Prophylaxis

To prevent skin fungal infections, one should pay attention to good personal hygiene. Especially with babies, parents should make sure that the diaper is changed regularly and that the children do not lie in a wet diaper for long periods of time. Because moisture favors the development of diaper dermatitis.

Against the development of athlete’s foot, wearing flip-flops in public swimming pools and showers is particularly helpful, as is changing socks regularly. Since also domestic animals can be carriers of fungal diseases, it should be discussed in consultation with the veterinarian how to avoid the risk of an infection. This should be done especially if you have a very close contact to the animal and if infants and toddlers or immunocompromised persons are also in contact with the animal.

Especially immunocompromised owners of birds or owners of a pigeon breeding, should consider a very hygienic handling of the bird excrements. At the first appearance of symptoms it is advisable to consult a doctor. For women who frequently suffer from fungal infections of the genital tract, it may be advisable to have a consultation with the gynecologist in charge and to change some of the hygiene and contraception methods. Tampons and bandages should also be changed regularly. Special shampoos, which are especially suitable for the genital tract and are available in drugstores, can also help.

Infections with filamentous fungi

This group of fungi can originate from the soil or from animals. Often the fungi are passed on to humans by pets such as cats. In rural areas, cattle can also be the carriers of the filamentous fungi.

When the filamentous fungi penetrate the uppermost layer of skin (epidermis), they then spread concentrically, i.e. in a circle around their entry port. This is clearly visible in the ring pattern the fungus leaves behind during growth. With these superficial forms of the filamentous fungus, two types of growth can be distinguished.

The fungus can either grow in acutely itchy thrusts with small vesicles or it grows chronically in the form of slowly migrating herds with severe scaling. The deep forms of fungal infestation (tinea profunda) usually migrate into the area of the hair roots or beard hairs and cause inflammation there. This form is very often transmitted by animals.

The filamentous fungi can occur in practically all parts of the body, although contact points are naturally preferred. The fungus is more common in diaper wearers with a weak immune system in the groin region. However, this is not the classical form of the so-called diaper dermatitis.

It mostly affects small children and old people. The fungal growth on the trunk of the body is usually genetically increased and is related to the body’s immune system. Most frequently the interdigital spaces between the toes are affected by fungi, this is the very well-known athlete’s foot (tinea pedis).

This fungus makes itself noticeable above all by itching. A fungus can also cause severe scaling on the palm of the hand. Also the toenails can be attacked by thread fungi.

Due to the fungal attack, the nails discolor, they can also become more brittle and tear. This fungal infestation occurs more frequently among the elderly and is prevalent in Europe with a disease rate of 5-12%. The head can also be treated with filamentous fungi.

The superficial form usually occurs in circular foci and causes scaling and hair breakage. This is how the picture of the mowed meadow is created in this clinical picture. At the head it can also come to a deep form of the fungal infestation.

In addition to a swelling of the lymph nodes in the neck, this form often causes hair loss in the affected area with subsequent scarring, which leads to a permanent lack of hair. Since this form of thread fungus infestation is very often transmitted by animals, pets should also be examined.The diagnosis is made by microbiological cultivation of the fungus from skin scales of the affected skin area. This is followed by a microscopy for the exact determination of the fungus.

In very special cases a molecular biological differentiation is also carried out. The superficial infections of filamentous fungi can be controlled with creams in a local treatment. Frequently, so-called broad-spectrum antifungals are used, which are not only effective against filamentous fungi, but also against yeasts and a certain class of bacteria.

These are mainly used if, in addition to a filamentous fungus infection, further infections are feared. In the case of a nail fungus, nail varnishes containing antimycotic agents such as azoles can also be used. With the deep forms of the thread fungus infestation a so-called systemic therapy is usually carried out.

This means that the patient is administered the medication into the vein. Azoles are also frequently used for these forms of skin fungal infections. The drugs also accumulate well in hair and nails, which is why the therapy time can sometimes be shortened. However, care must be taken to ensure that there are no undesirable interactions with other drugs, as this therapy blocks a major degradation enzyme.