Fungal diseases of the skin, nails, hair. Fungal diseases Skin fungus symptoms

Very often, the cause of itching of the scalp, peeling and inflammation, and often, against this background, and hair loss is a fungus of the scalp. It is impossible to immediately understand that you “acquired” a fungal infection, however, at the initial examination, when contacting a specialist, the doctor quite easily identifies the cause of your concerns. Fungal diseases of the scalp today are successfully treated, although some require more time and patience.

The fungus (mycosis) that affects the scalp has many varieties. The symptoms of each type of fungus are different, therefore, therapy in different cases is individual. Often, diseases are observed of an infectious nature, therefore they are easily transmitted through personal contact with the patient or through the use of common things and hygiene items. The only prevention of fungal infections is scrupulous personal hygiene.

Symptoms of a fungus on the scalp.
Symptoms of the manifestation of a fungal disease and methods of therapy are determined by the type of fungus that struck the patient. Meanwhile, one can name the general symptoms of a fungal infection, inherent to one degree or another in each variety, and indicating the presence of a disease. Among them:

• The general condition of the hair has worsened, dryness, dullness, loss of shine, and loss are noted.
• Peeling of the scalp, the appearance of individual scaly areas with indistinct contours and a rounded shape.
• In the affected areas, the hair falls out strongly, thins out, bald patches appear.
• The appearance of pink plaques on the scalp, which stand out above the surface of the skin, is noted. Small vesicles may appear on the plaques, gradually becoming covered with grayish or yellowish crusts.
• Hair breakage is observed at the base of the follicle, as a result of which black dots appear on the skin.
• With the superficial form of ringworm, foci of purulent lesions appear on the scalp.

Fungal diseases can occur (most often this happens) in a latent form, so it is difficult to identify the disease in the early stages of development. The signal that it is necessary to sound the alarm is the appearance of severe dandruff in a person to whom it is not characteristic.

Trichophytosis (ringworm).
Trichophytosis or, as people say, ringworm is perhaps the most severe fungal disease of the scalp. As a result of this disease, there is intense hair loss, the formation of bald spots. Most often, the disease overtakes children aged three to twelve years. The disease is highly contagious, transmitted by direct contact with a sick person and direct use of his personal belongings. You can also get infected from a sick animal, fortunately, this happens much less frequently. There is a superficial form and a deep form of ringworm.

When infected with a fungus that causes a superficial form of the disease, a person has its first signs already five to seven days after infection. The main signs include the appearance of areas of peeling on the scalp, brittle hair at the base of the follicles (from 2 mm to 2 cm), which creates the appearance of black dots on the head. Moreover, on the surface of the hair, which remained on the head after breaking, there is a gray coating, which is a product of the activity of the fungus. The lesions of the superficial form of trichophytosis can reach two to three centimeters. In addition to peeling, the lesions may turn red, itch, and swelling may occur on them.

When infected with ringworm, we have a deep form (infiltrative-purulent form), the incubation period is two months. At the very beginning, the disease does not give itself away. Two months after infection, symptoms of general malaise, weakness and intoxication of the body are noted, there is also some swelling and soreness on palpation of the lymph nodes, some fever, and an allergic rash. The deep form of trichophytosis is characterized by the appearance on the scalp of rounded tumor-like spots with clear red contours. The contours of each spot peel off more intensively, they may show crusts and vesicles (vesicles), on which, during pressure, the purulent contents are separated outward. Simultaneously with these signs, deformation of the nails, a change in their color can be observed. Such symptoms require urgent treatment, since the lesions will intensively spread to other areas, which threatens the development of an abscess and extensive inflammation.

Microsporosis (microsporia).
Microsporosis is observed mostly in children and, accordingly, their family members. Sources of infection are sick people (infected with a rusty microsporum) and less often animals (fluffy microsporum), as well as objects in common use with a sick person. This disease in terms of spread rate is in first place among other fungal infections of the scalp and hair. Microsporums, under favorable conditions, spread so quickly that it can be compared to an epidemic. The symptoms of microsporia are similar to the symptoms of superficial trichophytosis, therefore, in order to accurately identify the form and type of the disease, in addition to a visual examination, a laboratory test is required. On the scalp appear rounded areas with sharp outlines. These areas have peeling, brittle hair is also observed, the remaining hairs are covered with a grayish coating. Inflammatory processes are poorly expressed, the affected areas are edematous and have purulent crusts. Nails with this disease are not affected.

Favus (scab).
The sources of infection are the same as in the above fungal diseases. The disease is expressed in the appearance in the scalp and other parts of the skin of the body of crusts (scutes and skutulae) of a yellowish tint with the so-called indentation in the center, in which hair often grows. In the absence of proper treatment, the formations grow and form extensive lesions with crusts. Under these very crusts, atrophy of the skin develops and persistent baldness is observed. When the scalp is affected by this disease, the hair becomes dull, weakened, easily pulled out, and in general, resembles an old worn wig.

Causes of a fungal infection of the scalp.
The main cause of infection are bacteria, fungi and viruses that affect the scalp.

Diagnosis of the fungus of the scalp.
For an accurate diagnosis of a type of fungal infection, in addition to a visual examination of the scalp, a microexamination of a broken hair is prescribed, as well as samples of flaky skin are taken. Broken hairs are examined under a Wood's lamp in order to identify the fungus. If the result is positive, the specialist prescribes bacteriological cultures and culture analyzes to the patient.

Treatment of scalp fungus.
If itching, unusual dandruff occurs, especially if you do not have predisposing factors for its appearance (did not change your hair care product, you did not have stress, etc.), you should immediately contact a specialist. Only after identifying the source of the manifestation of symptoms, namely the type of fungus, should we talk about treatment.

Therapy of the fungus of the scalp is aimed primarily at the use of antifungal drugs of systemic action. In this case, it is important to know that such medicines of the modern generation are highly toxic, despite their effectiveness. Therefore, they are contraindicated in renal failure, cancer, blood diseases, impaired metabolism, vascular pathology of the extremities. Most often, drugs such as Clotrimazole, Griseofulvin, Miconazole, keratolic agents (ointments, tablets), local agents (antifungal balms and shampoos) are prescribed for the treatment of scalp fungus. Treatment takes not a single month, in especially severe cases, hormone-containing drugs, antibiotics, as well as prophylactic agents for the development of dysbacteriosis can be prescribed to patients.

Folk remedies for the treatment of scalp fungus.
With mild forms of fungal infections, it is effective to use eucalyptus oil, it soothes irritated and itchy skin. Spread a few drops on a brush or comb and comb the hair without injuring the scalp.

And here is a recipe for another effective remedy for relieving itching and redness of the scalp. Combine a teaspoon of garlic juice, olive oil (can be almond), lemon juice. Soak the sponge in the mixture and gently massage into the scalp. Wrap with a film and a towel on top, soak for an hour. I must say that there is a slight tingling sensation. After an hour, wash your hair with shampoo, rinse with vinegar water (a liter of water and 2 tablespoons of vinegar). Do this procedure every time you wash your hair. Relief comes from the first time, and the condition of the hair improves markedly after the fourth procedure. The only downside to this treatment is the garlic smell. But it is felt only when the hair gets wet.

Dilute vinegar and distilled water in a 1:1 ratio. Lubricate the affected areas daily with this composition for one to two months. Real relief comes on the third day.

To get rid of dandruff, you can use this remedy: pour a tablespoon of common tansy into 400 ml of boiling water, leave for two hours, strain. Infusion wash hair without shampoo for a month. Or rinse your hair once a week with a decoction of lemon peels. Remove the peel from four lemons, pour a liter of water. Cook for fifteen minutes over low heat.

Leather

You can become infected with fungi through close contact with a sick person or dog, cat, or through objects and things (towel, linen, washcloth, etc.) used by the patient, as well as through animal care items. Often, children become infected with fungi from stray cats and dogs. Redness with burning and peeling can appear both on the body and on the scalp. After some time, hair can also suffer - and the hair can suffer both from the outside and from the inside.

One of the well-known skin lesions is versicolor versicolor, in which the most superficial layer of the skin suffers. The foci have a round shape of various sizes with a color from yellow to light brown. With sweating, the foci can merge into large spots. Ultraviolet rays partially cure this disease, however, as a rule, ointments and solutions with antifungal antibiotics cannot be dispensed with.

Microsporia, trichophytosis- these are also spots of the correct form, red in color, with peeling. This scale contains a large amount of fungus, which can spread to other areas of the skin during bathing. If there are lesions on the scalp, eyebrows, the hair begins to break at a height of 0.5-1 cm (this is already ringworm). Suffer mainly children who become infected from kittens, puppies, guinea pigs and hamsters.

Treatment consists in long-term local use of antifungal drugs that inhibit the reproduction of fungi, taking antifungal antibiotics inside.

Nails

More often damaged in older people. It is difficult for fungi to get into healthy nails, because they need certain conditions - for the nails to be loose, flaky. And a person creates such conditions with age, when he appears. Damage to blood vessels impairs tissue nutrition, nails begin to suffer and become easy prey for pathogenic fungus. Or maybe this: when a person severely injured his toes, nails. After a while, everything seems to have healed, but the blood circulation in the damaged area will no longer be the same, which will become the basis for fungal damage in older age.

Moreover, after 40-50 years, the thumb and little finger of those men and women who wore too tight shoes. This usually leads to the death of very small vessels. And as soon as the small vessels of the arms and legs begin to suffer, the nails thicken, exfoliate, which facilitates the penetration of the fungus. At first, damage can also cover only the skin of the foot, and then spread to the toenails.

Hair

Peeling of the skin on the head (what we call dandruff) is not necessarily a pathogenic fungus that provokes the disease. When dandruff appears beyond what usually happens, you can periodically (a couple of times a week) use shampoo with tar or " Nizoral"(or others - with antifungal agents). This will help improve the microflora of the skin, remove not only the fungus, but also microbes.

Prevention of fungal diseases

1. Wash regularly with soap and water separate towels for body, legs, etc.
2. If the feet sweat a lot, this increases the risk of infection, and therefore the soles should be wiped 2-3 times a week after a shower vinegar.
3. Do not wear narrow shoes and sneakers with poor ventilation, in which the feet constantly sweat.
4. Do not wear other people's slippers.
5. Change socks daily. Do not wear other people's socks.
6. In the bath, use the pool shales.
7. Special precautions should be taken by people with diabetes as they are very vulnerable to fungal damage.
8. Pay attention to diseases of the gastrointestinal tract. Sometimes it's enough to heal gastritis as well as the condition of the scalp is also improving.
9. Pay attention to food. If you significantly limit fatty foods, this can cause deficiency, hence there will be brittle nails. For beautiful hair, nails, skin, you will also need vitamin E, C,. Plus a micronutrient.

About the treatment of fungus

• If only the skin is damaged, disinfectant solutions are needed that inhibit the growth of fungi.
• Ideally, clothing worn during treatment should be discarded.
• It is desirable to process shoes inside with a solution vinegar, formalin, leave for a while for complete weathering.
• Take antifungal drugs in tablets per kilogram of weight.
• For external treatment of damaged areas (with entry to healthy skin), a solution and cream are used. It's not as aggressive as it can be with iodine treatment.
• The elderly should be aware that the healing process will be slow.

