AtoZ Diseases

What do Doctors call this Condition - Dermatophytosis

What is this Condition?

Tinea is a fungal infection that may affect the scalp (tinea capitis), body (tinea corporis), nails (tinea unguium), feet (tinea pedis), groin (tinea cruris), and bearded skin (tinea barbae). Tinea infections are common in the United States. With effective treatment, the cure rate is very high, although about 20% of infected people develop chronic tinea.

What Causes it?

Tinea infections are caused by the fungi Trichophyton, Microsporum, and Epidermophyton. Transmission can occur directly through contact with infected lesions or indirectly through contact with contaminated articles, such as shoes, towels, or shower stalls.

What are its Symptoms?

Lesions vary in appearance and duration.

Tinea of the Scalp

This type of fungal infection mainly affects children and is characterized by small, spreading papules on the scalp, causing patchy hair loss with scaling. These papules may progress to inflamed, pus-filled lesions.

Tinea of the Body

This tinea infection produces flat lesions on the skin at any site except the scalp, bearded skin, or feet. These lesions may be dry and scaly or moist and crusty; as they enlarge, their centers heal, producing the classic ring-shaped appearance that gives this infection the common name ringworm

Tinea of the Nails

Infection typically starts at the tip of one or more toenails (fingernail infection is less common) and produces gradual thickening, discoloration, and crumbling of the nail, with buildup of debris under it. Eventually, the nail may be destroyed completely.

Tinea of the Feet

This tinea infection, commonly known as athlete’s foot, causes scaling and blisters between the toes. Severe infection may lead to inflammation, with severe itching and pain on walking. A dry, scaly inflammation may affect the entire sole.

Tinea of the Groin

Commonly known as jock itch, this infection produces red, raised. sharply defined, itchy lesions in the groin that may extend to the buttocks, inner thighs, and external genitalia. Warm weather and tight clothing encourage fungus growth.

Tinea of Bearded Skin

This uncommon infection affects the bearded area of the face in men.

How is it Diagnosed?

To confirm tinea infection, scrapings from lesions are examined under a microscope. Other diagnostic procedures include Wood’s light examination (which is useful in only about 5% of cases of tinea of the scalp) and culture of the infecting organism.

How is it Treated?

Tinea infections usually respond to topical agents, such as ketoconazole cream. Other antifungals used to treat tinea include Naftin, Loprox, Lamisil, Halotex, and Tinactin. Topical treatments should continue for 2 weeks after lesions resolve. Alternatively, the doctor may prescribe the oral drug Fulvicin, which is especially effective in tinea infections of the skin, hair, and nails.

Supportive measures include applying open wet dressings, removing scabs and scales, and applying drugs known askeratolytics to soften and remove lesions of the heels or soles.

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What is this Condition?

Dermatitis is an inflammation of the skin that occurs in several forms, including atopic, seborrheic, nummular (coin-shaped), contact, chronic, localized neurodermatitis, exfoliative, and stasis. The discussion below focuses on atopic dermatitis. (For information on contact dermatitis, see Uncovering the cause of contact dermatitis.)

Atopic dermatitis (also called infantile eczema) is a chronic skin inflammation that affects about 9 out of every 1,000 people. It’s often associated with allergy-related diseases, such as bronchial asthma and allergic rhinitis. It usually develops in infants and toddlers ages 1 month to 1 year - typically in those with a strong family history of allergy-related disease.

Atopic dermatitis typically flares up and subsides repeatedly before finally resolving during adolescence. However, it can persist into adulthood. It can lead to viral, fungal, or bacterial infections and can even cause eye disorders.

What Causes it?

The cause of atopic dermatitis is unknown, but there’s a genetic predisposition, which is worsened by food allergies, infections, irritating chemicals, extremes in temperature and humidity, and emotions. Approximately 10% of childhood cases are caused by allergies to certain foods - especially eggs, peanuts, milk, and wheat. Atopic dermatitis tends to flare up with increased sweating, psychological stress, and extremes in temperature and humidity.

Irritation is an important secondary cause of atopic dermatitis. It seems to change the skin surface structure, which eventually leads to chronic skin irritation.

What are its Symptoms?

The skin lesions of atopic dermatitis start as reddened areas on very dry skin. They typically appear on the forehead, cheeks, knees, elbows, legs, and neck. During flare-ups, itching and scratching cause swelling, crusting, and scaling. Eventually, chronic lesions lead to numerous areas of dry, scaly skin with white, firm, raised, intensely swollen lesions, which become thick and hard.

