Mycosis
The content of the article:
-
Causes and risk factors
Risk factors
- Forms of the disease
- Disease stages
-
Mycosis symptoms
- Versicolor versicolor
- Epidermophytosis inguinal
- Mycosis of the feet
- Favus
-
Diagnostics
Laboratory diagnostic methods
-
Mycoses treatment
- Systemic therapy
- Local therapy
- Possible complications and consequences
- Forecast
- Prevention
- Video
Mycoses are a group of infectious diseases caused by fungi. The most common are mycoses of the skin and its appendages, less often - mycoses of internal organs. Mycoses are very common, according to various estimates, only superficial mycoses suffers from 20 to 35% of the total population of the planet.
Microscopic fungi are the causative agents of mycosis.
Causes and risk factors
Mycoses are fungal lesions, respectively, they are caused by microscopic fungi. There are about 400 pathogens of mycosis. Some of them are conditionally pathogenic - this means that they can be part of the normal flora of the skin or mucous membranes of a person, and the disease is caused only under certain conditions, when the general and local immunity decreases. Thus, mycosis can be caused by a fungus present in the body, or be the result of infection with a pathogenic fungus from external sources.
Fungal infection spreads directly or indirectly. Direct - when a person comes into direct contact with an infectious agent, for example, with a sick person or animal, with plants or soil (soil is one of the main fungal reservoirs). An indirect path is spoken of when fungal infection occurs indirectly - through objects with which a sick person or animal has come into contact.
Microscopic fungi, depending on their ability to infect certain organisms, are divided into mono- and polypathogenic:
- monopathogenic - cause disease only in humans (anthropophilic) or only in animals (zoophilic);
- polypathogenic - cause disease in both humans and animals (zooanthropophilic).
Pathogenic fungi that cause damage to the skin and its appendages (nail plates, hair) are called dermatophytes, and the diseases they cause are called dermatomycosis.
Risk factors
The factors contributing to the development of mycosis include everything that contributes to a decrease in local and general immunity, primarily:
- lack of hygiene;
- excessive sweating;
- hot humid climate;
- uncomfortable, tight shoes and clothes;
- skin injuries: microcracks, abrasions, scratches;
- diabetes;
- long-term use of certain medications (antibiotics, sulfonamides, immunosuppressants, hormonal agents);
- HIV infection and other conditions leading to immunodeficiency.
Forms of the disease
Depending on the method of infection, there are mycoses:
- exogenous - caused by external infection;
- endogenous, or opportunistic - caused by opportunistic fungal flora with a decrease in the body's defenses.
Mycoses are also classified into:
- keratomycosis (versicolor versicolor, black piedra, white piedra);
- dermatomycosis (trichophytosis, microsporia, epidermomycosis, rubromycosis, favus);
- candidiasis (mucous membranes, skin, visceral);
- deep (systemic, visceral);
- subcutaneous, or subcutaneous (sporotrichosis, maduromycosis);
- pseudomycosis (erythrasma, actinomycosis, nocardiosis).
Dermatomycoses are classified as follows:
- Epidermophytosis is a fungal infection of the epidermis (interdigital spaces of the feet, skin folds, nails). These include: rubrophytosis (causative agent - rubrum), athlete's foot (T. interdigitalis), epidermophytosis inguinal (E. floccosum).
- Trichophytosis - lesions of the skin and its appendages anthropophilic (T. violaceum, T. tonsurans) and zoophilic fungi.
- Microsporia - mainly affects the hair (M. Ferrugineum).
- Favus is a predominant lesion of the skin and hair (T. schoenleinii).
Disease stages
Mycoses, like all other infectious diseases, have the following stages:
- Latent - the period from the entry of the pathogen into the body until the first symptoms appear.
- The height of the disease is a period of severe symptoms.
- Remission. In favorable conditions, recovery occurs. Many mycoses are prone to a chronic course, therefore, in unfavorable cases, the disease takes on a chronic nature (manifestations of the disease are constantly present) or chronic recurrent (periods of exacerbation are replaced by periods of remission).
Mycosis symptoms
The symptoms of fungal infections are extremely diverse, each of the fungal diseases has its own characteristics.
