal Candidiasis
   Other Viral Infections
   Papulosquamous Conditions
   Pediculosis Capitis
   Pediculosis Pubis
   Photoallergic Drug Induced Photosensitivity
   Phototoxic Drug Induced Photosensitivity
   Pitted Keratolysis
   Pityriasis Versicolor
   Polyarteritis Nodosa
   Polymorphous Light Eruption
   Porphyria Cutanea Tarda
   Port-Wine Stain
   Premalignant and Malignant Skin Tumors
   Pressure Ulcers
   Pruritic Urticarial Papules
   Pseudoxanthoma Elasticum
   Pyogenic Granuloma
   Radiation Dermatitis
   Raynaud's Disease
   Reiter's Syndrome
   Rocky Mountain Spotted Fevers
   X-Linked Hyper-IgM Syndrome
   Xeroderma Pigmentosum
   Yellow Fever
   Yellow Nail Syndrome
   Zinc Deficiency

Skin Disorders || Contact Us || Tweet

Copyright © All Rights Reserved.

Disclaimer - The data contained in the Web pages is provided for the purpose of educational purposes and information only. It is not intended nor implied to be a substitute for professional medical advice and shall not create a physician - patient relationship. We are not responsible for any consequence resulted from using this information. Please always consult your physician for medical advices and treatment.