Mushrooms among us? Dermatophyte infections, mimetics and treatment… (2023)

Jessica Perkins, ADDICTION,PGY-3,Resident in Dermatology, Nova Southeastern University College of Osteopathic Medicine/Largo Medical Center, Largo, FL

Molly Buckland, ADDICTION,PGY-1,Resident in Dermatology, Nova Southeastern University College of Osteopathic Medicine/Largo Medical Center, Largo, FL

Ricardo A. Miller, ADDICTION, Program Director, Dermatology Residency Program, Nova Southeastern University College of Osteopathic Medicine/Largo Medical Center, Largo, FL

Karl K. Kellawan, Doctor of medicine,State of the Art Dermatology, Centerville, OH


  • Ringworm is a common skin condition seen in general practitioners' offices, but it's often misdiagnosed and can be mistaken for imitations.
  • Unlike other fungi, dermatophytes metabolize keratin for energy and are generally not particularly virulent.
  • Ringworm is more common in black and Asian patients, has a predilection in young adults, and is three to four times more common in men.
  • Clinical dermatophyte infections are usually named after the affected area of ​​the body.
  • First-line treatment includes topical agents such as azoles, allylamines, ciclopirox, butenafine, and tolnaftate, but the treatment of choice for tinea capitis and tinea barbae is griseofulvin.
  • Scabies is caused by the mite,Sarcoptes scabiei, and should be considered in the differential diagnosis, but the distribution and appearance of the lesions are usually characteristic.
  • Treatment for scabies involves two topical applications of 5% permethrin cream seven days apart.

Ringworm refers to a superficial fungal infection of the skin, hair, and nails caused by dermatophytes. Dermatophytes are filamentous fungi; The three genera that cause disease areMicrosporum,Tricofiton, YouEpidermophyt.1 Trichophyton rubrumIt is the most common cause of dermatophyte infections, accounting for almost 70% of infections worldwide.1These infections are extremely common, but are more prevalent in warm tropical climates. Ringworm is more common in black and Asian patients, has a predilection in young adults, and is three to four times more common in men.1Dermatophyte infections are similar in their physiology, morphology and pathogenicity and are clinically referred to as "ringworm".

Transmission can be anthropophilic (human-to-human), zoophilic (animal-to-human), or geophilic (soil-to-human/animal).1Unlike other fungi, dermatophytes metabolize keratin as a source of energy. They are not particularly virulent and usually only invade the outer horny layers of the epidermis. Mannans in the cell wall of dermatophytes contribute to skin invasion, reduce epidermal proliferation, and exhibit immunosuppressive effects.1Skin barrier defects (diseases such as Darier, Hailey-Hailey, and ichthyosis) or maceration tend to favor dermatophyte invasion.1Host protective factors that limit penetration into keratinized tissue include protease inhibitors, sebum, serum factors, and the host immune system.1Immunodeficient hosts (chronic mucocutaneous candidiasis, common variable immunodeficiency, and HIV) tend to have more severe, chronic, or recurrent infections than immunocompetent hosts.

Dermatophyte infections are often misdiagnosed in clinical practice. The clinical presentation of these infections can vary, and many other skin conditions can have a similar presentation. This review will facilitate a more accurate diagnosis of dermatophyte infections and provide the most up-to-date treatment regimens.

Tinea infection subtypes

Clinical dermatophyte infections are usually named after the affected body part. Clinical subtypes include tinea corporis (body), tinea capitis (scalp), tinea cruris (groin), tinea pedis (feet), tinea manuum (hands), tinea unguium (nails), tinea barbae (beard), and tinea faciei ( Face). ). 🇧🇷 See figure 1 for the clinical presentation of tiña manuum. See Table 1 for clinical features of tinnitus and its imitations.

Figure 1. Mycosis of the hands

Small scale chains are typical of superficial fungal infections on the palms and soles.

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Image courtesy of Jessica Perkins, DO.

Table 1. Typical clinical features of mycoses and mimics

body moths

Ring plates with a central clearing and a scale leading edge

Eczema numerous

Erythematous, scaly, nummular or "coin-shaped" plaques with typical distribution (antecubital and popliteal fossa, posterior neck, lower extremities), atopic diathesis

Centrifugal annular erythema

Ring-shaped erythema with hanging scales; it may be a reaction to tinea infection; do a full skin exam


Erythematous papules to pustules with abrasions and possible ducts, flexor wrists, interstices, navel, genitals

lichen planus

Violet, polygonal, wane Papeln±Lace Web Scale; Wrist flexors, ankles, trunk±oral lesions

Psoriasis vulgaris

Raised, well-defined erythematous plaques with an overlying silvery scale

Seborrhoische Dermatitis

Yellow waxy scales on an erythematous base; Scalp, center of face, eyebrows, beard, center of chest

pustulöse Psoriasis

deep yellow papules±brown collars of scales on plantar/palmar surfaces

Subacute cutaneous lupus erythematosus

Annular erythematous plaques with central clearance in a photodistribution (V-neck and upper back)±upper arms)

whistle pink

Single patch (Herald Patch) followed by rash to erythematous tinged scaly patches in a "Christmas tree" distribution on trunk

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(Video) 5. Pneumonia Pneumocystis

body moths

Body ringworm is an infection of body surfaces other than the palms or soles, groin, face, scalp, hair, and nails. It usually occurs on exposed skin of the trunk and extremities and is usually confined to the epidermis. It is usually acquired through direct contact or transmitted secondarily from another infected area of ​​the body.1The most common pathogen isrot, followed byT. mentagrophytes.1infection withscissors t.It can occur in adults through contact with a child with tinea capitis.2Direct contact with an infected cat or dog can lead to contaminationDogs Microspore.2This infection is found worldwide; However, it is more common in tropical regions. The classic presentation is known as "ringworm" and is characterized by an itchy, erythematous, scaly patch with a raised edge and a central glenoid.3Figure 2 shows the mycosis on the side of the neck.

