Medicus, Vol. 16 No. 1_Dermatologija, 2007.
Review article
Superfi cial Fungal Infections and Contemporary Treatment Modalities
Mihael Skerlev
Abstract
Fungal infections are very important in dermatological
practice. On the other hand, the clinical appearance
of lesions consistent with the fungal infections of the face may
simulate other dermatological entities, making the diagnosis
diffi cult. For example, the data regarding the etiology of the
fungal infections due to Microsporum canis (M. canis) ranged
from 1 case in the year 1978 verifi ed by culture to 328 positive
cultures in 2006 according to the data of the Reference
Laboratory for Dermatological Mycology and Parasitology of the
Ministry of Health and Social Welfare of the Republic of Croatia
at the University Department of Dermatology and Venereology
of the University of Zagreb Medical School. The clinical features
were rather different, ranging from solitary lesion of 1 cm in
diameter up to a multiple “tinea incognita” pattern involving
almost the whole face. Fungal infections involving both skin and
its appendages represent one of the most common disease and
a recalcitrant problem in dermatology demanding appropriate
treatment strategy. In many cases introducing the specifi c, only
topical antimycotic therapy, was not suffi cient to obtain a good
therapeutic result. Topical antimycotic treatment is ineffective
as sole therapy, and an oral antimycotic agent is needed to
penetrate the hair follicle. Early systemic agents were not entirely
satisfactory. Onychomycosis, tinea capitis and disseminated
mycoses very often involving face and neck in both immunocompetent
and immunocompromised carriers represent a clear
indication for systemic antimycotic therapy. Until recently, however,
treatment options for such fungal infections were limited.
Griseofulvin requires prolonged course of treatment and it is not
effi cient against yeasts, whereas in the case of ketoconazole,
there is a rare but serious risk of hepatotoxicity. Fortunately,
new oral antifungal agents such as fungicidal terbinafi ne and
fungistatic itraconazole and fl uconazole are now available for
these indications. There should be greater awareness of the
mycotic infections of the face, to avoid missing the true etiology
and to avoid inappropriate treatment.
Keywords
fungal skin infections; changes; oral treatment
Hrčak ID:
23017
URI
Publication date:
25.1.2007.
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