Fungal Skin Infections

Ringworm

Photo of ringworm.

If you have ever experienced a red, itchy, peeling skin rash, you might have had a fungal skin infection. Ringworm, candida, jock itch, and tinea versicolor are just a few examples of fungal skin infections. Topical or oral antifungal medications are used for treatment. Pool areas, locker rooms, public showers, and other areas prone to dampness are prime locations to pick up a fungal skin infection. Browse the following medical images of fungal skin infections to learn the signs and symptoms, how to protect yourself, and about treatments that work.

Ringworm is a fungal skin infection that causes a red, circular, itchy rash. Ringworm is officially known as tinea or dermatophytosis. Ringworm is referred to by other names depending on the part of the body that is affected. For example, fungal infection of the feet is athlete's foot or tinea pedia. In the groin area, it is tinea cruris (jock itch). Depending on the location and extent of ringworm infection, topical and/or oral antifungal medications may be prescribed for treatment.

Ringworm of the Skin (Tinea Versicolor)

Photo of ringworm of the skin (tinea versicolor).
Tinea versicolor is a fungal infection of the skin. Affected areas may be lighter than or a different color than the surrounding skin. The characteristic scaly rash occurs most often on the back, chest, neck, and upper arms. The condition most commonly occurs in teens due to the contribution of oily skin. Tinea versicolor may either cause no symptoms or slight itching. When examined microscopically, skin affected by tinea versicolor may have a “spaghetti and meatballs” appearance due to clusters of fungal hyphae and spores.

Ringworm of the Hand

Photo of ringworm of the hand (tinea manus)

Ringworm infection can occur on the hands, especially on the palms and between the fingers. Often, just one hand is affected. Affected skin may have a rough, thickened (hyperkeratosis) appearance. Ringworm on the hands is called tinea manus. When ringworm occurs on the feet it is called tinea pedis. The two often occur at the same time.

Ringworm of the Nails (Tinea Unguium or Onychomycosis)

Photo of ringworm of the nails (tinea unguium or onychomycosis)
Tinea unguium is a fungal infection that affects the nails (onychomycosis). It does not typically occur in childhood. This type of infection starts to occur in puberty and the frequency increases with age. Tinea unguium occurs most often in toenails (tinea pedis). A culture of the nails can help confirm the diagnosis. Fungal nail infections are difficult to treat because most topical treatments do not penetrate the nail plate. The systemic agents of choice to treat onychomycosis are itraconazole and terbinafine. The picture shows an infection with dermatophyte fungi, which distorts nail plates. Dermatophytes tend to infect the distal parts of a nail before spreading to the more proximal areas. Candida albicans is another fungal organism that can infect the nails. Infection often produces itching and tends to involve the proximal and lateral portions of the nail.

Ringworm of the Nails

Photo of ringworm of the nails (onychomycosis or tinea unguium)

Ringworm is a fungal infection. When it affects the nails it is called onychomycosis or tinea unguium. Fungal nail infection makes nails thick, brittle, and change colors. Affected nails may be white, yellow, or brown.

Certain medical conditions that affect circulation increase the risk of onychomycosis. Diabetes, peripheral vascular disease, and obesity are just a few conditions that increase the risk of fungal nail infection. Wearing artificial nails is associated with a greater risk of onychomycosis because the surface of the nail is often scraped and prepped, making the nail susceptible to infection.

Warm, humid conditions such as those found around pool areas, public locker rooms, and shower areas provide the perfect breeding ground for fungus to thrive.

An alternative name is dermatophytic onychomycosis.

Ringworm Tinea Corporis (Faciei)

Photo of ringworm tinea corporis (faciei).

Ringworm - Superficial fungal infections of the skin are among the most common of all pediatric dermatoses. Infection at the sites pictured here may also be termed tinea faciei. T. tonsurans, T. rubrum, and T. mentagrophytes are common pathogens. Cutaneous infection with zoophilic species, such as M. canis, usually results from close contact with a household pet. On the body, fungi lodge in the stratum corneum and do not invade lanugo hairs.

Ringworm of the Scalp (Tinea Capitis)

Photo of ringworm of the scalp (tinea capitis).
Tinea capitis is a condition in which ringworm affects the scalp. It is a fungal infection and often affects school-aged children. The scalp of an affected person will have scaly patches, balding, and broken hair. Treatment of the condition involves oral antibiotics that can reach the affected hair roots. Tinea capitis is curable, and the hair will grow back after treatment.