Intense itching may cause swelling and unusual darkening of the upper eyelids, with a double fold appearing under the lower lids. In rare cases, atopic cataracts (clouding of the eye lens) may develop between ages 20 and 40.

How is it Diagnosed?

To diagnose atopic dermatitis, the doctor examines the person’s skin and checks for a family history of allergies and chronic inflammation. To rule out other inflammatory skin conditions, such as diaper rash, seborrheic dermatitis, and chronic contact dermatitis, the doctor checks for typical distribution of skin lesions.

How is it Treated?

The person with atopic dermatitis must eliminate known allergens and avoid irritants, extreme temperature changes, and other triggers.

To relieve itching and inflammation, the doctor may prescribe a topical steroid ointment such as Cortaid, which can be especially effective when applied after bathing. Between steroid doses, the person should use a moisturizing cream to help the skin retain moisture. Oral steroids should be reserved for extreme flare-ups.

Weak tar preparations and ultraviolet B light therapy may be used to thicken the skin’s outer layer. If the doctor determines that a bacterial agent is involved, he or she may prescribe an antibiotic.

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Skin is composed of two layers. The surface layer that you see is a thin covering called the epidermis. Below the epidermis is a thicker layer, the dermis. The dermis contains many specialized structures such as hair follicles and sweat glands . Below the dermis is a layer of fat that is called subcutaneous fat.The surface skin layer, the epidermis, is a very active layer of cells. Cells at its base are continuously dividing to produce new cells, which gradually die as they fill up with a hard substance, keratin. As they die, they move up to the skin surface, to be shed or worn away by rubbing from your clothes, washing, or handling things. In fact, virtually any movement that causes friction also causes some skin cells to be rubbed away. The continuous production of cells at the base of the epidermis keeps up with the continuous loss of cells from its surface. It takes an average of one month for any single epidermal cell to complete the journey from base to surface. On parts of the body where pressure and friction are greatest, the epidermis is thicker, and the journey takes longer. A number of skin problems are caused by a fault in the constant turnover of skin cells. In psoriasis, for example, there is an abnormal build-up of surface cells because there are increased numbers of cells being produced and pushed up from the base of the epidermis.

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Normal skin contains special cells called melanocytes that produce the brown skin coloring pigment melanin. There are several conditions in which melanocytes are either abnormal or abnormally distributed. Sometimes they are fewer in number or less active than usual; this results in a pale area of skin that does not tan from the sun. Alternatively, the melanocytes may be more numerous or more active than usual. This results in a darker area of skin that tans very readily.Albinism: This is a rare inherited condition. The melanocytes are unable to make melanin, so an albino is very pale skinned and has white hair and pink or pale blue eyes. Albinos are advised to wear dark glasses and to avoid sunlight, because sun hurts their eyes and burns their skin easily.

Abnormal suntan: Certain diseases, and some drugs can provoke a “suntan” without exposure to sun. If this happens to you, see your physician.

Vitiligo: In vitiligo, pale irregular patches of skin appear, often symmetrically placed on either side of the body. The patches may grow, shrink, or stay the same size.

Pityriasis or tinea versicolor: This uncommon fungal infection causes patches of paler or darker skin to develop on the trunk. In addition, the affected skin may flake. Chloasma: Hormonal changes during pregnancy or while taking oral contraceptives cause some women to develop patches of darker skin on the face, particularly over the cheeks. The condition disappears after childbirth or when the pill is stopped.

Moles: These are small dark areas of skin composed of dense collections of elaborates. Some moles are hairy. Very occasionally, one may become malignant. If you have a mole that changes in size or shape, you should see your physician.

Seborrheic warts: These are not true warts , but round or oval patches of dark skin 1 to 3 cm (up to about 1 in) across. They are common and often develop after middle­age. They have a crusty, greasy surface.

What should be done?

Most of these conditions are harmless, but if you are concerned, especially about a mole. consult your physician.

Self-help: You can find a number of non­prescription depigmenting creams available for lightening skin, but follow the instructions carefully and do not use one for more than a few weeks at a time. The darker your skin is. the more care you should take in using these preparations. Covering the discoloration with ordinary cosmetics may help.

Professional help: There are specific treatments available for some of these conditions. Vitiligo may be improved by ultraviolet lamp treatment combined with drug therapy. Pityriasis can be cured by an antifungal ointment. Moles may be cut out. Special cosmetics can cover various blemishes.

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