Figure 2. Tinea body

Tinea corporis on the side of the neck with characteristic scaly, erythematous patches, central bulge, and raised rim. The raised rim represents the centrifugal spread of a dermatophyte infection.

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Image courtesy of Jere Mammino, DO.

Clinical variants of tinea corpus

Majocchi granuloma is a rare and deep infection of the hair follicle that invades the dermis or subcutaneous tissue.2Triggering events include leg shaving, skin trauma, or immunosuppression. It is characterized by perifollicular papulopustules or granulomatous nodules.1Deep mycosis results from excessive inflammation in response to dermatophyte infection. It may have a granulomatous or verrucous appearance and be mistaken for cutaneous tuberculosis or squamous cell carcinoma.1

The imbricata tiña (Tokelau tiña) is a chronic infection caused byT. concentricand is characterized by concentric, scaly, annular, erythematous plaques.1Found in equatorial regions of the world.

Tinea Corpus-Imitato

The following conditions can mimic tinea of ​​the body: Dermatitis (including nummular eczema [see Figure 3], stasis, atopic, contact and seborrheic eczema), pityriasis versicolor, pityriasis rosea, parapsoriasis, centrifugal annular erythema, perforating serpiginous elastosis, annular psoriasis, annular granuloma, subacute lupus erythematosus (see Figure 4), mycosis fungoides and impetigo.1

Figure 3. Nummular eczema

Nummular eczema on the lower extremity can mimic ringworm of the body. The lesion is erythematous and scaly but lacks the classic central clearance of tinea corporis. Multiple lesions can be identified.

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Image courtesy of Jere Mammino, DO.

Figure 4. Subacute cutaneous lupus erythematosus

Subacute cutaneous lupus erythematosus (SCLE) can mimic tinea corporis because these lesions can have a prominent central discharge. LECS lesions are usually photodistributed to the upper trunk and extremities and lack distinct tinea scales.

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Image courtesy of Jere Mammino, DO.

I have headache

Tinea capitis is a dermatophytic infection of the scalp that primarily affects children. The peak age is 3 to 7 years and is more common in children.3 scissors responsible for more than 90% of tinea capitis in the United Statesdogas the second most common cause.1Other etiologies includeT. violaceum(endemic to Africa) andM. audiences(Europa).1Tinea capitis can have different clinical presentations depending on the pathogen and the host's immune response. Alopecia with or without scales is the most common manifestation; However, it can range from mild scaling to a severe pustular rash with alopecia called a kerion.1

The three invasive patterns of dermatophytes infecting hair include endothrix, ectothrix, and honeycomb. The Endotrix pattern is the result of anthropophiliaTricofitonInfection within the hair shaft, and common causes arescissors t.jT. violaceum.1Ectotrix patterns occur when the infection is outside the hair shaft and leads to the destruction of the cuticle. Presentation ranges from non-inflamed, scaly, patchy alopecia to the formation of kerions. Microspore infections can fluoresce under the Wood lamp. The honeycomb pattern is created byT. schoenleiniiand it is the most serious. It appears as a thick yellow crust and fluoresces bluish under a Wood lamp.1Scarring alopecia can develop when the infection is chronic. It is important to note that many scalp/hair conditions can cause dandruff or alopecia and it is very important to consider and rule out a yeast infection.

Imitation of tinea capitis

Seborrheic dermatitis, alopecia areata, psoriasis, and trichotillomania can mimic tinea capitis. When pustules are present, pyoderma gangrenosum and folliculitis may resemble tinea capitis.1If scarring is present, lichen planus, discoid lupus erythematosus, and centrifugal central scarring alopecia should be part of the differential diagnosis.1

leg ringworm

Commonly known as jock itch, tinea cruris is a dermatophyte infection of the groin area. It is usually seen on the inner thighs and thigh creases, but it can also be seen on the buttocks and gluteal crease. The three most common pathogens arerot,E. floccosum, YouT. mentagrophytes.1It is more common in men because the scrotum provides an ideal environment and because men are more likely to coexist with tinea pedis, which can be transmitted to the groin by putting on underwear.1Characteristically, the lesions are sharply demarcated with a raised, erythematous, scaly leading edge. The lesions may be vesicular and unilateral or bilateral. In men, the scrotum is usually preserved. Healthcare professionals should consider cutaneous candidiasis if the scrotum is affected.1

