Fungal Infection

Tinea Capitis

This is a common fungal infection amongst school age children. It presents with scaling, black dots and hair loss, often in people with dark curly hairs. It is spread by close contact from animals or human. There are many species that can cause this infection, the ones that fluoresces green under Wood’s Lamp are from animal source. Kerion is a severe boggy swelling caused by fungal infection. Untreated, this infection can cause scarring and permanent hair loss. Treatment of choice is oral anti-fungal medications such as lamisil.

Tinea Pedis

This is an extremely common fungal infection of the soles and webspaces of the feet. It affects people of all ages and it is commonly acquired in gym or swimming while walking bare foot. Fungus like to grow in a moist environment. Treatment is with topical medications such as lamisil cream and control of excessive sweating. Recurrence is common and can be prevented by footwear and use of anti- fungal powders.

Tinea Corporis is fungal infection of the body. Tinea faciei is fungal infection of face. Both are treated with anti-fungal creams.

TInea Cruris

This fungal infection of the groins is often caused by spread of fungus from the feet (tinea pedis). Treatment is with topical anti-fungal medication and control of moisture in this area.

Tinea Manuum

Fungal infection of usually one hand is spread from the feet (tinea pedis). Treatment is the same as tinea pedis.

Onychomycosis 

This is fungal infection of nails caused by spread of fungus from the feet (tinea pedis). It is extremely common and the chance of getting this increases with age. It can cause more severe problem such as cellulitis especially in patient with diabetes or immunodeficiency. Treatment of minor infection is topical anti-fungal nail solution for 1 year. Anti-fungal ream does not penetrate the nail and therefore does not work for this condition. The earlier you treat this problem, the more likely it will respond. Otherwise, the disease will spread to other nails or even the fingernails. This makes treatment more difficult and oral anti-fungal therapy should be considered. Laser therapy is only for cosmetic improvement and does not cure the infection. Removal of nail is a possible treatment for a single nail infection but must be followed up with topical anti-fungal cream after removal. Recurrence of infection is very common and prevention of tinea pedis is prudent.

Tinea Versicolor/Pityriasis Versicolor

This is actually not a fungal infection and therefore tinea versicolor is a misnomer. The new nomenclature is pityriasis versicolor, and it is caused by overgrowth of a yeast called Malazessia Furfur. This yeast normally lives on the skin but given the right environment or genetic predisposition, it can cause a non-itchy scaly pink or discoloured eruption of the trunk. When more severe, it can affected other areas such as neck, folds and arms. It likes to cause light patches in dark skinned and darker patches in light skinned individuals, hence the name versicolor. It is treated with anti-dandruff shampoo, anti-yeast or anti-fungal creams, oral anti-yeast medication, removal of moist environment to prevent overgrowth of yeast. This condition again likes to recur especially in susceptible individuals.

Tinea Incognito

This is fungal infection of the skin that looks different because of prior application of steroid creams. Steroid cream supressses inflammation of the skin but allows the fungus to grow more rapidly. The treatment is discontinuation of steroid cream, application of topical or oral anti-fungal medication.

Majocchi’s Granuloma 

This is fungal infection of the hair follicles often associated with prior use of steroid cream. This is very difficult to treat and oral anti-fungal medication is required.