Superficial mycoses

Abstract

Superficial fungal infections of the skin are a common presentation in clinical practice. They can affect any skin surface including the mucous membranes, hair follicles, nail plates, and nail beds. In this section common manifestations of Malassezia and Candida species are summarized. Malassezia species are members of the normal commensal skin microflora of human body and many warm-blooded vertebrates. They are lipophilic and are associated with some skin diseases. They may cause systemic disease in children and adults and sepsis in newborns and may play a role in certain dermatological diseases as well, due to differentiation of the skin structure, mostly in immunosuppressed patients. Pityriasis versicolor is a chronic and superficial fungal disease characterized by round-oval lesions in the upper part of the trunk and upper arms. Pityriasis versicolor is a common disease and constitutes 3% of dermatology patients in summer. Although the most common cause is M. furfur, recently publications about M. globosa, M. restricta, M. sympodialis, M. slooffiae, M. obtusa and M. dermatis have increased in tropical regions are seen at a rate of up to 40%. The disease is more common in adolescents and young adults. It is thought that hormonal changes are effective in the increase of the infection in sebaceous secretion. Pityriasis versicolor, which is widespread throughout the world, mostly seen in areas with high temperature with the prevalance of up to 50%, but the prevalence decreases through the north and the it is 2-8% in the USA and 03-1.1% in Sweden. Pityriasis versicolor is most commonly found in the trunk, scalp and face. Pityriasis versicolor lesions are in the form of small (1-1.5 cm), round to oval, fine scaly, mildly inflamed or unfolded, hypo or hyperpigmented (yellowish brown, brown or reddish brown) macules. Hypopigmented macules (Pityriasis versicolor alba) are often seen in dark-skinned people or sun exposed areas in light-skinned adults. In general, pityriasis versicolor is considered a cosmetic problem, since the majority of patients are asymptomatic. The diagnosis of pityriasis versicolor can be confirmed by diagnostic microscopy or Wood light examination. Culture is not necessary. Treatment with local antifungals is usually sufficient. Systemic antifungal drugs may be used in patients with frequent recurrence, where topical treatments are ineffective. Candida species are found as the members of the normal flora of gastrointestinal tract, skin and genitourinary system in healthy individuals. of Candida species infect the outer layer of the skin and mucosal epithelium, and can lead to serious systemic infections, which can sometimes be lethal. Candida albicans is an opportunistic yeast, it adheres to and replicates in the mucosal surfaces when endogenous flora changes due to recurrent gastrointestinal system surgery, prolonged use of antibiotics or an underlying disease. Mucocutaneous candidiasis is the name given to superficial fungal infections that occur in moisty skin areas, upper respiratory tract, and vulvovaginal mucosa.