Ringworm of the Feet (Tinea Pedis)

Photo of ringworm of the feet (tinea pedis).
Tinea pedis, or ringworm infection of the feet, appears as red, scaly, macerated patches of skin, often between the fourth and fifth toes. Breaks and tears in the skin may increase the risk of infection. The soles and sides of the feet may also be affected by pustules, vesicles, and edema. Affected skin is often itchy and uncomfortable.

Ringworm in Pets

Photo of ringworm in pets (dog and cat).
Ringworm is a fungal infection of the skin. It is zoonotic, meaning it may spread from animals to people or from people to animals. Affected areas on pets may look like round, bald patches of scaly skin. The infection spreads by direct contact with infected pets, people, or objects contaminated with the fungus such as furniture, bedding, grooming tools, and more. Contact with the fungus is not the only factor needed for transmission. The overall health, age, and nutritional status of the person or pet play a role in determining whether or not infection occurs. People or pets with weakened immune systems are at greater risk of becoming infected with ringworm. Ringworm can affect any area of the skin, but in pets it most commonly affects the face, feet, ear tips, and tails.

Fungal Nail Infection

Photo of fungal nail infection.

Toenail fungus is a very common infection that causes nails to become brittle or discolored. Older people are more likely to develop toenail fungus infections than younger people.

A brownish or whitish-yellow nail color often signals toenail fungal infection. The infection can be painful and may cause toenails to become thick, brittle, or to change shape. The big toenail is most likely to be infected with nail fungus.

People at greater risk of toenail fungal infection include those with damaged nails, circulatory problems in the legs or athlete's foot, and those who frequently contact fungi in environments like swimming pools and saunas. Wearing tight shoes increases the risk of toenail fungus.

Treatment for toenail fungal infection may involve the use of medicated, over-the-counter, colorless nail polishes that often contain amorolfine or ciclopirox. Other topical treatments include urea-based creams and creams containing bifonazole.

Oral medications are more effective than topical treatments at treating toenail fungal infection, but they also have more side effects and possible drug interactions. Itraconazole or terbinafine are common oral treatments. They typically need to be taken for at least 3 months.

Athlete's Foot 1

Photo of athlete's foot.
Athlete's foot is a fungal infection of the feet. It commonly occurs between the toes. Athlete's foot looks like dry, flaky, scaly skin. The skin may also crack. The infection spreads easily. The fungus thrives in warm, damp environments like swimming pool areas and gym locker rooms. Symptoms often include burning, itchy feet.

Athlete's Foot 2

Photo of athelete's foot.
Athlete's foot is a fungal infection on the soles of the feet and in between the toes. It causes itching and cracking, red, flaky skin. Breaks in the skin can allow bacteria into the area and lead to an infection. Antifungal oral medications and topical creams may be used to treat athlete's foot. Most people acquire athlete's foot from walking barefoot in high-humidity areas like locker rooms, gym bathrooms, and swimming pool areas.

Erythema Annulare Centrifugum

Photo of erythema annulare centrifugum.
Erythema annulare centrifugum is shown here appearing on a child's thigh. The child has tinea capitis infection and the lesion appears in a polycyclic formation.

Sporotrichosis

Photo of sporotrichosis.
Sporotrichosis is a fungal infection. The organism responsible for the infection is called Sporothrix schenckii, and it lives in contaminated plants or soil. It is found worldwide, but most cases occur in South and Central America. Some outbreaks occur in the United States. To acquire the infection, the fungus needs to enter the skin through a wound. The type of infection shown in the picture is fixed cutaneous sporotrichosis. This form remains confined to the affected skin area and does not spread throughout the lymphatic system. This patient in this picture developed sporotrichosis on the arm and elbow after falling on some rocks that contained the fungus. The crusted plaques that developed at the abrasion sites were found to contain Sporothrix schenckii when cultured.

Candidiasis (Moniliasis)

Photo of candidiasis (moniliasis)
Candidiasis is a fungal infection caused by an overgrowth of Candida yeasts, most commonly Candida albicans. Yeasts and bacteria like Streptococci and Staphylococci occur normally on the skin; overgrowth of any of these organisms can be a problem. The skin infection of the lips (perl├Ęche) is often due to a mix of organisms including C. albicans and bacteria. For these reasons, combination treatment with nystatin and a topical antibiotic is often warranted. Candidiasis is more difficult to treat in people who have compromised immune systems.