Tinea Leg-Imitator

The following conditions can mimic tinea cruris: reverse psoriasis, erythrasma, seborrheic dermatitis, intertrigo candidiasis, contact dermatitis, lichen simplex chronicus, parapsoriasis, Hailey-Hailey disease, and Langerhans cell histiocytosis.1


Tinea pedis, also known as athlete's foot, is the most common site of dermatophyte infection. Infection usually occurs on the soles of the feet, most commonly in the interdigital areas. 🇧🇷See Figure 5.) The main types of tinea pedis are interdigital, hyperkeratotic (moccasin-like), vesiculobulous (inflammatory), and ulcerative. The characteristic finding in the interdigital type is itchy and erythematous scales and/or erosions, usually appearing between the third and fourth fingers. Moccasin tinea pedis presents as a diffuse, erythematous, hyperkeratotic lesion covering the soles and the medial and lateral margins of the feet. 🇧🇷See Figure 6.) The vesiculobullous type presents as an erythematous vesicular or bullous rash that may be itchy or painful and most commonly occurs on the medial aspect of the foot. Similar to tinea cruris are the most common responsible pathogensrot,E. floccosum, YouT. mentagrophytes.1Patients can also have a secondary bacterial infection if they have foul-smelling erosions or ulcerations.

Figure 5. Tinea of ​​foot, interdigital

Erythematous, scaly interdigital patches characteristic of tinea pedis. This can be the single finding in tinea pedis or an indication of the diagnosis of more extensive non-specific dermatitis of the foot.

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Figure 6. Ringworm of the foot

It presents the classic appearance of tinea pedis with small collars of scales extending beyond the medial lateral aspect of the foot, with slight erythema noted at the base. Tinea unguium can also be seen, making this an easy clinical case.

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Image courtesy of Jessica Perkins, DO.

Tinea manuum has a characteristic appearance of unilateral hyperkeratotic lesions on the palms and interdigital spaces.1,4The most common pathogens are tinea pedis and tinea cruris, and these infections often occur together.

Tinea Pedis Mimic

Mimics of tinea pedis include dermatitis (dyshidrotic and contact), psoriasis vulgaris or pustular, secondary syphilis, pitted keratolysis, hereditary palmoplantar keratosis, and juvenile plantar dermatosis.1,3Erythrasma, or bacterial infection, can resemble the interdigital type of tinea pedis.1


Ringworm is a dermatophytic infection of the nail unit most commonly caused byrot,T. mentagrophytes, YouE. floccosum.1This infection is often referred to as onychomycosis, a generic term that includes all nail fungal infections, including non-dermatophytic causes. However, dermatophytes account for about 90% of onychomycosis cases. Tinea unguium is more common in men, is often associated with chronic tinea pedis, and is more common on toenails than fingernails. It can be unilateral or bilateral and can affect just one nail or multiple nails. Depending on the entry point of infection, there are three common patterns. The distal/lateral subungual type is the most common and shows onycholysis, yellowing, and thickening of the nails.1(See Figure 7.) The superficial white type is restricted to the dorsal surface of the nail and appears as white patches (T. mentagrophytes) or striped cross bands (rot).1The proximal subungual type penetrates below the proximal nail fold and is usually found in immunocompromised patients.1

Figure 7. Tinea ungium

Yellowish distal residues on the middle fingernail can serve as an indication of ringworm. It is advisable to examine the feet for nail infections as tinea manuum and pedis are often present.

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Image courtesy of Jessica Perkins, DO.

Tinea unguium mimic

Numerous pathogens (dermatophytes and non-dermatophytes) cause onychomycosis, and many factors can cause nail dystrophy, making accurate diagnosis difficult. Diagnoses that may mimic ringworm include candida infections, nail manifestations of psoriasis, lichen planus, dermatitis, hyperthyroidism, external trauma, pachyonychia, and Darier's disease.1Tinea unguium can be difficult to treat due to the long treatment times required, drug side effects, and recurrences.

Mycosis of the face

Tinea faciei is a dermatophytic infection of the skin of the face and is usually caused by the same organisms as tinea corporis.4infections withrotDiagnosis can be particularly difficult because the edges of the lesion are often indistinguishable. Tinea faciei is more commonly seen in AIDS patients.

Tinea Faecii-Imitatoren

Seborrheic, perioral, or contact dermatitis can mimic facial tinea. Other mimics include rosacea, lupus erythematosus, acne, and annular psoriasis in children.1


Tinea barbae occurs exclusively in the beard hair distribution on the face and neck of men. It is commonly transmitted by animals, and typical pathogens includeT. mentagrophytesjT. Wache.1The clinical presentation can be severe in zoophilic pathogens and often presents as intense inflammation, pustules, and abscesses with bacterial superinfection.4 rotcauses a slight surface variation similar to tinea corporis.

Tinea barbae mimic

Bacterial folliculitis, herpes simplex/zoster, acne vulgaris, and cervicofacial actinomycosis can mimic tinea barbae.1


The most important factor in diagnosing a dermatophyte infection is a thorough physical examination. It is important to remember that more than one area of ​​the body can be infected at the same time, requiring a thorough examination of the skin. For example, tinea pedis often occurs with tinea unguium or tinea cruris.2

Clinical findings suggestive of dermatophyte infection should be followed by confirmatory testing. The diagnosis is usually confirmed with a potassium hydroxide (KOH) test using microscopy or fungal culture. KOH tests can be improved by staining with Chlorazole Black E. The disadvantage of the KOH test is that it often gives false negative results.5A skin scraping for KOH examination should be taken from the active edge of the lesion with a #15 blade.6The provider should apply alcohol to the lesion prior to scraping to improve debris adhered to the blade.