Versicolor versicolor
The causative agent is the yeast-like fungus Malassezia. Initially, yellowish dots appear near the mouths of the hair follicles, which gradually grow, forming clear rounded spots up to 1 cm in diameter. Merging, the spots form large foci - 15 cm or more. More often the spots have a yellow color of different shades, but they can acquire a different color - from pale yellow to brown, which explains the name "versicolor versicolor". In the area of spots, the skin is covered with scales of dead epidermis, resembling bran, which gave the second name - "pityriasis versicolor". Peeling is enhanced by the sun or artificial ultraviolet radiation.
Versicolor versicolor is caused by the yeast-like fungus Malassezia
Epidermophytosis inguinal
The causative agent is the fungus Epidermophyton floccusum. Men are more susceptible to infection. The fungus mainly affects the inguinal folds, intergluteal folds, armpits, the skin of the scrotum and the skin of the inner thighs in contact with it in men, the skin under the mammary glands in women. At the site of the lesion, smooth red spots appear, slightly raised above the skin, these spots can merge into large foci. The spots are clearly demarcated from healthy tissue by an intermittent roller formed by inflammatory elements - nodules, vesicles, erosions, crusts. Inflammation is more pronounced in these areas, there are no inflammatory elements in the center of the spot, but it gradually turns brown, later peeling occurs there, due to which the center of the focus brightens. In the area of spots, severe itching occurs, sometimes burning.
Epidermophytosis inguinal develops in the groin and intergluteal folds
Mycosis of the feet
Mycosis of the feet can be caused by several fungal pathogens, most often dermatophytes Trichophyton rubrum, Trichophyton interdigitale, Epidermophyton floccosum, less often molds or yeast-like Candida fungi. The diseases they cause have similar manifestations. Mycosis of the feet can occur in the form of mycosis of the skin of the feet or mycosis of nails (onychomycosis), as well as their combination (see photo).
Mycosis of the feet is widespread
There are several forms of mycosis of the feet.
| Form of mycosis of the feet | Clinical picture |
| Erased | This is usually the initial form. Peeling of the skin of the interdigital folds (one or more) is characteristic, superficial skin cracks in these places are possible. In general, this form manifests itself weakly, sometimes imperceptibly for the patient himself. |
| Squamous | It is characterized by peeling of the skin of the interdigital spaces, the lateral surfaces of the feet. Scales of dead skin are small. |
| Hyperkeratotic | On the arches of the feet, reddish-bluish lichenized plaques and dry flat papules appear, the rash is clearly delimited from the surrounding skin, covered with several dense layers of dead epidermis. |
| Squamous-hyperkeratotic | There are signs of both squamous and hyperkeratotic forms. |
| Intertriginous | It resembles diaper rash that occurs in the interdigital folds. The affected skin looks inflamed, red, swollen and weeping, cracks, erosion, and areas of maceration appear. Patients report itching and burning in the affected area. |
| Dyshidrotic | It is characterized by the appearance of profuse rashes on the arches of the feet, in the interdigital spaces, on the fingers. The rashes are small vesicles with dense walls. They merge to form multi-chambered bubbles, which, when opened, form wet erosion. |
| Sharp | The site of inflammation can capture the skin of not only the feet, but also the legs, the skin becomes edematous, numerous bubbles with serous or serous-purulent contents appear on it, after opening which erosions occur. Local inflammation is accompanied by general symptoms: an increase in temperature to febrile values (38 ° C and above), a deterioration in well-being. The inguinal-femoral lymph nodes on both sides are inflamed. |
| Onychomycosis | Nails are affected - one or more, depending on the location of the lesion of the nail plate, onychomycosis can be distal, lateral, proximal, total. The color of the nail changes, the nail plate loses its transparency, thickens, later breaks off or crumbles. |
Favus
The causative agent is the fungus Trichophyton schoenleinii. Weakened children suffer more often. The obsolete name of the disease is scab. May occur on the scalp (more often), smooth skin, nails. Favus of the scalp usually runs in a scutular form. Scootula - yellowish dry saucer-shaped crusts. At first they are small, later they acquire the size of a pea. In the center of the scutula there is dull hair that has lost its elasticity, which easily falls out. Scooters, increasing in size, merge, forming layers. Inflamed skin is found under the scutula, and after the scutula leaves, an atrophic scar is formed. The affected skin emits a specific odor that is described as granary or mousey. The lymph nodes closest to the foci are inflamed and enlarged.
