Fungal infections

Overview of fungal infections

Fungi mainly thrive on human or animal body that serves as a host. Currently, over 300 million people worldwide are suffering from fungal infections. The incidences are more in the low and middle-income countries which have poor hygiene conditions. Hot and humid climate also serves as an ideal condition for the survival of the fungal agents. Though mortalities are not reported in any such cases, these infections in general interfere with a healthy lifestyle.

What are fungal infections?

“Fungal infections” is a common name for skin diseases caused by fungal pathogens.

These microbes reside on human and animal skin for a long period of time and slow start spreading the infection. These infections are precipitated by environmental, hygiene and dietary conditions.

Nail fungus

Nail fungus or “Onychomycosis” is a medical term for a particular nail disease mediated by fungal infections.

The nail, in this case, is called “mycotic nail” and is severely damaged in most of the cases.With the gradual growth and spread of the fungus, the nails become hard, thickened and yellowish with corroded edges and can even be uprooted in case of extreme damage. Nail fungus not only affects the nails but also damages the surrounding skin and underlying tissues.

What causes nail fungus?

Three main causative agents are responsible for fungal infection in the nails. These are-

• Dermatophytes:  They survive on keratin (the protein element of skin, hair, and nails) and cause considerable damage to the nail tissues and adjoining skin.
• Yeasts: These are microscopic fungi made of single oval cells that multiply rapidly within a particular area and can cause severe infections of the toenails and skin.
• Non-dermatophyte molds: They comprise of mainly saprophytes and plant pathogens. They normally survive on the dead and decaying matter.

Some of the other general factors are given below-

• Unhygienic bedrooms, bathrooms, and laundry rooms
• Dark and humid conditions
• Unclean and moist footwear
• Sweating in the feet
• Untreated nail injuries and diseases
• Repetition of footwear
• Expired nail cosmetics
• Unhygienic manicure and pedicure

How do you know if you have nail fungus?

The following signs and symptoms are indicative of nail fungus-

• Yellowish or brownish discoloration of the nails
• Nails turn hard and thick
• Brownish debris beneath the nails
• Whitish patches on nails
• Brittle and eroded nail edges
• Thick ridges along the nail borders
• Bad odor from the nails
• The adjacent skin turns red, cracks and peels off
• Minute blisters
• Skin inflammation, burning, itching and stinging
• Bleeding from the fissures
• Lifting of the nails (after complete decay)
• Difficulty in toe movements and walking 

Types

Fungal infection in the nails may be of the following types

• Distal Lateral Subungual Onychomycosis (DLSO): Thickening of the nail plate occurs along with increased opacity.
• Endonyx Onychomycosis (EO): Infection occurs on the nail plate, making it milky white.
• White Superficial Onychomycosis (WSO): The nail surface becomes rough and powdery flakes appear.
• Proximal Subungual Onychomycosis (PSO): White spots and streaks in the nail folds.
• Total Dystrophic Onychomycosis (TDO): Greenish brown nails 

Ringworm

Ringworm is a fungal infection caused by the tinea species that affects both human beings and other animals. This infection is highly contagious.

What are the causes?

Ringworm infections are mainly caused by tinea corporis (affects the skin of the body), tinea capitis (affects scalp), tinea cruris (affects groin region), tinea pedis (affects the skin of feet). The common transmission routes are-

• Human to human
• Animal to human
• Object to human
• Soil to human

How do you know if you have it?

Visit the dermatologist if you have any of the following signs-

• Elevated, reddish patches with prominent thickened edges and normal skin in the middle (ring-shaped appearance)
• Skin Lesions
• Itching
• Blisters (with or without fluid)
• Reddish streaks around the blisters
• Cracks and fissures
• Overlapped rings

Types

Ringworm infection may be of any of the following types-

• Tinea corporis infection
• Tinea capitis infection
• Tinea cruris infection
• Tinea unguium infection 

Scalp Psoriasis

Scalp psoriasis is the medical condition in which scaly patches and reddish plaques appear in different regions of the scalp.

Under such conditions, the immune system of the body mistakes the dead skin cells as harmful foreign substances and attacks the skin itself.

This results in the formation of whitish or greyish flakes on the skin along with itching, redness, and tenderness.

What causes scalp psoriasis?

Scalp infection is precipitated by the following factors-

• Immune system disorders
• Toxicity caused by certain chemicals
• Genetic factors (genes involved: NAT9,RAPTOR, SLC12A8, HLA-C, SLC9A3R1, and CARD15)
• Existing illnesses (eczema, seborrheic dermatitis, joint diseases)
• Allergies
• Medication overdose 

What are the symptoms of scalp psoriasis?

The following signs are observed-

• Whitish or silvery flakes
• Irregular reddish patches
• Irritation, itching, and inflammation of the infected skin
• Burning sensation in the scalp
• Reddish bumps or pustules
• Release of watery fluid from the pustules

What are the different types of scalp psoriasis?

Scalp psoriasis if of the following types-

• Flexural psoriasis (erythematous plaques)
• Pustular psoriasis (fluid-filled pustules)
• Psoriatic erythroderma (reddish plaques)

What are the available diagnostic tests?

The doctors usually recommend the following tests-

• Culture of nail specimens, punch biopsy (Nail fungus)
• Wood’s lamp, skin biopsy (Ringworm)
• Histology, skin biopsy (Scalp Psoriasis)

How to treat fungal infections?

Fungal infections of mild nature can be treated by antifungal creams like miconazole or clotrimazole. For scalp psoriasis, medicated shampoos may be effective.

Fungal infections are self-limiting in many cases and may resolve even without medical intervention.

However, it is always advisable to take care in the early stages to avoid severity in future.

Dermatologists should be consulted in every case instead of choosing self-medications. This can help prevent complications.

References