All dermatophytes appear the same on KOH scans. When a specific species needs to be identified, culture is required. Fungal cultures are grown in Sabouraud's medium, which allows identification of fungal species.3Cultures are slow growing and require several weeks of incubation.7If the KOH test and fungal cultures are negative and dermatophyte infection is still suspected, a skin biopsy may be done. Skin biopsies show fungal hyphae within the stratum corneum. Periodic Acid Schiff Stain (PAS) (see Figure 8) and silver stain are commonly used to enhance fungal elements in biopsy specimens. Techniques using polymerase chain reaction (PCR) and mass spectroscopy can also be used to identify strains of dermatophytes.8PCR is a fast, simple, and highly specific method for diagnosing dermatophyte infections.9There are also promising studies for the immunochromatographic diagnosis of dermatophytes.10The most reliable method for diagnosing onychomycosis is histological examination of a nail plate fixed in formalin and stained with PAS.1The doctor places a cut nail in formalin and sends it to the local pathology lab for evaluation.

Figure 8. Periodic acid Schiff staining

Shows a positive periodic acid Schiff stain. Note the fungal elements highlighted in purple in the keratinized layer of the epidermis.

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Image courtesy of George Gibbons, MD.


The first-line treatment for uncomplicated, superficial, and localized tinea infections (corporis, cruris, and pedis) is topical antifungals. Topical agents include azoles (clotrimazole, econazole, ketoconazole, efinaconazole, luliconazole, miconazole, oxiconazole, sertaconazole, sulconazole), allylamines (naftifine, terbinafine), cyclopirox, butenafine, and tolnaftate.2Some of these topical preparations are available without a prescription and are often an adequate treatment for minor infections. The azoles tend to be more economical although not as effective as the allylamines.6Topical antifungals should be used once or twice daily for two to four weeks and continued for one week after clinical approval.6It is important to note that while topical nystatin is effective in treating Candida, it is not effective in dermatophyte infections.2Photodynamic therapy is also a treatment option when other methods have failed.6

Infections including tinea manuum, tinea capitis, tinea unguium and Majocchi's granuloma; large-scale infections; and infections that fail topical treatment often require systemic antifungal medication. Oral agents include terbinafine, fluconazole, itraconazole, and griseofulvin. Prescribing guidelines for widespread infection, topical treatment failure, and recurrent infection recommend terbinafine 250 mg daily for 14 days, fluconazole 50 mg daily for two to four weeks (six weeks for tinea pedis), or 150-200 mg once weekly for two to four weeks four weeks, Itraconazole 100 mg daily for 15 days or 200 mg daily for seven days (tinea pedis and manuum may require longer treatment) or griseofulvin in micro-sizes of 500-1000 mg daily for two to four weeks.2,6

The treatment of choice for tinea capitis and tinea barbae is griseofulvin. Terbinafine, itraconazole, and fluconazole are not FDA approved for the treatment of tinea capis or barbae.1Adjunctive treatment for tinea capitis includes antifungal shampoo (2% ketoconazole or 2.5% selenium sulfide every other day), disinfection of cleaning equipment, and treatment of close contacts.1In addition to antifungal treatment, products containing urea, glycolic acid, and lactic acid can be used to treat tinea pedis or tinea pedis.1,11Tinea unguium can be extremely difficult to treat and often requires long-term systemic treatment.

Mycosis incognita is a condition that occurs when a dermatophyte infection is misdiagnosed and treated with a topical corticosteroid. It can alter the clinical presentation of the infection and complicate diagnosis. Treatment with corticosteroids can also make the infection worse and cause Majocchi granuloma.2The use of topical corticosteroids in conjunction with antifungal medications is not recommended, although it may result in faster resolution of inflammation and disease.2


scabies mite,Sarcoptes scabiei var. of man, causes human scabies.12(See Figure 9.) The entire life cycle of the mite takes place in the epidermis, with the female mite laying three eggs daily. These eggs mature over the course of 10 days. Mites generally live on the human host for less than three days, except in the case of crusted scabies where they can survive up to seven days.12Crusted scabies is a type of scabies found in people with compromised immune systems that allows the mite to survive with minimal symptoms and large numbers of mites.12

Figure 9. Scabies mite

scabies mite,Sarcoptes scabiei var. of man, as seen under the oil microscope.

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Scabies skin lesions have a typical distribution. They commonly affect the finger webs, the flexion of the wrists, the neck, and the navel. Men usually have lesions on the penis and scrotum, while women are more likely to have lesions on the vulva and areola. The burrow is the classic and characteristic clinical finding of scabies and represents the female mite's oviposition route. Clinically, the duct appears as a small white to gray convoluted plaque.12Construction may not always be present.12Other skin findings may include erythematous papules, pustules, or vesicles, often with significant excoriations. 🇧🇷See figures 10 and 11.) Diagnosis can be confirmed by skin scraping, curettage, or microscopic examination of an affected area. A skin biopsy can confirm the diagnosis.12Figure 12 shows a skin biopsy from a scabies infestation.