Trichomycosis- fungal quarantine infections that affect the hair. These include trichophytosis superficial, chronic and deep, microsporia and favus.

The zoophilic type of the disease includes deep infiltrative suppurative trichophytosis, in which the spores and filaments of the mycelium of the fungus are outside the hair (Trichophyton ectothrix). Due to this arrangement in relation to the hair, patients develop a pronounced perifocal inflammation with purulent fusion of the hair follicles and surrounding tissue. Pure cultures of the fungus are called Trichophyton gypseum (gypsum) and Trichophyton faviforme (faviform). The source of infection with infiltrative suppurative trichophytosis are cows, calves, horses, rats, mice, rabbits, guinea pigs.

Superficial trichophytosis. Predominantly children of preschool and school age are ill. Hair and smooth skin are affected. The source of infection are adults and sick children with chronic trichophytosis. Infection of children occurs directly through contact with patients or through objects used by the patient - hats, toys, scissors, razors, etc. Superficial trichophytosis of smooth skin is manifested by localization, mainly on open areas of the skin, of pink spots of a rounded shape with clear boundaries raised above the level of the skin, with peeling in the center of the spots. Subsequently, resolution occurs in the center of the spot, and a rim with the presence of microvesicles, serous crusts is formed along its periphery, and the focus takes the form of a ring. Sometimes a new focus is formed in the center of the ring due to autoinoculation, and then it resembles the shape of a ring within a ring. Rashes on the skin do not bother the patient at all.

Diagnostics. Microscopic and bacteriological studies from the lesions.

Differential Diagnosis. The clinic of superficial trichophytosis of smooth skin resembles a lesion with microsporia. The main thing for confirming superficial trichophytosis is the history and data of microscopic and cultural diagnostics.

Treatment. Without damage to vellus hair, external treatment is sufficient with the use of 5% alcohol tincture of iodine, lubrication with lamisil, ointments containing sulfur, tar and other antifungal agents.

Superficial trichophytosis of the scalp is usually manifested by several round-shaped lesions with peeling, on which hair is broken off at the level of the skin in the form of black dots or in the form of stumps 2-3 mm long., There are also individual unaffected hair. Due to peripheral growth, lesions slowly increase in size. There are no subjective feelings. The illness can last for years. In the absence of treatment at the age of puberty, more often in boys, self-healing occurs. If self-healing does not occur, then superficial trichophytosis turns into chronic adult trichophytosis.

Diagnostics. The diagnosis must be confirmed by microscopic and bacterioscopic methods. Differential diagnosis is carried out with microsporia and favus, which is helped by laboratory data.

Chronic trichophytosis. Chronic trichophytosis of adults is more often observed in women who did not have self-healing of superficial trichophytosis in childhood. The reasons for the transition of superficial trichophytosis to chronic are endocrine disorders, including hypofunction of the gonads in women, Itsenko-Cushing's disease, diabetes, hyperthyroidism, hypovitaminosis, immunodeficiency, peripheral circulatory disorders and others. Patients with chronic trichophytosis are sources of infection with superficial trichophytosis in children. Smooth skin, scalp, nail plates are affected. The causative agents of the disease are identical to the causative agents of superficial trichophytosis.

Smooth skin lesions are localized in the buttocks, shins, thighs, forearms, knee and elbow joints, symmetry is possible. It is characterized by the presence of pink-violet spots with clear scalloped borders, rather large in size. The surface of the spots with the phenomena of small-lamellar or bran-like peeling over the entire surface or in its individual sections. There may also be papular grouped or ring-shaped rashes. Slight itching of the skin is possible. Often, vellus hair can be affected, which is the cause of recurrence of the disease.

Chronic trichophytosis of the scalp proceeds without inflammation, localized more often in the occipital and temporal regions with mild peeling. Hair breaks off at skin level and is visible as black dots. There may be small areas of skin atrophy. Patients with chronic trichophytosis are detected, as a rule, during examinations of contacts of children suffering from superficial trichophytosis. Damage to the nails can be both in combination with damage to the hair, smooth skin, and independent, isolated. Fingernails are predominantly affected. The lesion begins with the free edge of the nails. Grayish-white spots and stripes appear in the thickness of the nail plate. The nail plate thickens, becomes loose and brittle, takes on a bumpy appearance. Characterized by the absence of inflammation of the nail folds

Diagnostics is based on the epidemiological history, clinical manifestations and laboratory detection of pathogens. Differential diagnosis is carried out with all trichophytosis.

Infiltrative suppurative trichophytosis. The most common routes of infection are direct contact with diseased animals (cows, calves, horses, rabbits, mice, and mouse-like rodents), or indirectly, through various objects that have hair of diseased animals infected with fungi. Less commonly, people become infected from patients with infiltrative-suppurative trichophytosis when hair affected by fungi gets on the skin of healthy people (hats, hair clippers, clothes and other items).

The lesion of smooth skin is characterized by the appearance of an acutely inflammatory, sharply defined, rounded infiltrated plaque, on the surface of which there are many follicular pustules, purulent crusts, and peeling. Without treatment, after a few weeks, the lesions resolve on their own, leaving pigment spots or scars behind.

Trichophytides or allergides occur with improper treatment, when the elements of the fungus or their decay products enter the bloodstream and cause the development of an inflammatory skin reaction far beyond the main focus.

Diagnosis of infiltrative suppurative trichophytosis is based on microscopic and bacteriological studies, clinical manifestations and epidemiological history. Differential diagnosis is carried out with all trichomycosis.

Anthropophilic type of microsporum more common in European countries, in China, Japan, on the territory of Belarus can be imported from these countries. In our region, a zoophilic type of disease is common, the source of infection of which are cats and dogs. The main pathogens are Microsporum lanosum (furry or feline) and Microsporum canis (canine), pathogenic for both animals and humans. Microsporia carriers can be hamsters, horses, cats. In our conditions, the most common sources of human infection are cats and dogs. In 85% of cases of microsporia, cats are the source of infection, in which eyebrows, mustaches, eyelashes, and hair can be affected, and these lesions are most often detected using a Wood's lamp. Recovered cats do not acquire immunity. Cat microsporum can vegetate for 1 - 2 months on vegetable peelings, wet rags, moistened paper. In dry soil, garbage, dust of basements and stairwells, in affected hair, it remains viable for up to 1.5 years. The incidence is seasonal and is associated with the breeding period of cats. Infection occurs when children come into contact with animals or with sick children, or through objects contaminated with fungi. The increase in incidence begins in June - July, reaches its highest height in September - October, when kittens of the second offspring appear. Fleas and flies can carry pathogens from sick cats to healthy ones. Microsporia affects smooth skin, scalp, extremely rarely nails. In adults, smooth skin is predominantly affected, the lesion is superficial, and the deep form is rare. The incubation period lasts from a week to 2 - 3 months.

Microsporia of the scalp, caused by fluffy microsporum (Microsporum lanosum), is manifested by the presence of one or two large foci of a rounded shape with clear boundaries. There are small foci around the main foci. Inflammatory phenomena are not pronounced, with the presence of a large number of white scales. In the focus, all the hairs are broken off at a height of 4-6 mm above the skin level, which resembles a mowed meadow, hence the popular name of the disease is "ringworm", and at the base of the hair there is a whitish cap, which is an accumulation of mycelial threads and fungal spores. Affected hair, when irradiated with a Wood's lamp (Uviol glass impregnated with nickel salts, through which ultraviolet rays are passed), glows green. Sometimes microsporia can proceed acutely with infiltration phenomena, with the presence of screenings, microsporides, due to an increase in the allergic reactivity of the patient's body.

Anthropophilic microsporia, caused by rusty microsporum (Microsporum ferrugineum), is characterized by multiple, larger lesions mainly in the marginal zone of hair growth with a transition to smooth skin, with pronounced peeling and fuzzy boundaries. The hair breaks off at a height of 6-8 mm and above, wrapped in a white cap. However, with this form of the disease, not all hair breaks off in the lesions, and normal ones remain.

Microsporia of smooth skin manifested by the presence of sharply defined pink spots, round or oval in shape with an inflammatory ridge along the periphery, raised above the level of the skin, resembling a ring, on which microvesicles, pustules, papules, serous-purulent crusts, scales are located. Peeling is noted in the center of the spot. Due to autoinoculation, new rashes appear, as a result of which a "ring in a ring" focus or the so-called "iris" shape is formed, which can be compared with the appearance of the iris of the eye. This clinical picture is typical for anthroponotic microsporia. The foci can merge with each other and form bizarre figures with scalloped edges. Vellus hair may be affected.

Diagnosis of microsporia based on clinical manifestations of lesions of the scalp and smooth skin, a greenish glow when illuminated by a Wood's lamp. However, it must be remembered that even after a single lubrication of the lesions with any antifungal agent, there may not be a glow. Microscopic and bacteriological diagnostics are mandatory. For research, hair or scales broken off with the presence of a cap are taken. Differential diagnosis is carried out with trichophytosis, which is helped by microscopic and bacteriological research methods.

Favus. The disease is caused by the anthropophilic fungus Trichophiton Schonleinii, which is located inside the hair. Favus is less contagious than microsporia and trichophytosis, is focal or familial. The source of infection is a sick person, extremely rarely mice, cats and other animals. Infection occurs through direct contact with a sick person, but more often through objects used by the patient (hats, combs, fur collars, children's toys, etc.). The incubation period ranges from 2 weeks to 12 months. The disease begins in childhood more often in persons suffering from gastrointestinal, neuro-endocrine diseases, hypovitaminosis, immunodeficiency states. The scalp, nails and smooth skin are affected.

Favus of the scalp can manifest itself in the form of scutular, squamous, impetigo clinical forms.

Scutular shape develops due to the introduction of the fungus into the mouths of the hair follicles, skutu or shields appear, which are a pure culture of the fungus. Approximately 2 weeks after infection, itchy, hyperemic, slightly edematous spots appear, on which yellow or yellowish-gray saucer-like dense dry crusts - skutules are formed with a sink in the center. Due to peripheral growth, they merge, forming large plaques. Affected hair does not break off, but loses its elasticity and shine, and is easily pulled out. A barn or mouse smell comes from the foci, which is formed as a result of the vital activity of fungi. When the shields are removed, a bright pink, smooth surface of the skin is visible. The disease ends with the formation of an atrophic scar and persistent baldness, with the exception of the marginal zone, in the form of a narrow border of unaffected hair up to 2 cm wide. An increase in regional lymph nodes is noted.

squamous form manifested by large-lamellar peeling on slightly hyperemic skin. When removing the scales, foci of atrophied skin are visible.

Impetiginous form rarely seen in children. In the mouths of the hair follicles, pustules are formed, which dry out with the formation of layered, dirty yellow crusts. Hair is changed, the process ends with atrophy.