Baby Yeast Infections

Photo of baby yeast infection.

A yeast infection that affects the lips and tissues of the mouth, including the tongue, is called thrush. Anyone at any age can get thrush, but it most commonly occurs in infants and older adults.

In infants, patches of thrush may be mistaken for formula or milk as they have a whitish, cottage-cheese like appearance. It is not advisable to touch or try to wipe away the lesions because it may make the areas red and tender. Babies who have thrush may be cranky and refuse to eat.

Histoplasmosis

Photo of histoplasmosis.
Histoplasmosis is a type of fungal infection that is more likely to occur in those who are elderly or immunocompromised. The picture depicts disseminated histoplasmosis with reddish papules and pustules in a patient who is infected with HIV.
Sources:

IMAGES PROVIDED BY:

  1. Dr. Lucille K. Georg/CDC
  2. Color Atlas of Pediatric DermatologySamuel Weinberg, Neil S. Prose, Leonard KristalCopyright 2008, 1998, 1990, 1975, by the McGraw-Hill Companies, Inc. All rights reserved.
  3. CDC
  4. Color Atlas of Pediatric DermatologySamuel Weinberg, Neil S. Prose, Leonard KristalCopyright 2008, 1998, 1990, 1975, by the McGraw-Hill Companies, Inc. All rights reserved.
  5. CDC
  6. Color Atlas of Pediatric Dermatology Samuel Weinberg, Neil S. Prose, Leonard Kristal Copyright 2008, 1998, 1990, 1975, by the McGraw-Hill Companies, Inc. All rights reserved.
  7. Image reprinted with permission from Medscape
  8. Color Atlas of Pediatric DermatologySamuel Weinberg, Neil S. Prose, Leonard KristalCopyright 2008, 1998, 1990, 1975, by the McGraw-Hill Companies, Inc. All rights reserved.
  9. Melissa Carlson/Second Chance Animal Aid (SCAA)
    Dogchatforum.com/Ringworm in Dogs
  10. iStock
  11. Credit: Phanie / Photo Researchers, Inc
  12. CDC / Dr. Lucille K. Georg
  13. Color Atlas & Synopsis of Pediatric DermatologyKay Shou-Mei Kane, Jen Bissonette Ryder, Richard Allen Johnson, Howard P. Baden, Alexander StratigosCopyright 2002 by The McGraw-Hill Companies. All rights reserved.
  14. Color Atlas of Pediatric DermatologySamuel Weinberg, Neil S. Prose, Leonard KristalCopyright 2008, 1998, 1990, 1975, by the McGraw-Hill Companies, Inc. All rights reserved.
  15. Color Atlas of Pediatric DermatologySamuel Weinberg, Neil S. Prose, Leonard KristalCopyright 2008, 1998, 1990, 1975, by the McGraw-Hill Companies, Inc. All rights reserved.
  16. Copyright © Watney Collection / Phototake -- All rights reserved.
  17. Color Atlas & Synopsis of Pediatric DermatologyKay Shou-Mei Kane, Jen Bissonette Ryder, Richard Allen Johnson, Howard P. Baden, Alexander StratigosCopyright 2002 by The McGraw-Hill Companies. All rights reserved.

REFERENCES:

  • American Academy of Dermatology: "Athlete's Foot."
  • American Academy of Dermatology: "Ringworm."
  • American Academy of Dermatology: "Tinea Versicolor."
  • American Family Physician: "Diagnosis and Management of Common Tinea Infections."
  • American Family Physician: "Diagnosis and Treating Hair Loss."
  • American Family Physician: "Treating Onychomycosis."
  • American Osteopathic College of Dermatology: “Erythema Annulare Centrifugum.”
  • American Podiatric Medical Association: "Athlete's Foot."
  • CDC: "Candidiasis."
  • CDC: "Fungal Nail Infections."
  • CDC: ""Histoplasmosis."
  • CDC: "Oropharyngeal/Esophageal Candidiasis"
  • CDC: "Ringworm."
  • CDC: "Ringworm Information for Healthcare Professionals."
  • CDC: "Ringworm Risk & Prevention."
  • CDC: "Sporotrichosis."
  • The Merck/Merial Manual for Pet Health: "Ringworm (Dermatophytosis)."
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