Figure 10. Scabies infestation

Erythematous papules, vesicles, abrasions and crusts secondary to scabies infestation

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Figure 11. Scabies infestation, web space

Classic web space intervention in case of a scabies infection

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Image courtesy of Jere Mammino, DO.

Figure 12. Skin biopsy for scabies

Skin biopsy showing the itch mite in the epidermis and a dense dermal infiltrate with eosinophils and lymphocytes

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Image courtesy of George Gibbons, MD.

Symptoms of scabies can appear two to six weeks after the first exposure, or within a day or two after the second exposure. The main symptoms are itching and skin lesions. Scabies is commonly known as one of the most itchy skin rashes. Itching can be made worse by a hot bath or cause insomnia as it is worse at night. Household contacts also often cause itching.

Standard treatment for scabies can be completed with two topical treatments of permethrin 5% cream seven days apart (application on day 1 and day 8).12In adults, the cream is applied to all skin surfaces from the neck down in the evening and washed off in the morning. In elderly patients and infants (from 2 months), the cream should also be applied to the face and scalp. Patients with sensitivity or allergies to formaldehyde or chrysanthemum should avoid using permethrin cream. Other topical medications to consider for scabies if you are resistant or allergic to permethrin are lindane 1% lotion/cream, sulfuric ointment (5-10%), and crotamiton 10% lotion/cream. Ivermectin (200 to 400 mcg/kg) orally is also an excellent option for resistant scabies and is treated on day 1 and day 8 or 14.12Ivermectin can cause central nervous system (CNS) toxicity in infants and young children. Lindane also has potential CNS toxicity in patients weighing less than 50 kg.12Therefore, these drugs are used only when absolutely necessary.

scabies mimics

lichen planus lesions (See Figure 13) have a typical appearance on the flexor wrists, but are flat-topped purplish papules, often with a reticulated white veil, and do not have the characteristic gait of scabies. Other mimics may include viral rashes, guttate psoriasis, secondary syphilis, drug reactions, or other arthropod attacks.

Figure 13. Lichen planus

Flat, purplish, polygonal papules at the wrist flexor are a classic presentation of lichen planus.

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Image courtesy of George Gibbons, MD.


Dermatophyte infestations and scabies are very common around the world and are often misdiagnosed. Many other dermatological skin conditions can mimic these infections. A thorough skin examination can often provide clues to the diagnosis. Other laboratory modalities, such as skin swab, biopsy, or culture, may further aid in the correct diagnosis. If the therapies discussed above do not treat the rash, it is always advisable for primary care physicians to refer the dermatologist for further evaluation and treatment.


  1. Elewski B, Hughey L, Sobera J, Hay R. Fungal diseases. In: Bologna JL, Jorizzo JL, Schaffer JV, Eds.Dermatology🇧🇷 3rd ed. Philadelphia: Elsevier Saunders; 2012: 1251-1284.
  2. Goldstein A, Goldstein B. Dermatophyte infections (mycoses). updated. Available in:🇧🇷 Accessed July 1, 2017.
  3. Marcelino L.ringworm infections🇧🇷 Philadelphia: Elsevier; 2013.
  4. There are R. dermatophytosis (mycosis) and other superficial mycoses. In: Bennett JE, Dolin R., Blaser MJ, eds.Mandell, Douglas and Bennett Principles and Practice of Infectious Diseases🇧🇷 8th ed. Philadelphia: Elsevier Saunders; 2015
  5. Liansheng Z, Xin J, Cheng Q, et al. Diagnostic applicability of confocal rod microscopy to laser in tinea corporis.Int J Dermatol2013;52:1281-1282.
  6. Lebwohl M, Heymann WR, Berth-Jones J, Coulson I, Hrsg.Treatment of skin diseases: comprehensive therapeutic strategies🇧🇷 4th ed. Philadelphia: Saunders; 2014
  7. A. Rezusta, S. de la Fuente, Y. Gilabete et al. Evaluation of the incubation period of dermatophyte cultures.fungal infections2016;59:416-418.
  8. Sahoo AK, Mahajan R. Management of body moths, leg moths, and foot moths: a comprehensive review.Indian Dermatol Online J2016;7:77-86.
  9. Eckert JC, Ertas B, Falk TM, et al. Identification of dermatophyte species in paraffin-embedded biopsies using a novel polymerase chain reaction assay targeting the internally transcribed spacer 2 region and comparison to histopathological features.Br J Dermatol2016;174:869-877.
  10. Noriki S, Ishida H. Production of a monoclonal anti-dermatophyte antibody and its application: Immunochromatographic detection of dermatophytes.with mycol2016;54:808-815.
  11. Elewski BE, Haley HR, Robbins CM. The use of 40% urea cream in the treatment of tinea moccasin foot.First2004;73:355-357.
  12. Burkart CN, Burhart, CG, Morrell DS. Chapter 84: Infestation In: Bologna J, Jorrizzo JL, Shaffer JV, eds.Dermatology🇧🇷 3rd ed. Philadelphia: Elsevier Saunders; 2012: 1423-1426.