Favus of smooth skin as an independent disease is rare and is usually combined with lesions of the scalp. Against the background of inflammatory spots, typical scutulae are formed, which, merging with each other, form rather large plaques (scutular form), occupying rather large areas of the skin. Sometimes, against the background of pink spots, peeling is determined, most pronounced in the mouths of vellus hair follicles (squamous form). Sometimes, against the background of erythematous spots, grouped small bubble elements (herpetic form) may appear. Smooth skin lesions do not leave cicatricial atrophy. More often the skin of the face, neck, extremities, scrotum, penis is affected.

Favus nails predominantly fingers is characterized by the appearance of spots and yellow stripes in the thickness of the nail plate, thickening, irregularities and the presence of grooves. Nail ridges are not involved in the pathological process. Diagnosis of the disease is based on the clinical picture, laboratory data (microscopic and cultural). Differential diagnosis is carried out with trichophytosis, microsporia, seborrhea, psoriasis, chronic lupus erythematosus. The main confirmation of the diagnosis is the detection of the causative agent of the disease.

Treatment of trichomycosis consists in the appointment of antifungal antibiotics inside: griseofulvin, nizoral, oranosol, lamisil, orungal and others. In our conditions, griseofulvin is often used to treat trichomycosis. When prescribing it, it is necessary to take into account the patient's body weight and be sure to take it with vegetable oil. With microsporia, prescribe at the rate of 21-22 mg / kg of body weight of the child, with trichophytosis - 18 mg / kg., With favus - 15-16 mg / kg of body weight. Moreover, for the first 3-4 weeks, the daily dose of the drug is prescribed daily in 3 doses (until the first negative analysis), then for 2-3 weeks the daily dose is prescribed every other day (up to three negative tests), the next 2 weeks are taken 2 times a week. At the same time, multivitamins, calcium gluconate 0.25 3 times a day, hepatoprotectors - Karsil 1 tablet 3 times a day for 25 days, silibor 1 tablet 3 times a day, hepatofalk and others, biogenic stimulants, immunomodulators are prescribed.

Prevention of trichomycosis consists in the timely identification of patients and sources of infection through medical examinations of children's groups and contacts, in the timely isolation of patients and their treatment, in the implementation of anti-epidemic, anti-epizootic and disinfection measures in the outbreaks. It is necessary to carry out sanitary and hygienic supervision of baths, laundries, hairdressers, as well as veterinary supervision of animals. Great importance in the prevention of trichomycosis is given to sanitary - educational work among the population and in organized groups. An important role in prevention is also dispensary observation of those who have been ill and contact. With microsporia, observation is carried out for 1.5 months with a frequency of examination for treated patients on a weekly basis, for contact patients - when registering and before deregistration after 1.5 months. In organized children's groups, examinations are carried out weekly. With superficial and deep trichophytosis, observation is carried out for 2 months, for treated patients - weekly, for contacts in family foci - when registering and 2 months before deregistration, and in children's groups - weekly. In chronic trichophytosis of adults, dispensary observation is carried out for 2 years: the first 3 months - 1 time in 2 weeks, then after 6, 9, 12 and 24 months. With favus, observation is 2 years with a frequency of examination for the first 3 months 1 time in 2 weeks, then after 6, 9, 12 and 24 months. Children who have recovered from illness are allowed to visit organized groups after 3 negative tests for fungi during treatment with griseofulvin and 2-fold control examination (after 5 negative results). When identifying patients with trichomycosis, it is imperative to send a notice to the dermatological dispensary and the center of epidemiology and hygiene, and in case of a zoophilic form, to the veterinary service.

Fungal lesions of the skin of the feet.

This group of diseases includes epidermophytosis and rubromycosis. The causative agent of epidermophytosis of the feet is Trichophiton mentagrophytes, interdigital - Trichophiton interdigitalis and inguinal - Epydermophiton inquinale. The causative agent of rubromycosis is Trichophiton rubrum. Infection with these diseases can occur when elementary sanitary and hygienic conditions are not observed in baths, showers, baths, pools, on beaches and in gyms, when wearing someone else's shoes, family infection is possible. Factors contributing to the development of the disease include increased sweating (hyperhidrosis), minor injuries to the skin of the feet, functional disorders of the vessels of the lower extremities, resulting in a violation of the microcirculation of the skin of the feet, flat feet, narrow interdigital spaces, prolonged wearing of rubber or tight shoes, dysfunction nervous and endocrine systems. The decrease in the immunological reactivity of the body is also of great importance.

Athlete's foot. There are the most common clinical forms of the disease - squamous, intertriginous, dyshidrotic and epidermophytosis of the nails.

Squamous epidermophytosis characterized by fine-lamellar peeling on the skin of the soles and in 3, 4 interdigital folds without pronounced inflammatory phenomena, in the center of which cracks form, which is one of the conditions for the penetration of streptococcal infection. On the periphery of the foci, a collar of the exfoliating stratum corneum is formed. This form can turn into dyshidrotic. Subjectively, patients report slight itching.

Intertriginous, or interdigital, epidermophytosis often occurs as an exacerbation of an erased or squamous form of the disease and is manifested by the appearance in 3-4 interdigital folds of hyperemia and maceration of the stratum corneum, vesicles, erosions, along the periphery of which there is a collar of macerated epithelium. The process extends to the plantar surface of the fingers and the sole. When a secondary infection is attached, a pronounced edema and hyperemia of the skin of the fingers and the back surface of the feet, lymphangitis and regional lymphadenitis develop. The general condition of the patient is disturbed.

Dyshidrotic epidermophytosis is one of the most severe forms of the disease. It is localized mainly on the inner arch of the soles, outer and inner side surfaces and is manifested by rashes of vesicular elements with a thick tire, with transparent or cloudy contents. Vesicular elements can be multiple, grouped, merging, form large multi-chamber bubbles. When they are opened, extensive erosive surfaces appear with clear scalloped edges and collars of the exfoliating stratum corneum. Over time, erosion epithelialize, covered with lamellar scales. Perhaps the accession of a secondary infection, the development of lymphangitis and lymphadenitis. The disease is accompanied by itching and general symptoms. Due to the fact that dyshidrotic epidermophytosis develops against the background of sensitization of the body to fungi, with improper local treatment in such patients, rashes remote from the main focus, which are called epidermophytides or allergides, may appear. Most often they are localized on the skin of the palms in the area of ​​the tenor and hypotenor, fingers. Given that this manifestation is allergic in nature, it is not advisable to search for the causative agent of the disease on the hands.

Athlete's nails observed only on the toes, and the nails of the 1st and 5th fingers are affected. This localization of the lesion develops as a result of constant traumatization and squeezing of these fingers and nails with tight shoes, which leads to disruption of microcirculation and nutrition, resulting in good conditions for the development of the fungus. The nail plate is dull, yellowish-gray in color. The free edge is deformed, thickened, crumbled. Due to subungual keratosis, the nail bed thickens. An atrophic variant of nail damage (onycholysis) is also possible.

Epidermophytosis of large folds. The inguinal folds are predominantly affected, less often the axillary and under the mammary glands. The causative agent is Epidermophyton inquinale. Inguinal epidermophytosis often occurs during puberty with increased activity of the eccrine and apocrine glands, changes in the pH of sweat to the alkaline or slightly acidic side, increased reactivity of the epidermis and dermis, and vegetovascular dystonia. Infection occurs in baths, baths, when using common washcloths, towels, from patients through care and toilet items (linen, thermometers, bedpans, etc.). The incubation period is from 1-2 weeks to 2 months. On the inner surfaces of the thighs, itchy spots of a pink-red color, rounded in shape with small-plate peeling, appear, the edges somewhat rise above the skin in the form of a roller, on the surface of which there are small bubbles and pustules. Growing along the periphery, the spots merge with each other, forming ring-shaped and garland-like figures, go beyond the folds. The diagnosis is made on the basis of clinical manifestations and laboratory detection of fungal mycelial filaments. The differential diagnosis is carried out with erythrasma, candidal lesions, limited neurodermatitis. Treatment of epidermophytosis of the feet consists in prescribing hyposensitizing agents (10% calcium chloride solution, 10% calcium gluconate solution, 30% sodium thiosulfate solution), more often with dyshidrotic and intertriginous forms of epidermophytosis, as well as vitamin B1, ascorbic acid. When complicated by a secondary infection with the development of lymphangitis and lymphadenitis, antibiotics or sulfonamides are prescribed. Local treatment of epidermophytosis is carried out depending on the clinical form and stage of the disease. In the squamous form, the affected areas are lubricated with 3%-5% alcohol solutions of iodine, Castellani paint, iodine with salicylic alcohol, antifungal ointments are used (amizol, undecin, mykoseptin, mycosolone, lamisil, viosept, mycospor, batrafen, travocort, travogen, etc.) . With intertriginous and dyshydrotic forms, as well as with acute inflammation and weeping, it is advisable to start local treatment with the use of lotions of 0.25% - 0.5% silver nitrate solution, 5% boric acid solution, 1% -2% resorcinol solution, 5% solution tannin. After the cessation of weeping, antifungal solutions and ointments are prescribed.

Rubromycosis. The disease is characterized by a chronic relapsing course and contagiousness. Pathogen Trichphyton rubrum, affects smooth skin, palms and soles, nails, vellus hair. The epidemiology of the disease is similar to epidermophytosis of the feet.

Rubromycosis of the palms and soles is manifested by dry skin, hyperkeratosis, and the appearance of cracks. The skin pattern in the lesions is pronounced, in the skin grooves there is a small pityriasis peeling, due to which a white striation appears. As a rule, all interdigital folds on the feet are affected.

With the defeat of the smooth skin of the legs, buttocks, trunk, face and other areas, redness of the skin with peeling and follicular papular elements are observed. The foci may resemble ring-shaped, arcuate figures with clear, intermittent borders, with a raised ridge-like edge.

Rubromycosis of nails. All nail plates on the hands and feet are affected. The lesion begins with the formation of yellowish or grayish-white spots in the thickness of the nail. In the hypertrophic form, the nail thickens due to subungual hyperkeratosis, becomes brittle, crumbles, and is often deformed. With the atrophic type, the nail plate becomes thinner until it is destroyed or completely separated from the nail bed by the type of onycholysis. In the normotrophic type, the nail retains its luster, its free or lateral edge is affected with the appearance of yellow-gray spots. In the affected vellus hair, the elements of the fungus are located inside the hair. This determines the duration of the course and resistance to treatment. Diagnosis of rubromycosis is based on the results of microscopic examination and inoculation of pathological material on Sabouraud's medium. Differential diagnosis is carried out with epidermophytosis, psoriasis, pink lichen, chronic trichophytosis of smooth skin, horny eczema.

