Fungal Diseases

Athlete's Foot

Athlete's foot, also called tinea pedis, is a fungal infection of the foot. It causes peeling, redness, itching, burning, and sometimes blisters and sores.

Athlete's foot is a very common infection. The fungus grows best in a warm, moist environment such as shoes, socks, swimming pools, locker rooms, and the floors of public showers. It is most common in the summer and in warm, humid climates. It occurs more often in people who wear tight shoes and who use community baths and pools.

What Causes Athlete's Foot?

Athlete's foot is caused by a microscopic fungus that lives on dead tissue of the hair, toenails, and outer skin layers. There are at least four kinds of fungus that can cause athlete's foot. The most common of these fungi is trichophyton rubrum.

What Are the Symptoms of Athlete's Foot?

Signs and symptoms of athlete's foot vary from person to person. However, common symptoms include: 

·         Peeling, cracking, and scaling of the feet

·         Redness, blisters, or softening and breaking down of the skin

·         Itching, burning, or both

How Is Athlete's Foot Treated?

Athlete's foot is treated with topical antifungal medication (a drug placed directly on the skin) in most cases. Severe cases may require oral drugs (those taken by mouth). The feet must be kept clean and dry since the fungus thrives in moist environments.

Medication  fungal nail infection

Antifungal tablets will often clear a fungal nail infection. The medication will also clear any associated fungal skin infection, such as athlete's foot. Your doctor will usually recommend one of the following two drugs. The one chosen may depend on the type of fungus causing the infection. Both of these drugs cause side-effects in a small number of people, so read the packet that comes with the drug for a full list of cautions and possible side-effects.

·         Terbinafine tablets. The usual adult dose is 250 mg once a day; for between 6 weeks and 3 months for fingernails, and for 3–6 months for toenails. Visible improvement can be expected after the end of two months of treatment for fingernails and three months of treatment for toenails.

·         Itraconazole tablets. This is usually given as 'pulsed' treatment. That is, for an adult: 200 mg twice a day for one week, with subsequent courses repeated after a further 21 days. Fingernail infections require two pulsed courses and toenail infections require at least three pulsed courses.

Studies suggest that in about 5 in 10 cases the nail will look fully normal again after treatment. In about a further 2 in 10 cases the fungus will be cleared from the nail after treatment, but the nail does not look fully normal again. Fingernails tend to respond better to treatment than toenails. One reason for treatment to fail is because some people stop their medication too early.

introduction of new treatment modalities has

significantly broadened options available to physicians who

treat these conditions. Once largely limited to the use of

amphotericin B, flucytosine, and a handful of clinically available

azole agents, today’s pharmacologic treatment options include

potent new azole compounds with extended antifungal activity,

novel lipid forms of amphotericin B, and a new class of antifungal

drugs known as echinocandins. In light of all these developments

in the incidence, diagnosis, and treatment of pulmonary fungal

infections, the American Thoracic Society convened a working

group on fungi to develop a concise clinical summary of the

current therapeutic approaches for those fungal infections of

particular relevance to pulmonary and critical care practice. This

document focuses on three primary areas of concern: the

endemic mycoses, including histoplasmosis, sporotrichosis, blastomycosis, and coccidioidomycosis; fungal infections of special

concern for immune-compromised and critically ill patients,

including cryptococcosis, aspergillosis, candidiasis, and Pneumocystis pneumonia; and rare and emerging fungal infections.

Treatment

Antifungal drugs are used to treat mycoses. Depending on the nature of the infection, a topical or systemic agent may be used. Photochemotherapy or photopheresis is a technique used at medical centers for the treatment of mycosis fungoides.

An example of antifungal is fluconazole, or Diflucan, which is the basis of many over-the-counter antifungal treatments. Another example is amphotericin B (the A form being toxic) which is more potent. It is used in the treatment of the most severe fungal infections that show resistance to other forms of treatment and it is administeredintravenously.^[5]

Drugs to treat skin infections are Tolnaftate (Tinactin), an over the counter topical; Ketoconazole, especially used to treat tinea versicolor and other dermatophytes;Itraconazole; Terbinafine (Lamisil); Echinocandins (caspofungin); Griseofulvin, commonly used for infections involving the scalp and nails.^[6]

Yeast infections in the vagina, caused by candida albicans, can be treated with medicated suppositories and pessaries whereas skin yeast infections are treated with medicated ointments.^[7]