Which antifungal drug used only in the treatment of dermatophyte infection? ›

Griseofulvin is only approved as a systemic (oral) agent and is indicated for the treatment of dermatophytoses of the skin, hair, and nails, which is severe or refractory to topical therapy. Specifically, this drug treats tinea (corporis, pedis, cruris, barbae, capitis, and unguium).

What is the treatment for dermatophyte infections? ›

Most cutaneous dermatophyte infections limited to the epidermis can be managed with topical antifungal therapy. Examples of agents effective for dermatophyte infections include azoles, allylamines, butenafine, ciclopirox, and tolnaftate (table 1).

What kills dermatophytes fungus? ›

Treatment with oral terbinafine, itraconazole, and griseofulvin has been used with good efficacy. Terbinafine 250 mg daily for 2–4 weeks may be preferred over itraconazole and griseofulvin in patients on multiple drugs.

What drugs are used to treat dermatophytes? ›

Ringworm on the scalp needs to be treated with prescription antifungal medication.
Prescription antifungal medications used to treat ringworm on the scalp include:
  • Griseofulvin (Grifulvin V, Gris-PEG)
  • Terbinafine.
  • Itraconazole (Onmel, Sporanox)
  • Fluconazole (Diflucan)

What drug would be most effective against dermatophytes? ›

The azole derivatives, such as clotrimazole, miconazole, econazole, and oxiconazole, are the generally used. Agents from the allylamine family, such as terbinafine and naftifine, are also used. Other topical agents, such as ciclopirox or amorolfine, can be effective in the less severe cases of onychomycosis.

What is a natural antifungal for skin? ›

Citronella, geranium, lemongrass, eucalyptus, and peppermint, among others, have been tested specifically against fungi and found to be effective antimicrobials for that purpose. Tea tree oil is another essential oil that has demonstrated antifungal capabilities.

What fungus causes dermatophytosis? ›

These diseases are attributed to two sets of fungi, ascomycete dermatophytes, including the genera Trichophyton, Microsporum, and Epidermophyton, and basidiomycete fungi in the genus Malassezia.

What are the three types of dermatophytes? ›

There are over 20 species of dermatophytes which are classified into three genera: Trichophyton, Microsporum, and Epidermophyton. Dermatophytes can be further classified into different subtypes—anthropophilic, zoophilic, and geophilic— according to their natural habitat.

What is the most common dermatophyte? ›

Tinea pedis, onychomycosis, tinea cruris, and tinea capitis are among the most common dermatophyte infections and are seen in all socioeconomic groups.

What do dermatophytes feed on? ›

Dermatophytes are fungi that feed on keratin. Because of the high amounts of keratin in your hair, skin, and nails, dermatophytes often create infections in these areas.

Where do dermatophytes thrive? ›

Dermatophytes generally grow only in keratinized tissues such as hair, nails and the outer layer of skin; the fungus usually stops spreading where it contacts living cells or areas of inflammation. Many dermatophytes can invade hairs as well as the skin; however, some anthropophilic species such as E. floccosum and T.

Can dermatophytes cause bloodstream infections? ›

In these cases, the fungi can enter the bloodstream and disseminate to distant major organs, including the lymph nodes, liver, brain, and bone. This often causes systemic infections, which can be fatal [3, 10, 11]. A recent article provided a descriptive review of 46 cases of dermatophyte abscess [5].

What is the strongest treatment for ringworm? ›

Terbinafine (Lamisil) comes in creams, sprays, and gels and can treat athlete's foot, jock itch, and other ringworm infections on the skin. The CDC says terbinafine seems to be the most effective treatment for tinea pedis. Possible side effects include: peeling.

Which body part is affected by dermatophytes? ›

Dermatophytes are fungi that require keratin for growth. These fungi can cause superficial infections of the skin, hair, and nails. Dermatophytes are spread by direct contact from other people (anthropophilic organisms), animals (zoophilic organisms), and soil (geophilic organisms), as well as indirectly from fomites.

How do you treat Trichophyton fungus? ›

Current treatment modalities include oral terbinafine, oral itraconazole, and intermittent "pulse therapy" with oral itraconazole Fingernail infections can be treated in 6–8 weeks while toenail infections may take up to 12 weeks to achieve cure.

How long can dermatophytes live? ›

Abstract. Trichophyton rubrum, Trichophyton mentagrophytes and Candida albicans were shown to survive at least 123 days in chlorinated swimming-pool water of 28-30 degrees, at least 18 days in ozonized water at 34-35 degrees, and at least 25 days in pipe water at room temperature of 23-25 degrees.

Can you get oral antifungals over the counter? ›

How do you take antifungal medications? There are OTC and prescription antifungal medicines. Talk to your healthcare provider about what treatment to use.

How do you get rid of ringworm permanently? ›

Most cases of ringworm can be treated at home. Over-the-counter antifungals can kill the fungus and promote healing. Effective medications include miconazole (Cruex), clotrimazole (Desenex) and terbinafine (Lamisil).
1. Apply a topical antifungal
  1. Antifungal cream.
  2. Antifungal lotion.
  3. Antifungal powder.