Treatment of rubromycosis presents a certain difficulty. With damage to the palms and soles, treatment begins with detachment of the stratum corneum with keratolytic ointments or varnishes. After a soda-soap bath (2 teaspoons of baking soda and 20 grams of soap per 1 liter of water), 20% -30% salicylic ointment or Arievich ointment (6% lactic and 12% salicylic acid or a collodion film, which includes includes lactic and salicylic acids, 10 g each). After two days, lubricate for a day with 5% - 10% salicylic ointment. Then the patient takes a soda-soap bath, the horny masses are removed. After detachment, the lesions are lubricated with fungicidal solutions or ointments. Usually, lubrication with ointments and solutions alternates after 3 days, i.e. solution in the morning, ointment at night, vice versa three days later. Baths for hands and feet are made once a week. Treatment of smooth skin lesions is carried out from the very beginning with fungicidal agents.

Treatment of fungal nail infections (onychomycosis). It is possible to recommend surgical removal of the affected nail plates, which is not always possible. Most often used keratolytic agents. These include ureaplast containing 20% ​​urea, an ointment with potassium iodide and lanolin in equal proportions (method of A.N. Arabian). In recent years, batrafen lacquer has been proposed for the treatment of onychomycosis, which is applied daily to the nail plates for 10 days, then a month - every other day, the next month - 2 times a week and then 1 time per week. The method of removing nail plates with ureaplast and ointment with potassium iodide is laborious. After a soda-soap bath, the nail plates should be trimmed, removed, as far as possible, hyperkeratotic masses. Then the skin around the nail plate is glued with an adhesive plaster so that the ointment does not get on it, and the softened ureaplast is smeared on the nail plate and strengthened with an adhesive plaster. After 5-7 days, the ureaplast is removed, a soda-soap bath is made, and softened horny masses are removed with a scalpel. If the complete softening of the nail plate has not occurred, then after a few days the detachment procedure is repeated. After removing the nail plate, the nail bed is treated with fungicidal agents - 5% alcohol solution of iodine, 3% - 5% salicylic alcohol iodine solution, antifungal ointments. With lesions of the nails and smooth skin, in addition to local treatment, it is necessary to prescribe the antifungal antibiotic griseofulvin. Its daily dose depends on the age of the patient, the effectiveness and tolerability of the drug. In addition to griseofulvin, nizoral, oronazole and other drugs are widely used, but they have a fungistatic effect and hepatotoxicity. In recent years, for the general treatment of rubromycosis, the use of lamisil and orungal, which have a fungicidal effect, has been recommended. Lamisil is prescribed at 0.25 once a day, it is advisable to take it up to 4 months, which will increase the cure rate for onychomycosis. Orungal pulse therapy is widely used. One course of pulse therapy consists in daily intake of 2 capsules of orungal 2 times a day for one week. For the treatment of lesions of the nail plates on the hands, 2 courses are recommended, and for lesions of the nail plates on the feet, 3 courses of treatment are required. The interval between courses, when you do not need to use the drug, is three weeks. In addition to taking antifungal antibiotics, patients are prescribed vitamins B, A, C, nicotinic acid, hepatoprotectors (Lif-52, hepatofalk, etc.). ), vasodilators.

To prevent recurrence of the disease, it is necessary to disinfect linen, socks, mittens by boiling or ironing through wet gauze. If the skin and nails of the feet are affected, it is advisable to disinfect the shoes. At home, shoes can be treated with acetic essence (acetic acid). To do this, cotton wool moistened with acetic acid is placed inside the shoe, and then in a plastic bag tightly closed for 12-24 hours. You can use disinfected shoes after it has been well ventilated.

Prevention of fungal infections of the feet is to comply with sanitary and hygienic rules. This includes sanitary supervision of cleaning and disinfection of rooms and equipment in baths, showers, swimming pools, gyms. Disinfection of impersonal shoes, especially in medical institutions, sports shoes. Active detection of patients and their timely treatment, dispensary observation of patients after treatment for a year. Of great importance in the prevention of fungal diseases is the proper care of the skin of the hands and feet, the fight against excessive sweating. In this regard, it is necessary to harden the feet. To reduce sweating of the skin of the feet, it is recommended to walk barefoot in dew, hot sand, to carry out prophylactic treatment of the skin of the feet with antifungal agents, especially in the spring and summer. Sanitary and educational work is needed, primarily among the organized contingent in order to explain to them the conditions, ways of infection with fungal diseases of the feet and their prevention.

Organization of the work of the mycological office. One of the important functions of tannery institutions is organizational, methodological and treatment-and-prophylactic work in the fight against fungal diseases. The fulfillment of these tasks is entrusted to mycological rooms or departments that function in skin care clinics. The main tasks in the work of the offices are: identification of patients and sources of their infection; conducting medical examinations to identify mycoses in children's institutions; control over the effectiveness of preventive measures carried out in children's institutions, hostels, etc.; treatment of fungal diseases; dispensary observation of patients and family members where the disease is registered; registration of those who have been ill and those who have been in contact with them; control over the dynamics of fungal diseases in your region; carrying out sanitary and educational work among patients and the population. In the performance of these and other tasks, the primary role belongs to the nurses working in these offices or departments.

Candidiasis. Candidiasis - a disease of the skin, mucous membranes, nails, internal organs, caused by yeast-like fungi of the genus Candida, which are widely distributed in nature on vegetables, fruits, berries, as saprophytes live on the skin and mucous membranes of a person, when special conditions occur, they become pathogenic and cause disease . The causes of the disease can be both exogenous and endogenous. Of the exogenous factors, increased sweating, constant maceration, trauma to the skin and mucous membranes, overheating and high humidity of the environment are important, which leads to a change in the state of the water-lipid mantle of the skin, lowers its pH and favors the penetration of yeast-like fungi. The development of candidal lesions of the interdigital folds of the hands, nail folds and nails is also influenced by working conditions associated with prolonged exposure of hands to water at dishwashers, when cleaning vegetables, in the confectionery industry in contact with powdered sugar, with rotting vegetables and fruits in fruit and vegetable production. Diabetes mellitus, in which an increase in blood glucose levels leads to an increase in its content in the skin (normally, the skin contains half of its concentration in the blood), is a good breeding ground for the development of the causative agent of candidiasis. In addition, blood diseases (leukemia, anemia), dysbacteriosis, obesity, acrocyanosis, vitamin balance disorders, especially B 2 (riboflavin) and B 6, the use of glucocorticoids and antibiotics, immunosuppressants, changes in the functional state and mechanisms of cellular and humoral immunity. We must not forget that almost half of AIDS patients have candidal lesions of the skin, mucous membranes and internal organs.

There are superficial, visceral (systemic) and chronic generalized candidiasis. As an intermediate form between superficial and visceral candidiasis, candidomycids or allergids are separately isolated.

Candidiasis of the mucous membranes, or thrush, affects the oral mucosa. In the lesions, against the background of severe hyperemia, a white plaque appears in the form of a film, the removal of which is accompanied by bleeding.

Vulvovaginal candidiasis is manifested by hyperemia or dryness of the vulva and vaginal mucosa with a grayish-white coating. There may be a liquid cloudy discharge with crumbly white lumps. Lesions are accompanied by itching of the genital organs.

Candida balanoposthitis. The skin of the glans penis and the inner layer of the foreskin is hyperemic, macerated, sometimes eroded, with whitish layers. Subjectively worried about itching. Syphilis must be ruled out.

Chronic generalized granulomatous candidiasis begins with the oral mucosa (thrush) in infancy or early childhood with a transition to the red border of the lower lip (cheilitis), the corners of the mouth (jam). Periungual ridges and nail plates (paronychia, onychia) are affected. Hyperemic scaly spots, papules appear on the skin. Gradually, infiltration develops in the lesions, and the papules turn into tumor-like, granulomatous formations with loose brown crusts. When removing the crusts, bleeding growths (vegetations) are visible. After resolution of the granulomas, atrophic spots remain.

Candidiasis of the corners of the mouth (zaeda) is manifested by erosions or painful cracks with a whitish border of the macerated stratum corneum. There may be candidal lesions of the red border of the lips.

Candidiasis of large folds is more often localized in the inguinal-scrotal region, in the intergluteal fold, under the mammary glands in women, in the armpits and in the folds of the abdomen. Small vesicles and pustules appear in the lesions, upon opening of which erosions are formed, sharply limited from healthy skin with a collar of a swollen macerated stratum corneum. The surface of the erosions is dark red, moist. Cracks form in the center of the fold, an accumulation of a whitish mushy mass. On the periphery of the main focus, there may be screenings in the form of pustules and vesicles.

Interdigital candidal erosions are most often localized in the 3rd interdigital fold of the hand and often in all interdigital folds of the feet, as well as on the lateral surfaces of the fingers of a dark red color with a white border of a peeling macerated stratum corneum. The lesion is accompanied by burning and itching.

Candidiasis of the nail folds and nail plates most often affects the nails of the 3rd and 4th fingers. The posterior and lateral nail folds swell, turn red, the nail skin (eponychia) disappears. When pressing on the nail roller, a drop of pus or a crumbly mass is released from under it. The nail plate is affected from the lateral edges and the hole, becomes cloudy, crumbles and becomes thinner, brownish-gray in color, its lateral edges are separated from the nail bed. Detachment of the nail plate may occur. Diagnosis of the disease is based on the clinical picture of the lesion and laboratory research, microscopy and seeding on a nutrient medium. It is necessary to differentiate candidal lesions with lichen planus, autotic stomatitis, erosive syphilis, streptococcal lesions.

Treatment. It is necessary to examine the patient in order to identify pathogenetic factors of the onset of the disease, conduct a general blood test, examine blood glucose and other biochemical and immunological parameters. Be sure to rule out HIV infection. General strengthening treatment is carried out with vitamins B1, B2, B6, B12, A, C, phytin, aloe, folic acid, immunocorrective agents - gamma globulin, sodium nucleinate, taktivin, methyluracil, placental suspension and others. Iron preparations are widely used. For etiological treatment, anti-candida drugs are prescribed - nystatin, levorin, dekamin, pimafucin, pimafucort, lamisil, orungal, ketoconazole, fluconazole, flucytosine and others. External treatment consists in the use of clotrimazole, pimafucort, travogen, travocort, mycospore, a solution of aniline dyes, mycosolone, nizoral, dactarin, lamisil, citeal, triderm and other preparations in the form of ointments and creams.

Prevention of candidiasis consists in rational nutrition, disinfection of objects used by patients with candidiasis, in identifying and eliminating exogenous and endogenous factors that contribute to the development of the disease. The medical staff of the wards and departments of newborns with candidal lesions of the skin and mucous membranes should not be allowed to work.

Keratomycosis. The group of keratomycosis includes fungal diseases in which the stratum corneum of the epidermis and the hair cuticle are affected. A representative of this group of diseases is pityriasis or versicolor, which is caused by the fungus Pityrosporum orbiculare. The development of the disease or its recurrence is promoted by excessive sweating, diabetes mellitus, obesity, diseases of the gastrointestinal tract, non-compliance with sanitary and hygienic standards.

Clinical picture It is characterized by the appearance mainly on the skin of the chest, shoulder girdle, back, neck, less often on the scalp, slightly scaly yellowish spots. Peeling comes to light more clearly when scraping (symptom of Besnier-Meshchersky). Subjective sensations, as a rule, are absent. The course of the disease is long, the spots increase in size, merge, and can occupy a large area of ​​the skin.

