Dermatophyte infections - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Dermatophyte infections may be diagnosed clinically. However, speciation via fungal culture and proof of mycologic cure via serial fungal culture may aid patient care.
Confirm diagnosis of onychomycosis (fungal nail disease) and tinea capitis (fungal scalp infection) prior to treatment if possible.
Limited tinea corporis (body) infection can usually be managed with topical therapy alone. Systemic therapy is preferred for tinea capitis (scalp), tinea barbae (beard), tinea manuum (hands), and onychomycosis (nails).
Most fungal infections of the skin are mild. However, in cases of immunocompromise, fungi can sometimes cause severe disease.

Tinea corporis of the axilla. Central clearing with an active border of inflammation noted. Satellite lesion is present

Department of Dermatology Medical University of South Carolina; used with permission

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History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Tinea corporis of the axilla. Central clearing with an active border of inflammation noted. Satellite lesion is present
Annular lesion on the elbow, with a silvery scale. No central clearing. Microscopic exam with potassium hydroxide revealed no fungal elements. Despite the resemblance to tinea corporis, there was a similar lesion on the extensor surface of both knees and a family history that together confirmed the diagnosis of psoriasis
Tinea capitis
Tinea capitis in a child with Fitzpatrick type VI skin with the typical appearance of fine scale and brown hair, which may be visualised as black dots
A kerion (abscess due to dermatophyte infection) in a child with Fitzpatrick type 1 skin
Tinea barbae. Note the pustules in the follicles, redness, and scaling
Tinea manuum. On the extensor surface of the hand there is extensive inflammation, scaling, hyperkeratosis, and erythema
Tinea manuum
Tinea pedis. Intense inflammation produces hyperpigmentation and vesicle formation. Vesiculobullous form of tinea pedis
Vesiculobullous form of tinea pedis and onychomycosis
Distal lateral subungual onychomycosis
Majocchi granuloma
Infant presenting with rash formerly known as moniliasis, now called candidiasis, caused by Candida spp.

Citations

Key Articles

Ameen M, Lear JT, Madan V, et al. British Association of Dermatologists' guidelines for the management of onychomycosis 2014. Br J Dermatol. 2014 Nov;171(5):937-58.[Abstract][Full Text]
Fuller LC, Barton RC, Mohd Mustapa MF, et al. British Association of Dermatologists' guidelines for the management of tinea capitis 2014. Br J Dermatol. 2014 Sep;171(3):454-63.[Abstract][Full Text]
Fuller LC, Barton RC, Mohd Mustapa MF, et al. British Association of Dermatologists' guidelines for the management of tinea capitis 2014. Br J Dermatol. 2014 Sep;171(3):454-63.[Abstract][Full Text]
Foley K, Gupta AK, Versteeg S, et al. Topical and device-based treatments for fungal infections of the toenails. Cochrane Database Syst Rev. 2020 Jan 16;(1):CD012093.[Abstract][Full Text]

Referenced Articles

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