What deficiency causes skin fungal infection? ›

CARD9 deficiency is a genetic immune disorder characterized by susceptibility to fungal infections like candidiasis, which is caused by the yeast fungus Candida.

What herb can cure fungal infection? ›

In the discovery of fungal overgrowths, whether yeast or mold, treatment options are vast. These 5 herbs discussed: goldenseal, echinacea, grapefruit seed extract, garlic, and black walnut are options that should be considered.

What natural remedy kills fungus? ›

Read on to discover 11 natural treatments for fungal infections, such as ringworm:
  • Garlic. Share on Pinterest Garlic paste may be used as a topical treatment, although no studies have been conducted on its use. ...
  • Soapy water. ...
  • Apple cider vinegar. ...
  • Aloe vera. ...
  • Coconut oil. ...
  • Grapefruit seed extract. ...
  • Turmeric. ...
  • Powdered licorice.

Are dermatophytes mold or yeast? ›

Dermatophytes are molds (multicellular filaments of organisms) that require keratin for nutrition and must live on stratum corneum, hair, or nails to survive. Human infections are caused by Epidermophyton, Microsporum, and Trichophyton species.

What is the most commonly isolated dermatophyte in the United States? ›

T. rubrum was the most commonly isolated dermatophyte species, although Trichophyton tonsurans was more common in tinea capitis and equally common in tinea corporis/tinea cruris.

What are the signs and symptoms of dermatophytes? ›

Symptoms of dermatophytoses include rashes, scaling, and itching. Doctors usually examine the affected area and view a skin or nail sample under a microscope or sometimes do a culture.

How does dermatophytes affect the body? ›

Dermatophytoses are fungal infections of the skin and nails caused by several different fungi and classified by the location on the body. Dermatophyte infections are also called ringworm or tinea. Symptoms of dermatophytoses include rashes, scaling, and itching.

What does dermatophytosis look like? ›

Dermatophytosis, also known as ringworm, is a fungal infection of the skin. Typically it results in a red, itchy, scaly, circular rash. Hair loss may occur in the area affected.

What diseases are caused by dermatophytes? ›

Dermatophytoses are fungal infections of the skin and nails caused by several different fungi and classified by the location on the body. Dermatophyte infections are also called ringworm or tinea. Symptoms of dermatophytoses include rashes, scaling, and itching.

Is a dermatophyte contagious? ›

Dermatophyte infection is of public health concern due to its contagious nature, as it has been found to be easily transmitted through close skin-to-skin contact with an infected person, sharing of combs and clothes, and playing with domestic animals.

Is Candida a dermatophyte? ›

A dermatophyte is simply a type of fungi that can cause skin, hair, or nail infections. "Candida is a yeast," says Weinberg. These fungi can cause infections on many areas of the body.

Is a dermatophyte a parasite? ›

Dermatophytes are the causative agents of dermatophytosis (tinea). They are the group of parasitizing filamentous fungi that are able to infect the keratinized tissues such as the stratum corneum of the epidermis, nails and hairs.

Can ringworm grow inside your body? ›

The scientific name for ringworm is tinea. The condition can also be named for where it occurs on your child's body. The condition is caused by skin fungi called dermatophytes, which live on top of skin and typically do not invade deep inside the skin. Additioanlly, dermatophytes do not live inside the mouth.

How does the immune system fight dermatophytes? ›

Dermatophytes are eliminated from the skin by a cell-mediated immune reaction. Immunity is acquired by active infection. The inflammatory reaction that ensues may increase the proliferatory activity of keratinocytes, causing the fungus to be sloughed from the skin surface.

How long do dermatophytes live on surfaces? ›

The fungus can survive on contaminated objects for long periods of time, sometimes up to 18 months. Who is at risk for ringworm? Anyone who is exposed to the fungus can get an infection.

Is there a vaccine for dermatophytes? ›

canis called Funhikanifel to immunize dogs and cats against experimental dermatophytosis. A single vaccination was followed by recovery of 27% of dogs, while double vaccination cured 96.8% of all animals.

Which organ does fungal infection affect? ›

Systemic fungal infections affect organs such as the lungs, eyes, liver, and brain and also can affect the skin. They typically occur in people who have a weakened immune system (see Opportunistic fungal infections. They were once thought to be plants but are now classified as their own kingdom.

What part of the body do most fungal infections infect? ›

Fungal infections, or mycosis, are diseases caused by a fungus (yeast or mold). Fungal infections are most common on your skin or nails, but fungi (plural of fungus) can also cause infections in your mouth, throat, lungs, urinary tract and many other parts of your body.

Which body part is most likely to get a fungal infection? ›

Fungi reproduce by releasing spores that can be picked up by direct contact or even inhaled. That's why fungal infections are most likely to affect your skin, nails, or lungs. Fungi can also penetrate your skin, affect your organs, and cause a body-wide systemic infection.

What kills ringworm in the body? ›

If the ringworm is on your skin, an OTC antifungal cream, lotion, or powder may work just fine. Some of the most popular ones are clotrimazole (Lotrimin, Mycelex) and miconazole. In most cases, you'll have to use the medicines on your skin for 2 to 4 weeks to make sure you kill the fungus that causes ringworm.