Diagnostics the disease is based on clinical manifestations, a positive Balzer test (lubrication of lesions with 2% - 5% alcohol solution of iodine). With a positive test, intense staining of the spots occurs, since small scales absorb iodine more. To diagnose a lesion of the scalp, a Wood's fluorescent lamp is used, with a lesion in the foci there will be a red-yellow or dark-brown glow. In some cases, a microscopic examination of the scales for the presence of a fungus is performed. Differential diagnosis. Due to the fact that white spots remain after treatment, which do not tan under the influence of UV light, it is necessary to distinguish them from syphilitic leukoderma, from secondary spots after pink lichen, psoriasis and other skin diseases.

Treatment presents certain difficulties in connection with possible relapses of the disease. In this regard, it is necessary to warn the patient about the mandatory disinfection of linen and clothing that came into contact with the affected skin. Local treatment consists in lubricating stains with 2% - 5% alcohol solution of iodine, 2% salicylic alcohol, a saturated solution of boric acid, 20% benzyl benzoate, UVI, fungicidal agents. Prevention consists in observing the basic rules of personal hygiene, combating excessive sweating, and treating concomitant diseases.

Erythrasma. Erythrasma is caused by carinebacteria and belongs to pseudomycosis. Men get sick more often. One of the predisposing factors in the development of the disease is excessive sweating. Localization of lesions is more often in the inguinal-scrotal fold, less often in the intergluteal, in the armpits, under the mammary glands in women. The disease manifests itself as sharply limited and slightly scaly brown spots, usually not bothering a person. Diagnosis is based on the clinical manifestations of the disease and microscopic examination of the scales. It is necessary to differentiate the disease from the manifestations of epidermophytosis of large folds.

Treatment. Means are used, as with pityriasis versicolor. A good therapeutic effect is the use of 5% erythromycin ointment for two weeks.

Prevention The disease is based on the observance of elementary sanitary and hygienic rules, wiping the folds with 2% boron-salicylic alcohol.

Fungal diseases, namely those that a person generally has to deal with, are called mycoses. Mycoses are infectious diseases, they affect the mucous membranes, skin, hair and nails, such an effect is due to specific pathogenic fungi. Fungal diseases of the nails, including the hands and feet directly related to them, have their own definition and are called onychomycosis. In today's our article, we will consider those main provisions that relate directly to this disease.

general information

Mycoses are detected on average in 10% of the total population, and some data indicate their even greater prevalence, two or even three times the indicated figure. Remarkably, as part of a review of the last ten years, it was revealed that the incidence over this period, compared with previous data, has approximately doubled. This can be explained by the fact that in most cases, patients ignore the need for treatment, which, accordingly, leads to a similar prevalence of mycoses.

Turning specifically to fungal diseases of the nails, that is, to onychomycosis, we note, first of all, that they never occur in children. The increase in the incidence occurs in older patients, and in particular, onychomycosis becomes a frequent companion for elderly patients (at the age of 79 years, there is a peak incidence). A certain trend is also noted in terms of gender in the consideration of onychomycosis - in men it occurs almost one and a half times more often than in women.

Some professions are also considered as a predisposing factor for the development of onychomycosis. So, factory workers, athletes, military personnel, miners - representatives of all these professions, in particular, often face problems directly related to the disease in question, the predisposition to its development is on average 30% higher than the predisposition to it in other groups of patients. It has also been observed that in groups within certain limited areas, onychomycosis is similarly a fairly common disease, which is predisposed to by common locker rooms and showers. A separate point on the predisposition to the disease concerns the need to wear heavy boots and a certain form of clothing.

Onychomycosis of the feet occurs 3-7 times more often than onychomycosis of the hands. On the hands of onychomycosis is more common in women (three times on average), in addition, this disease is also more common in the hands of people whose professional activity causes prolonged contact with water or sugars (i.e. confectioners, cooks and etc.).

The main causative agents of the disease we are considering are dermatophytes. In addition to the listed criteria that determine the predisposition to onychomycosis for patients (age, professional activity, etc.), current immunodeficiency states, obesity, vascular diseases, and any type of serious illness can also be identified. With the advent of summer, the peculiarities of weather conditions significantly increase the chances of the onset of this disease. And, of course, the risk of "catching" onychomycosis is especially great among lovers of public pools, saunas and baths. Carpets, paths, gratings, benches and any other types of surfaces on which skin flakes and pathogenic fungi on it can get from a sick person - all this also becomes dangerous in the context of considering the factors provoking this disease.

There are a number of questions and myths associated with fungal diseases of the nails and skin, and we will dwell on them a little lower, of course, without disregarding the question of treatment.

The main forms of fungal nail lesions (from left to right: distal-lateral lesion type, total lesion type, superficial lesion type and proximal nail lesion type)

Fungal diseases of nails and skin: main myths

• The appearance of nails and skin allows you to determine the presence of a fungus in a patient

Oddly enough, this statement really belongs to the category of myths. Of course, the identification of the characteristic signs of the disease suggests its relevance for this criterion, but it is not indisputable. The fact is that due to changes caused by the influence of environmental factors, nails are easily amenable to change. As such influencing factors, one can designate both ordinary housework, exposure to chemical or physical factors, and the effect on the body that is practically traditional for the development of most other diseases against the background of stress and certain medications. In other words, what we, looking at the hands and nails, can take for a fungus, is not a fungus, although the manifestations of the influence of these factors can be very similar to it.

Remarkably, the fungus quite often disguises itself as certain skin diseases, such as, for example, or. Moreover, such a “scenario” is not uncommon, in which patients are treated for a fungus for a long time, unsuccessfully acting on it with sufficiently strong drugs, while a completely different disease is to be treated. Considering even this feature, the treatment of fungal diseases of the nails should be determined only on the basis of the doctor's recommendations, while self-medication in this case becomes an unacceptable option, as, however, it is unacceptable for any other diseases.

How to determine the fungus, or what symptoms of a fungal disease of the nails (skin) require an appointment with a specialist? Most likely, the reader has a general idea of ​​\u200b\u200bwhat a fungus looks like, but we will not fail to note those signs for which you should find time to visit a doctor. If we are talking about healthy nails, then it is clear that outwardly they are pinkish, smooth and shiny. As a rule, with a fungus, the skin is subject to peeling, in which it looks like rings, plates, or resembles flour (the grooves of the skin in this case are, as it were, sprinkled with flour, which determines such an analogy). Bubbles appear, in some cases they can even suppurate, after which they open up.

When exposed to a fungal infection, nails become dull, begin to crumble and exfoliate, become yellow or dirty gray. In addition, there is a thickening of the nail plates, their deformation. As other signs indicating a fungal infection of the nails, the following changes can be identified: "corroded" edges of the nails, separation from the nail bed of the nails, their thinning, deformation, in which the nails can resemble the appearance of a "beak" in an altered form, transverse striation of the surface .

• A visit to the pool, fitness club, sauna, bathhouse and other similar public places will certainly lead to the appearance of a fungal disease due to the fact that it is in such places that fungal infection occurs most often

As already noted, these types of places can indeed be considered as places predisposing to infection by the fungus. However, this does not mean at all that under other circumstances and with the exclusion of places with high humidity (namely, this criterion is suitable for potential sites of fungal infection), there is no danger of infection. Thus, wearing clothes that have previously been in contact with the body of a person with a fungus, there is a significant risk of infection. Drying with a towel previously used by a person with fungus identifies a similar risk.

Further, this list can be supplemented, for example, with shoes. As the reader is probably aware, someone else's shoes are highly discouraged. This applies, as is clear, to any shoes, even ordinary slippers offered at a party. In the latter case, there is no way out and walking barefoot, because particles of skin that have previously been subjected to fungal infection may be on the floor, which will determine the likelihood of subsequent infection. In this case, ordinary cotton socks can be considered as an option for “protection”. By the way, it is better to limit wearing nylon socks, because they create a not very favorable environment for the legs, while contributing to the retention of sweat.

In addition, it is easy to get infected with a fungus even in public transport - just hold on to the handrail, which the sick person previously held. Again, a fitness club, a gym and other places, a visit to a manicure or pedicure master (in this case, infection occurs due to contact with non-sterile instruments). Thus, the conditions initially indicated in this paragraph are certainly predisposing to infection by the fungus when spread through sweat and sports equipment, however, any tactile contact is also equally dangerous in terms of the possibility of infection with a fungal infection.

With regard to fungal infection in the pool, this probability is relatively small, which is due to the influence of the processes through which the water passes (in particular, filtration, chlorination and frequent replacement). On the beach, the fungus can also be infected, in which case the sand mixes with infected skin particles. It is for this reason that it is recommended to come to the beach in shoes (i.e. not barefoot). It is also recommended to regularly wash towels, followed by their steaming. This recommendation is based on the life span of fungi - their death occurs only when exposed to temperatures above 100 degrees.

Based on recent studies, it has been revealed that nail fungus most often spreads in families, that is, it literally “is inherited”. At the same time, contact under the conditions we have considered does not always lead to infection, in some cases it is caused by the presence of additional conditions predisposing to this. For example, it can be a reduced body resistance against the background of a certain type of disease (diabetes mellitus, etc.). You can reduce the risk of infection by avoiding sharing shoes, using antibacterial soap to wash your hands and feet, and using special antibacterial shoe insoles.

• When a fungus is detected, it is necessary to get rid of shoes

The decision, of course, is radical, although not mandatory, therefore we will answer if such a question nevertheless arises: you do not need to throw away shoes with a fungus. However, inaction is also not encouraged when it comes to getting rid of the fungus. It is possible and necessary to process shoes, for this, for example, you can use vinegar (40%) or formaldehyde (25%). After this treatment, you additionally need to wipe the shoes with ammonia. Bed and underwear, including socks, stockings, tights, are subject to disinfection, washing and ironing.

• It is impossible to completely cure the fungus

This statement is not entirely true. It can be really difficult to recover from a disease, especially if there are factors “reinforcing” this disease, such as the presence of certain chronic diseases, reduced immunity, etc. In some cases, the spread of the fungus can affect not only the arms or legs, but also the chest, stomach. 1 out of 5 cases considered, as a rule, determines the transition of the fungus with its prolonged flow from the legs to the hands. Be that as it may, in the vast majority of cases, the fungus can be cured. If treatment is not allowed for certain reasons (in particular due to general health), one can at least move on to the implementation of preventive measures. For this, a 5% solution of iodine is used, as well as some recommendations from the doctor (in accordance with the general picture of the patient's condition).

• You can get rid of the fungus literally in one procedure using nail polish or a special cream

With a greater degree of probability, we can assume that such a promise is just a banal publicity stunt. There are, of course, relative exceptions, they concern cases in which the disease has just begun, and therefore it will really be easier to get rid of it. In addition, this option is also possible if the damage to the nails is “marginal”, that is, only the edges are affected. To do this, it is enough to cut off the affected area, and then apply a miracle cure, whether it be a cream or varnish.