Favorite location of favus is the scalp under the hair
In addition to the scutular, favus can occur in an erythematous-squamous or herpetic (vesicular) form.
The scutular shape of the favus of smooth skin is characterized by the appearance of pink spots on the skin, on which scutules are formed, in the center - vellus hair. The erythematous-squamous form proceeds without scutules, instead of them, only pink spots are formed with peeling near the follicles of the vellus hair. With a herpetic, or vesicular form, groups of small vesicles (vesicles) are formed, resembling herpetic eruptions. After the favus of smooth skin, atrophic scars are not formed.
Favus of the nails mainly affects the fingers. The affected nail plate becomes yellow, loses its transparency, thickens, becomes uneven, brittle in the area of the free edge.
Diagnostics
Diagnosis is suggested by examination by a dermatologist. To confirm it and determine the pathogen, they resort mainly to laboratory diagnostics. Hardware examination is represented by an examination in the rays of a Wood lamp (fluorescent diagnostics). This method is based on the fact that some parasitic fungi, or rather, the substances they release, exhibit a fluorescent glow in ultraviolet light. For example, hair affected by microsporia gives an emerald glow in the rays of a Wood lamp.
Laboratory diagnostic methods
Test material: scrapings from the skin and affected nail plates, loose skin scales, pieces of nails, affected hair, pus, blood, sputum, cerebrospinal fluid, gastric juice, feces, etc., depending on the type of disease.
The following methods are used:
- microscopy - examination of pre-processed material under a microscope, allows you to detect cells, spores, mycelium of fungi;
- mycological method - sowing on nutrient media, which allows you to identify the pathogen and determine its sensitivity to antimycotic drugs;
- serodiagnostics - determination of the pathogen by detecting antibodies in serum by ELISA (enzyme-linked immunosorbent assay), RIF (immunofluorescence reaction), RSK (complement binding reaction), RA (agglutination reaction), RNGA (indirect hemagglutination reaction), immunoblotting;
- allergodiagnostics - determination of the body's sensitization to one or another fungal pathogen by conducting an allergy test or in vitro;
- histological analysis - identification of the pathogen in tissues obtained by biopsy;
- gene diagnostics - detection of fungal DNA fragments in the test material using PCR (polymerase chain reaction). Allows to identify more than 40 types of fungi.
Mycoses treatment
Treatment of mycoses can be local (external drugs), systemic (drugs are taken orally) or complex. In most cases, local treatment of foci is sufficient, in severe cases, as well as in visceral forms of mycosis, systemic or complex therapy is prescribed.
Systemic therapy
Systemic treatment of mycoses consists in the course of oral administration of antimycotic drugs of different groups, the so-called antifungal antibiotics, for example, Griseofulvin, Lamisil, Nystatin, Levorin, Dekamin, etc. In severe cases, antimycotic systemic drugs can be administered parenterally (intravenously and intramuscularly).
In addition to antimycotics, vitamin preparations, hyposensitizing (antihistamines) agents, biogenic stimulants can be prescribed.
Local therapy
Local treatment consists in the treatment of superficial lesions. The following groups of external drugs are used:
- antifungal ointments, creams, sprays (Clotrimazole, Mikoseptin, Lamisil, Terbinafine);
- antiseptic and disinfectants (ichthyol ointment, salicylic ointment, iodine tincture, resorcinol solution, silver nitrate solution, borax solution in glycerin).
Treatment of mycoses can be carried out for a long time, for several months.
Possible complications and consequences
Superficial mycoses usually do not pose a threat to life, but their consequence can be a skin defect, however, in most cases it is reversible. The consequence of deep systemic mycoses, especially given that they usually develop in immunocompromised individuals, can be fatal.
Forecast
The prognosis is usually good. Most mycoses are completely curable. The prognosis is cautious in patients with visceral forms of mycosis and severe concomitant pathology.
Prevention
Prevention consists in careful observance of hygienic rules, especially for public places with high humidity (swimming pools, baths, showers at gyms, etc.). You must have individual household items, never wear someone else's shoes.
Preventive measures also include all those aimed at strengthening the body's defenses.
Video
We offer for viewing a video on the topic of the article.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
