16th July 2026

Fungal Infections

Fungal infections of the skin, also known as superficial mycoses, affect the stratum corneum and adnexal structures like hair and nails. These infections are typically caused by dermatophytes (Trichophyton, Microsporum, Epidermophyton), Candida species, and Malassezia. Dermatophyte infections are grouped under the term ‘tinea’ and are named according to the site involved — for example, tinea corporis (body), tinea pedis (feet), and tinea capitis (scalp).

Clinical features

Tinea corporis typically presents as annular plaques with an advancing scaly edge and central clearing. Tinea pedis may manifest as interdigital maceration, moccasin-type scaling, or vesiculobullous eruptions. Tinea capitis often affects children and presents with patchy hair loss and black dot alopecia. Onychomycosis affects the nails and causes discolouration, thickening, and onycholysis.

Candidal infections involve intertriginous areas, such as under the breasts or in the groin, presenting with erythematous plaques and satellite pustules. Malassezia infections like pityriasis versicolor cause hypopigmented or hyperpigmented macules with fine scale, commonly on the trunk.

Diagnosis

Diagnosis is often clinical but can be supported by potassium hydroxide (KOH) microscopy, fungal culture, or Wood’s lamp examination (especially in tinea capitis or pityriasis versicolor). Dermoscopy is increasingly used as a non-invasive adjunct.

Management

Management involves topical antifungals such as clotrimazole, miconazole, or terbinafine for most localised infections. Systemic treatment (e.g., oral terbinafine, itraconazole, or fluconazole) is indicated for tinea capitis, onychomycosis, or extensive disease. Preventative strategies include avoiding shared towels, keeping the skin dry, and managing risk factors like diabetes or immunosuppression.