For the most part, treatment begins at later stages, at which the achievement of effectiveness in the shortest possible time becomes an option almost impossible. The fungus in this case penetrates deep into the nails, their self-renewal occurs in about three months, that is, the treatment in any case will be delayed in time. When only the skin is affected by the fungus, in combination with the two extreme nails with the possibility of cutting them, the treatment is mainly reduced to external exposure. With a larger fungal infection, drugs for internal use (systemic treatment) are additionally prescribed. Remarkably, during the treatment period, patients with a fungus in most cases are not dangerous to the environment, that is, they are not contagious.

• The fungus is accompanied by physical pain

Some patients are really interested in whether the fungus can cause physical pain, some are completely convinced that pain is an integral companion of this disease. So this is only partly. In most cases, of course, fungal infections are not accompanied by the manifestation of pain. Nevertheless, as noted, it is not necessary to exclude pain with a fungus. It is caused by special types of fungi, due to the impact of which the tissues surrounding the nail become inflamed, which, in turn, causes itchy and aching pain.

• False nails, nail extensions - all this allows you to eliminate the fungus

This statement is absolutely wrong. Artificial nails in no way act as a “protective layer” for nails, moreover, their presence creates an ideal environment for the habitat and reproduction of a fungal infection. In any case, artificial nails can be created on your own, but perfectly healthy nails, and only for a short period of time, if such a need arose. A separate topic in this matter is the negative impact on natural nails and their structure when artificial nails are created on their surface. In any case, the nails simply need to "breathe", and the presence of layers in one form or another deprives them of this possibility, which is why they are simply clogged.

Fungal diseases: treatment

Local treatment of the fungus, that is, when certain agents are applied to the affected area, is in many cases ineffective, because penetration of this type of preparation into the depth of the nail is required, which does not happen. In order to achieve such a result, patients in many cases refuse to remove the surface layer of the nail (nails), which excludes, accordingly, the effectiveness of local exposure. Taking into account the need to influence the nail, which is also relevant for long-term large-scale damage to the nails, systemic treatment is used.

The use of drugs applied internally allows exposure through the blood to the affected nails. At the same time, such treatment determines the risk of side effects on the background of long-term use of drugs, which, therefore, excludes the possibility of using systemic therapy drugs by pregnant women, nursing mothers, as well as patients with drug allergies or liver diseases.

Returning to local therapy, we can identify the advantage over systemic therapy, which is the absence of toxic and side effects. In addition to removing the nail plate, in this case, two other options for exposure can be proposed, causing the subsequent effect of local exposure to the affected area, in particular, the use of keratolytics or cleaning the nail bed.

To date, the most optimal solution in the treatment of fungus is combination therapy, that is, therapy in which both topical drugs and systemic drugs are used simultaneously. Due to this approach, it is possible to reduce the terms of comprehensive impact, while providing it in both directions, that is, both from the inside and outside. At the same time, by reducing the time of exposure and, accordingly, treatment, the risks associated with the occurrence of side effects and the intensity of their manifestation should also be reduced.

Non-fungal nail diseases

Considering our main topic, that is, fungal diseases of the nails, it is impossible not to dwell on a topic that is opposite in nature, that is, on non-fungal diseases. In most cases, nail changes are really associated with a fungus, but it also happens that they are caused by chronic nail injury, or psoriasis. In addition, nails can also change against the background of a number of internal diseases (in which the nervous, cardiovascular, endocrine systems, etc. are affected), with dystrophic processes and with intoxications. Moreover, nail changes are also congenital, although outwardly there is a resemblance to a fungal infection.

As is clear from the specifics of nail damage, the treatment of non-fungal diseases will be at least ineffective when using anti-fungal drugs. This, accordingly, necessitates a mandatory visit to a dermatologist - only he can reliably determine the nature of the disease and the specifics of nail damage, that is, determine whether it is a fungus or not.

There are a number of signs, on the basis of which it can be assumed “offhand” what exactly the damage to the nails is connected with, we will highlight them below.

• The nail is white, the nail plate is cloudy. There is a term for this kind of change - leukonychia. In this case, psoriasis should be assumed as one of the main possible causes of the changes.
• The nail has become white, the nail plate is separated from the nail bed. In this case, the term pseudoleukonychia is used. Psoriasis or chronic nail injury should be considered as the main causes accompanying such changes.
• The nail turns black. The term melanonychia is used, with nail tumors or subungual hematoma considered as the main causes of such a lesion.
• The color of the nail is changed, for example, it becomes yellow. The term chromonychia is used, either specific drug reactions or yellow nail syndrome are considered as the main causes.
• The area of ​​the periungual roller was inflamed. In this case, the term paronychia is used. Possible bacterial infections, contact dermatitis or contact allergic dermatitis are considered as the main causes that provoked changes in the nails.
• The nail bed has undergone a specific thickening. In this case, the term hyperkeratosis is used. Eczema, psoriasis, chronic dermatitis or lichen planus are considered as the main causes.

Let us dwell separately on chronic nail injury, or rather on what such an effect implies. Chronic injury is the most common variant of nail changes, and it is its consequences that are often confused with onychomycosis. Various kinds of foot deformities (including congenital ones), playing sports (football, athletics), tight shoes - all this leads to a systematic effect on the nail plate, due to which it begins to separate from the nail bed. Also, nail trauma can be caused by the peculiarities of professional activity, in particular, contact with certain chemicals.

The diseases listed in this list (, eczema, psoriasis) are also often accompanied by involvement in the pathological process of nails, and in a similar way to a fungus. Meanwhile, the typical form of manifestation of a fungal infection is characterized by the fact that with it the damage to the nails occurs not only on the hands, in contrast to other skin diseases. This can manifest itself, for example, candidiasis of the nails (which is combined with the inflammatory process of the area of ​​the periungual roller). We also add that non-fungal nail diseases can manifest themselves both together with onychomycosis, and as a precursor of this disease.

Based on the features discussed in this part of our article, it can be distinguished that there are several more signs, comparing which we can assume that fungal nail damage is not:

• only the fingernails were changed;
• nail changes appeared some time after birth;
• there are signs indicating the possible relevance of a different type of skin disease (for example, psoriasis, etc.) or this disease has already been diagnosed;
• the state of all nails has changed (that is, both on the hands and on the legs).

Based on statistics, it is known that every second nail lesion is fungal. Thus, the altered state of the nails determines the 50% probability of the fungus, regardless of the circumstances and the factors accompanying the general condition of the body. It is also important to know that the fungus does not go away on its own, in addition, as you know, the disease contributes to a decrease in the quality of life.

Nail fungus: consequences

The fungus itself can become quite a serious disease in terms of possible consequences. The main problem associated with the fungus can be called the fact that it is a chronic and infectious disease, which means that it is easy for them to become infected with the immediate environment of a sick person, including members of his family.

In addition to this, there are other problems. Thus, a lesion provoked by mycoses becomes a specific entrance gate in patients, causing the possibility of any other infectious agents entering the body. So, getting a bacterial infection can provoke erysipelas. Also, in the presence of a fungal infection, the course of such an actual disease for patients as is complicated. In the presence of a fungal infection, the possibility of developing an allergization of the body is allowed, in which an increased sensitivity to the fungus as an allergen is formed, in other words, this leads to an allergy to the fungus (fungal allergy).

The fungus can also cause certain diseases to develop or cause them to worsen. As such diseases, for example, various types of skin reactions and rashes can be designated. Rare (rather even isolated) cases are accompanied by the development of deep mycosis with an uncured nail fungus, such a diagnosis, in particular, is accompanied by the ingestion of a fungus with blood, its germination into internal organs, which can cause death. Nevertheless, such situations can rather be called an exception, which, as is clear, cannot be ignored in any case. Modern possibilities of medicine make it possible to exclude such options for the progression of the fungus, although in any case it is unacceptable to leave it without treatment. Therefore, we repeat that it is extremely important to consult a dermatologist if you have signs of nail and skin fungus.

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Interestingly, the fungal infection of the toenails usually begins with the first or fifth toe, most likely this is due to their frequent injuries that provoke foot mycosis. Symptoms diseases of the nail plates: gradual loss of gloss, turbidity, yellowish or dirty gray color, thickening, detachment, deformation, cracking and brittleness of the nail. At the same time, the nail bed is partially exposed, its tissues look loose and curdled.

How to understand that your skin and nails have been attacked by fungi?

Although athlete's foot has a vivid clinical picture, it is not worth making a conclusion about the presence of a disease without resorting to specialized diagnostics, because a competent one is quite expensive, lengthy and sometimes not very easily tolerated by the body.

Peeling of the skin of the feet and hands, for example, can occur when there is a violation of its care or as a result of a chronic lack of vitamins, and nail damage, like mycosis of nails, often occurs when they are traumatic, and very often when wearing tight shoes. Turbidity and detachment of the nail may be a consequence of peripheral circulation disorders in heart disease, diabetes mellitus. So before taking any measures, you need to make sure that the fungus is present, and this can be done only by contacting a doctor and undergoing a special microbiological examination. And even if you have already started treatment on your own, in order for the analysis for fungi to be accurate, you need not to use any antifungal ointments and creams for 3-4 days.

Spray and gel Deo-Active Fresh

Sweat glands regulate body temperature - they cool it by evaporating fluid from the body. The skin of the feet contains more than 250,000 sweat glands, which is an order of magnitude more than in the skin of any other part of the body, because increased sweating is necessary to maintain the natural hydration and elasticity of the skin. However, damp skin is the perfect breeding ground for bacteria that break down sweat, which leads to bad breath.

Wearing closed shoes, the use of synthetic materials, and non-compliance with the rules of personal hygiene lead to the fact that the moisture that accumulates in shoes does not disappear, but collects, creating a favorable environment for the emergence and reproduction of pathogens. This increases the likelihood of infections, in particular, the fungus of the skin of the feet.

Scholl launches two Deo-Active Fresh products to combat foot odor based on Aseptix technologies: a spray and a gel. Scholl products provide an immediate deodorizing effect, provide a long-lasting and effective antibacterial effect, eliminate and prevent odor for a long time.

Deo-Active Fresh gel has the added benefit of cooling ingredients to keep you feeling cool and fresh, while the special Hydro-alcoholic Gel technology ensures that the growth of harmful bacteria on the skin of the feet is limited.

The Aseptix Active Oxygen technology used in Deo-Active Fresh Spray is a patented antimicrobial technology whose key ingredient is a special form of hydrogen peroxide that has been modified to ensure that this ingredient is safe, stable and highly effective for antibacterial purposes.

In order to improve the performance of hydrogen peroxide at low concentrations present in Deo-Activ Fresh Spray, additional processing of a key component was carried out, which contributed to the creation of a special form of hydrogen peroxide - Plasma Enhanced Peroxide. The active substance is irradiated with ultra-short powerful electrical pulses, while the oxidizing power of hydrogen peroxide is so high that it allows the resulting substance to be classified as active oxygen species.