What kills ringworm in laundry? ›

Heat (above 110°F) is also effective at killing ringworm spores. This means that clothing does not necessarily need to be washed with bleach, as long as it can be dried on high heat.

What oral medication is best for ringworm? ›

Fungal infections on the scalp must be treated with a prescription antifungal. Examples include Grifulvin V or Gris-PEG (griseofulvin), Onmel or Sporanox (itraconazole), terbinafine, and Diflucan (fluconazole).

Can dermatophytes cause systemic disease? ›

Dermatophyte invasion is mostly restricted to keratinized tissues such as skin, hair, and nails but with the potential to cause extensive chronic superficial infections or even invasive systemic disease in immunocompromised patients.

How do you treat dermatophyte infection? ›

Most cutaneous dermatophyte infections limited to the epidermis can be managed with topical antifungal therapy. Examples of agents effective for dermatophyte infections include azoles, allylamines, butenafine, ciclopirox, and tolnaftate (table 1).

What kills Trichophyton? ›

Ozone gas effectively kills laboratory strains of Trichophyton rubrum and Trichophyton mentagrophytes using an in vitro test system. J Dermatolog Treat.

Can baking soda help fungal infection? ›

Baking soda's positive effects on fungal infections may also make it an effective treatment for the itchiness, redness, and swelling caused by candidiasis, an overgrowth of Candida yeast on skin. Research is limited, but you may try soaking in a baking soda bath to help treat candidiasis.

Which of the antifungal drug is used only in the treatment of dermatophyte infections works by inhibiting mitosis in fungal cells? ›

The allylamines (terbinafine and naftifine) are synthetic antifungal agents that are effective in the topical and oral treatment of dermatophytes (fungi that infect the skin and other integumentary structures). Like the azoles, the allylamines act through inhibition of fungal ergosterol biosynthesis.

Which antifungal drug used only in the treatment of dermatophyte infections works by inhibiting mitosis in fungal cells Mcq? ›

It inhibits cell division and nucleic acid synthesis in fungi. Griseofulvin is active against dermatophytes, but has no effect against yeasts or other fungi.

Is fluconazole effective against dermatophytes? ›

Among topical antifungal agents, fluconazole and terbinafine are known as effective treatments for dermatophytosis (24).

Which antifungal agent is used to treat fungal infections? ›

The clinically useful imidazoles are clotrimazole, miconazole, and ketoconazole. Two important triazoles are itraconazole and fluconazole.

What are the 4 classes of antifungal drugs? ›

The four main classes of antifungal drugs are the polyenes, azoles, allylamines and echinocandins.

What are the 3 groups of anti fungal drugs targeting ergosterol? ›

Three main classes of antifungal drugs, namely polyenes, allylamines, and azoles, directly target ergosterol itself, or enzymatic steps of its biosynthetic pathway. The polyene amphotericin B (AMB) has represented, for more than 30 years, the standard antifungal therapy for invasive aspergillosis (IA).

Can you get oral antifungals over-the-counter? ›

How do you take antifungal medications? There are OTC and prescription antifungal medicines. Talk to your healthcare provider about what treatment to use.

What oral antifungals treat ringworm? ›

Griseofulvin (Grifulvin V, Gris-PEG), Terbinafine, and Itraconazole are the oral medicines doctors prescribe most often for ringworm.
Prescription Treatments for Ringworm
  • Terbinafine. If your doctor puts you on these tablets, you'll have to take them once a day for 4 weeks. ...
  • Griseofulvin. ...
  • Itraconazole.
Sep 19, 2022

Can fluconazole treat fungal skin infection? ›

Fluconazole works by killing the fungus (or yeast) that is causing the infection. The medicine kills fungus by making holes in its cell membrane, so that the contents leak out. This treats the infection and allows your symptoms to get better.

What are the strongest antifungals? ›

Here are the top antifungal supplements to consider when fighting Candida.
  1. Caprylic Acid. Coconut oil is made up of three fatty acids: caprylic acid capric acid and lauric. ...
  2. Undecylenic Acid. ...
  3. Oregano Leaf Extract. ...
  4. Berberine. ...
  5. Betaine HCl. ...
  6. Garlic Extract. ...
  7. Olive Leaf Extract.

Is there a stronger antifungal than fluconazole? ›

Conclusion: Itraconazole was found to be more effective in the treatment of vulvovaginal candidiasis compared to fluconazole with high cure and low relapse rate.

How do you get rid of stubborn fungal infection? ›

Fungal infections are typically treated with antifungal drugs, usually with antifungal drugs that are applied directly to the affected area (called topical drugs). Topical drugs may include creams, gels, lotions, solutions, or shampoos. Antifungal drugs may also be taken by mouth.

What is the best systemic antifungal? ›

Polyene macrolides such as amphotericin B and nystatin are important antifungal agents that have a fast fungicidal effect, broad spectrum of activity, and very low tendency of resistance development among fungal pathogens.

What is the drug of choice for widespread fungal infection of the skin? ›

Oral antifungal drugs currently in use include itraconazole, fluconazole, ketoconazole and terbinafine. They are reserved for extensive or severe infection for which topical antifungal agents are inappropriate or ineffective, because of high cost, potential side effects and drug interactions.

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