Skin Infections due to Fungi 🦠
🌐 Tinea Corporis (Ringworm)
- Clinical Tests: KOH prep, skin scraping, fungal culture
- Features: Annular red scaly plaques with central clearing and raised edges; itchy; common in children and athletes
- Management: Topical antifungals (clotrimazole, terbinafine) for 2–4 weeks; oral antifungals if widespread or resistant
👣 Tinea Pedis (Athlete’s Foot)
- Clinical Tests: KOH test, clinical examination
- Features: Scaling and fissuring between toes, itching, sometimes vesicles; recurrent in humid environments; risks include occlusive footwear, diabetes
- Management: Topical antifungals (terbinafine, miconazole); keep feet dry, use cotton socks, avoid shared footwear; oral antifungals for chronic/refractory cases
🩳 Tinea Cruris (Jock Itch)
- Clinical Tests: Clinical diagnosis, KOH test
- Features: Well-demarcated, itchy red rash in groin/inner thighs, sparing scrotum; more common in men, obesity, excessive sweating
- Management: Topical antifungals (terbinafine, clotrimazole); keep area dry, wear loose clothing; avoid topical steroids (may worsen infection)
🧑🦱 Tinea Capitis
- Clinical Tests: Wood’s lamp, fungal culture, KOH prep
- Features: Patchy hair loss with “black dots” (broken hairs), scaling, lymphadenopathy; severe cases → kerion (boggy, pus-filled swelling)
- Management: Oral antifungals (griseofulvin, terbinafine) are essential; antifungal shampoo reduces spread; treat household contacts
💅 Onychomycosis (Nail Fungus)
- Clinical Tests: Nail clipping & fungal culture, KOH prep
- Features: Thickened, brittle, yellow-brown discoloured nails; may cause discomfort, bacterial superinfection, cosmetic distress
- Management: Oral antifungals (terbinafine, itraconazole) for months; topical ciclopirox/amorolfine for mild disease; monitor LFTs with prolonged systemic therapy
🍞 Candidiasis
- Clinical Tests: Clinical diagnosis, KOH prep
- Features: White curd-like plaques in mouth (oral thrush); erythematous rash in skin folds with satellite lesions; risks: immunosuppression, antibiotics, diabetes
- Management: Topical antifungals (nystatin, clotrimazole); oral fluconazole for extensive/recurrent cases; treat underlying risk factors
💡 Pearls:
🔍 Always check for diabetes, HIV, or immunosuppression in recurrent fungal infections.
🚫 Avoid topical steroids in dermatophyte infections (“tinea incognito”).
👨👩👧 Treat close contacts and reinforce hygiene to prevent reinfection.