When stored, this special form of hydrogen peroxide (Plasma Enhanced Peroxide) is stable, and upon contact with the skin, it activates and fights bacteria and fungi by destroying the cell wall and destroying the DNA of the bacterium, then decomposing into water and oxygen, which guarantees safety - both for consumer and for the environment.

Scholl also strives to meet the needs of people with diabetes as much as possible. In particular, the Scholl Deo Activ Fresh line of products has been tested for toxicity or the ability to cause irritation to the skin of the feet. The results showed that these products are ideal for people with diabetes.

The composition of the Deo-Activ Fresh line of products includes specialized ingredients, selected taking into account the features of gentle foot care.

The components of Deo-Activ Fresh products solve the problem of unpleasant odor through the complex use of antiseptics, active oxygen, and vitamin B5 and aloe vera carefully care for the skin of the feet. Thus, Scholl antiperspirants are highly effective, killing up to 99.9% of bacteria, and guarantee long-term (up to 24 hours) protection against odor-causing bacteria.

I have a fungus on my skin, what should I do? First of all, don't panic, it's all treatable. There are about two thousand skin diseases, fungal diseases are not the last among them. Fungal disease can be obtained anywhere. To prevent this from happening, you need to know about such diseases and follow simple hygiene rules for their prevention. Well, you need to treat fungal skin diseases with a dermatologist.

Fungal diseases of the skin

The causative agents of fungal diseases of the skin are plant microorganism (fungi). Infection occurs when a healthy person comes into contact with a sick person or with an animal, as well as with objects containing elements of the fungus.

Depending on the depth of penetration of the infection deep into the skin, there are:

• fungal diseases, in which fungi are localized in the uppermost layer of the epidermis - the stratum corneum, do not affect hair and nails; these are the so-called keratomycosis, for example, pityriasis versicolor;

• fungi are localized in the deeper layers of the epidermis, causing a pronounced inflammatory reaction, affecting hair and nails; these are fungal lesions of the feet, microsporia, trichophytosis and favus;

• deep mycoses, in which, in addition to the skin and mucous membranes, muscles, bones and internal organs are involved in the pathological process.

A separate group includes candidiasis, the cause of which are yeast-like fungi. They affect the mucous membranes, skin, nails and internal organs.

colorfullichen

Pityriasis (varicolored) lichen appears as pinkish-brown spots with slight pityriasis peeling on the skin of the neck, back, and chest. Spots become especially noticeable after sunburn, remaining light against the background of pigmented skin. The main source of infection is wooden beach chairs or sand, on which a sick person lay shortly before a healthy person, as well as bed or wear linen that was in contact with the patient's skin. The disease is not very contagious and occurs mainly in people with excessive sweating and altered chemical composition of sweat. It does not occur in children under 7 years of age. When it occurs, 3% salicylic alcohol and sulfuric ointment are used externally.

Fungus on the feet

Mycoses of the feet are very common. They usually become infected in baths, swimming pools, showers, gyms, where flakes of the epidermis of patients containing elements of the fungus fall on the skin of a healthy person. Peeling appears in the interdigital folds, then weeping, erosion occurs. On the arch of the feet - blisters, peeling. Nails thicken, deform, become brittle.

To avoid mycosis of the feet, you do not need to use someone else's shoes, do not walk in the pool or in the bath barefoot. After the pool, you should take a shower and dry your skin thoroughly, especially in the folds. For prevention, the skin of the feet can be wiped with antimycotic agents or lubricated with appropriate creams. At home, you should not keep rubber mats or wooden grates in the bathroom, on which mushrooms get along well. If mycosis of the feet still occurs, then after the treatment performed by a dermatologist, all used shoes should be thoroughly disinfected: grease its inner surface with a swab dipped in 70-80% acetic acid (do not touch with your hands - it can cause burns), after which each pair of shoes place in a plastic bag for 24 hours, tying it well. After a day, the shoes are taken out, dried and aired.

Manifestations of microsporia

Microsporia is caused by two varieties of the fungus, one of which is infectious only for humans (rare type), the other - for humans and animals. Therefore, in the first case, the disease occurs when using other people's hats and combs, in the second - from sick cats, dogs or through objects containing elements of this fungus.

With microsporia, characteristic foci of rounded outlines appear on smooth skin with a roller around the periphery of merged vesicles, nodules and crusts. On the skin of the scalp, foci of rounded outlines also have clear boundaries with slight peeling on the surface. Hair broken off, as if trimmed. Short (4-5 mm) hair stumps stick out above the surface of the skin, covered with a whitish bloom of the fungus.

Treatment of microsporia is carried out only by a dermatologist, treatment is fraught with a long course with the addition of complications in the form of various infections.

To prevent microsporia, the following rules must be observed:

• do not contact with stray animals;
• do not wear other people's hats and clothes.

When the first signs of the disease appear, children should not attend kindergarten. Domestic cats and dogs that are a possible cause of the disease should not be kicked out of the house (they will infect others!), They should be treated at a veterinary clinic. Objects that the patients have come into contact with are disinfected, and the hair that has fallen out is burned.

Remember! Dermatology cannot be mastered by self-study. Basic basic knowledge you need to prevent skin diseases. Well, if some kind of rash appears on the skin, then it is better to consult a dermatologist.

According to the article by Galina Romanenko " Fungal diseases of the skin»

Saprophytic fungi (fungi), mostly yeast genus Candida, constantly live on our skin, in the mouth, on the genitals, without causing pathological changes. But they can cause diseases of the skin and mucous membranes, especially in infants, if the skin is excessively moist. Fungal growth is facilitated by the suppression of the bacterial flora - usually with long-term use of broad-spectrum antibiotic combinations.

The harmlessness of most of these fungi is relative: in the event of a decrease in immunity, they become aggressive, penetrate the skin and mucous membranes, and even worse - into the bloodstream, into organs and tissues, causing extremely severe damage. Fortunately, this is rare - only in rare cases of congenital immunodeficiency, in patients with AIDS and in the treatment of malignant diseases. Therefore, with the development of "deep" fungal lesions, it is imperative to find out the reason for the decrease in the body's resistance.

Another part of skin diseases is caused by pathogenic fungi that live in animals.

yeast fungi

These yeasts inhabit our skin and mucous membranes, and their growth is controlled by both the immune system and other microbes living on these surfaces. If you suppress the activity of microbes with antibiotics, candida "comes to life" and manifests itself as pathogenic. Stimulates the growth of yeast fungi and the violation of the integrity of the skin, its constant hydration.

The disease caused by yeast fungi in infants is called diaper dermatitis, it is manifested by reddening of the skin with clear contours, the formation of scales along the edges of the inflamed plaque, sometimes with bubble elements.

Candidiasis in infants also develops in the form of thrush - white loose overlays appear on the oral mucosa, usually not accompanied by the child's anxiety. They often occur during antibiotic treatment. This lesion is harmless, but persistent thrush may indicate that the child has an immunodeficiency, which requires an examination.

In older children, candidiasis usually develops in the folds - in the groin, in the armpits, under the mammary glands, between the fingers, around the anus. Increased sweating with inadequate toilet plays a role in its development. The type of lesions differ little from those in diaper dermatitis.

Candida sometimes causes damage to the nails - they become dull, thicken. Candidiasis of the genital organs in girls and women (vulvovaginitis) is manifested by discharge and itching, sometimes very strong, in boys - inflammation in the cavity of the foreskin (balanoposthitis). The disease can also be associated with the use of antibiotics, steroid drugs, be a consequence of taking birth control pills.

Treatment of skin candidiasis requires, first of all, improved care for it - more frequent swaddling and washing of the child with thorough drying of the folds, the use of powders, and if the folds are irritated - ointments. In older children, you should also monitor the hygiene of the folds, avoid prolonged moisturizing of the skin.

For treatment, antifungal ointments with clotrimazole, ketoconazole and others are used; since an allergic component is often present in candidiasis, the use of combined ointments - antifungal and steroids is justified.

With thrush, the oral mucosa is irrigated with hydrogen peroxide, sugar syrup, a quick effect occurs with local treatment with pimafucin, clotrimazole, miconazole, in persistent cases, ketoconazole (nizoral) or fluconazole (diflucan) is taken orally as directed by a doctor. Genital infections are treated with the same ointments or vaginal suppositories. Nystatin due to low efficiency and toxicity should not be used.

ringworm

Now parents rarely meet with ringworm. Ringworm is a collective concept, they designate a group of fungal diseases, which are sometimes called by the type of dermatophyte fungi that caused them - trichophytosis, microsporia. The source of infection are dogs and cats (kittens), but it is possible to become infected with a fungus not only from animals, but also from a person, for example, through a comb, although this rarely happens in our time; in hairdressing salons, combs and other common items are disinfected. So now street dogs are the main source of infection. But domestic cats, if they communicate with street cats, may be infected.

The disease is easily diagnosed by the type of lesion; to identify fungi, they are examined under a microscope (skin scraping) or grown on nutrient media.

In a child, one or more foci with a mild inflammatory reaction appear on the affected areas. The skin in the focus thickens, covered with scales containing spores of the fungus. In the area of ​​the focus, the hair is broken off 5-7 mm from the root ("hemp"), they are surrounded by inflamed skin. The focus with late detection and treatment increases in size, and "daughter" foci appear. In advanced cases, purulent vesicles form, scratches become infected with bacterial flora, and then the whole head becomes covered with a purulent crust - now such forms are not observed.

Having identified ringworm in a child, it is necessary to consult a doctor, since treatment includes a long course of the antibiotic griseofulvin, ketoconazole. Local treatment of such a disease (lubrication with iodine, ointments, tar, etc.) is ineffective, although many dermatologists prefer to combine griseofulvin with ointments that act on fungi.

The patient must be removed from the children's team until the cure. Persons who have been in contact with him should be periodically examined to see if they have become infected. With modern treatment, it is not necessary to shave the head, remove hair and wear a cap.

Ringworm on smooth skin

This disease is caused by the same dermatophyte fungi as lichen of the scalp, the source of infection is the same.

The skin lesion has a round or oval shape with clear boundaries. The lesion slowly grows, subsequently becoming ring-shaped; more or less normal skin in the center indicates a cure, small nodules forming a corolla are visible along the periphery of the lesion. Sometimes nails are involved in the process - they thicken, crumble.

Miconazole, clotrimazole, econazole, naftifin, tolnaftat, ciclopirox ointments are used 1-2 times a day for four weeks. With the ineffectiveness of ointments, a course of griseofulvin or lamisil is carried out. In case of damage to the nails, laceryl, lamisil, exoderil are applied topically.

Pityriasis versicolor

This disease is caused by two specific fungi that are different from ringworm pathogens. The disease is contagious, although less so than ringworm.

Yellowish-brown spots appear on the smooth skin of the back, neck, limbs, sometimes on the scalp; the disease got its name from the type of lesion - when scraped, it reveals a small, like bran, peeling.

Treatment is carried out locally with nitrofungin, mycoseptin, miconazole, resorcinol alcohol. Since the fungus can nest on other areas of the skin without appearing for some time, it is recommended to lubricate the entire skin with a 25% solution of sodium thiosulfate twice a day for two to four weeks, or, more simply, - 2.5% - m solution of selenium sulfide once a month for three months.

Diseases are caused by rubrophyton and epidermophyton

The disease is caused by a group of related fungi (rubrophyton, epidermophyton) that live on our skin. Infection occurs from patients most often in shower pools or baths. These diseases usually occur in children older than seven years and adults. In the development of the disease, increased sweating of the hands and feet, as well as inguinal folds, where the main lesions are localized, plays a role.

Lesions usually have the appearance of reddish elements, sometimes scalloped scalloped; they disturb the patient a little - they do not hurt and do not itch. Often the nails are also affected, they thicken, become dull, scaly. When rubrophytia affects the scalp, dandruff appears, sometimes you can see reddish, scaly plaques or scalloped elements.

The treatment of these diseases requires the elimination of excess skin moisture. Nitrofungin, ointments bifonazole, mycoseptin, clotrimazole, miconazole, terbinafine are used locally. In persistent cases with persistent relapses, the use of oral ketoconazole or fluconazole for four to six weeks (possibly two to three times a week) is justified.

In case of damage to the nails, earlier it was necessary to resort to removal, now you can cure the nail from the fungus with the help of exoderil under the patch, laceryl, lamisil. I don't recommend using these remedies on your own, though - the drugs are not without side effects and are available by prescription, and ointments for treating nails are expensive, so a doctor's advice can save you money.

Based on the article by Professor Vladimir Tatochenko "Fungal diseases of the skin and mucous membranes"

Fungal diseases of the feet

Fungal diseases of the feet today can be called a disease of civilization.

Fungi or their spores are everywhere - in the air, in the soil, on the skin of every person. A healthy organism is in symbiosis with a fungus. But it is worth changing the conditions, and the fungus immediately violates the “neutrality”.

Some have learned to take fungi on their feet philosophically, as a given. You still can’t get rid of it, so why waste energy, nerves and money! Others may be happy to join the fight, but give up in advance, having read that victory cannot be easy and quick. In the end, everything turns into a real thriller, where the "villain" does not even consider it necessary to hide and harasses decent people openly, slowly and painfully.

"Survive" the fungus is really not so easy. And only a qualified specialist can solve this problem.

Development of the disease

The impetus for the development of the disease can be not only poorly chosen shoes, which provide increased temperature and sweating of the feet, but also endocrine diseases of the pancreas and thyroid glands. He loves the fungus and areas of the body with impaired blood supply. An important factor that opens the way to the disease is the weakening of the immune system, while the entire flora living on the human body is activated, and usually does not cause diseases.

As a rule, the disease begins with the skin of the feet - peeling appears, the skin between the fingers cracks and acquires a white coating. Cracks and outgrowths of rough skin appear on the heels.

Damage to the nails

If no action is taken in time, then damage to the nail plates occurs. The nail plates turn yellow and often flake off the nail bed. Sometimes multi-colored spots appear on the nails, they become cloudy. However, similar symptoms can occur in a wide variety of diseases not associated with a fungal infection. Therefore, before prescribing treatment, it is necessary to confirm the diagnosis by examining the affected areas under a microscope or by sowing a culture.

Most often, the fungus is considered as a cosmetic defect. However, the problem is that affected nails are a permanent reservoir of fungal infection that can spread throughout the body, even affecting internal organs.

Treatment of fungal infections of the feet

To prevent the occurrence of fungal infections of the nails, it is necessary to treat fungal infections of the feet as early as possible. Previously, the fungus was treated by treating the affected areas with antiseptics or folk remedies. Now there are many drugs with which at the initial stage you can get rid of mycosis of the feet (in the absence of pathology of the internal organs).

Difficulties arise if the disease has already affected the nails, or foci of hyperkeratosis (increased keratinization) have appeared on the skin of the feet. In this case, treatment should be complex.

It should include the appointment of antifungal drugs - if there are no contraindications to their appointment. In this case, if necessary, the patient should receive a highly qualified consultation of a gastroenterologist or an endocrinologist (according to indications).

The second important step in the complex treatment of fungal diseases is the mechanical removal of increased keratinization on the skin or nails. Today, several methods are used.

The most common is the dissolution of the upper layers of the nail, or areas of increased keratinization of the skin, with special liquids at home. However, this is a rather lengthy and exhausting work that requires a lot of time.

Surgical removal of the nail plate has become less common in recent years. Abroad, this method has long been abandoned. In Russia, it is still used (although it has a number of complications)

The fastest, safest and painless way to mechanically remove increased keratinization on the skin or nails is the hardware method (“medical pedicure”). Using this method, with the help of a special apparatus equipped with many devices, polishing, filing nails, removing excessive keratinization on the skin, removing calluses, etc. is performed. When grinding, the surface of the nail is leveled and the layers affected by the fungus are removed.

And if the doctor has determined that in your case only local treatment (application of varnishes, creams) will be enough - then the thinner the affected nail tissue is, the better the active substances contained in the varnish or cream will penetrate into the intercellular space of the nail plate.

Therefore, "medical pedicure" will save you from long and exhausting work at home. After all, only a qualified specialist can determine the line where it is necessary to stop so as not to injure the nail bed.

Only an integrated approach to solving this problem will allow you to quickly and reliably get rid of the fungus.

Based on the article by Oksana Makeenko "Fungal diseases of the feet"

Aspergillosis

Aspergillosis is an infection of the skin, paranasal sinuses and lungs or other internal organs caused by molds of the genus Aspergillus, in particular A. fumigatus. Infection occurs as a result of inhalation of fungal spores.

The disease is relatively rare, predominantly among agricultural workers and pigeon keepers. The tissues of the outer ear are usually affected (otomycosis), which is accompanied by itching and pain; when scratched, the skin may thicken and become gray or black.

A large number of spores, getting into the lungs, causes extensive changes resembling tuberculosis. Cutaneous aspergillosis responds well to antibiotic treatment. For lung infections, amphotericin is used. However, systemic lesions sometimes lead to death.

Maduromycosis

Maduromycosis (Madura foot) is an infectious lesion of the feet (and sometimes other parts of the body) caused by various types of fungi or (in half the cases) by bacteria of the genera Nocardia and Actinomyces, which form long branching filaments and in this respect are similar to fungi.

The disease occurs in the tropics and the southern United States. Regardless of the type of pathogen, edema appears around the site of its introduction. In the early stages, ulcerated tumors appear, but later they disintegrate with the formation of abscesses connected by deep fistulas.

In advanced cases, the skin darkens and becomes covered with scars, erupted abscesses and abscesses filled with mucous fluid with yellow, red, white or black granules. Coming out of the abscesses, these granules enter the soil, after which the pathogen can again enter the body from the infected soil, usually through wounds on the foot, but sometimes on the hands.

Left untreated, the feet become deformed and eventually the muscles, tendons, and bones are destroyed. Actinomyces infection is treatable with penicillin caused by Nocardia, a sulfa drug. In severe cases, the limb is amputated to prevent a secondary bacterial infection, which can be fatal.

Sporotrichosis

Sporotrichosis is a chronic infection that mainly affects the skin and superficial lymph nodes. Its causative agent is Sporotrichum schenckii, a fungus that usually infects plants, in particular the barberry. The disease occurs throughout the world, mainly among farmers and gardeners who grow barberries.

Initially, a dense rounded nodule appears under the skin, which gradually becomes soldered to the skin. When a superficial ulcer forms, the skin around it turns pink and then blackens. Numerous nodules and ulcers appear along the lymphatic vessels.

Sporotrichosis can also develop on mucous membranes, in bones and internal organs, and also spread throughout the body. With the exception of this last, disseminated form, the disease is rarely fatal and can be treated with amphotericin.

Candidiasis (moniliasis)

Candidiasis (moniliasis) is an infection of the skin, nails, mucous membranes or internal organs caused by the yeast-like fungus Candida (Monilia) albicans. Candidiasis occurs throughout the world. The pathogen often enters the body through the mucous membranes of the mouth and throat and causes creamy-white spots on the tongue and oral mucosa that spread to the palate, tonsils and pharynx. Since the pathogen is swallowed, infection of the lungs and gastrointestinal tract is possible if left untreated. Damage to the nails (onychia) or periungual tissues (paronychia) begins with painful swelling and redness. The nail becomes hard, thick, striated and often takes on a brownish coloration. Sometimes there is a detachment of the nail plate from the nail bed, which becomes white or yellow. Vaginal candidiasis causes symptoms similar to thrush. When the lungs are affected, bronchitis or pneumonia occurs, and a severe infection can manifest itself as lobar pneumonia. When an infection enters the bloodstream or on the meninges, the disease is always fatal. Treatment depends on the site of the lesion.

Dermatomycosis

Dermatomycosis is a superficial infection of the skin, nails or hair, the most common are dermatophytosis (growth of fungi on dead parts of the skin and its derivatives), as well as the so-called. athlete's foot (athlete's foot); and various other forms of dermatitis, such as versicolor versicolor and seborrheic eczema.

Multicolored (pityriasis) versicolor

Multi-colored (pityriasis). This common disease is caused by the fungus Pityrosporum orbiculare (formerly called Malassezia furfur). Only the outermost layer of the skin is affected, usually on the trunk and lower neck, where round, brownish-red, scaly patches appear, sometimes with mild itching.

Seborrheic eczema (seborrheic dermatitis)

Seborrheic eczema (seborrheic dermatitis). It develops on the skin around the sebaceous glands. It appears as flat or slightly swollen spots covered with greasy scales (see). The most common cause of seborrheic eczema is the yeast-like fungus Pityrosporum ovale.

Actinomycosis

Actinomycosis is traditionally considered as one of the mycoses, although this chronic, slowly developing infection is caused by several types of actinomycetes (most often Actinomyces israelii), which, according to modern classification, are classified not as fungi, but as bacteria.

Having settled in human or animal tissues, they form granules - accumulations of numerous threads formed by their branching cells. Infection occurs when granules contained in abscess fluid enter the respiratory or digestive tract. The infection can enter any part of the body.

Initially, ulcerated tumors (granulomas) appear, which, decaying, turn into deep abscesses with internal passages and cavities. In most cases, the maxillofacial region and neck are affected. The skin in these areas thickens, loses its smoothness and acquires a reddish or purple color. Gradually, the foci of infection are opened with the formation of fistulas.

In the chest, actinomycetes colonize the pleura, can germinate the wall of the chest cavity, forming chronic fistulas, sometimes spread to the esophagus and pericardium (the outer shell of the heart). This form of the disease often ends in fatal bleeding. Another fatal form is abdominal actinomycosis. The first sign is the appearance of a tumor in the ileum and rectum. Then damage to the liver, spleen and kidneys develops, and in the absence of treatment, often also bones and the central nervous system. The most effective treatments are penicillin and tetracyclines. The chance of recovery is highest for skin lesions and decreases markedly as the infection spreads.

Operation: clean feet