Athlete’s foot, Jock Itch, Ringworm, tinea, toenail fungus – Are any of these terms familiar to you? If yes, then it’s probably because you or someone you know has been affected (or you’ve heard the Blue Star Ointment commercial hundreds of times). Well, all these terms refer to the same thing – a fungal infection of the skin, hair or nails. NOT a worm!
Certain types of fungi have an affinity for the keratinized parts of the skin such as the epidermis and nails, and these fungi are called dermatophytes. Dermatophyte infections in humans are caused by the fungi Epidermophyton, Microsporum, and Trichophyton. Common symptoms of infection include rashes, itching, cracking, and flaking of skin or thickening and discoloration of the nails.
Most of us are regularly exposed to pathogenic fungi, but we don’t become infected. When an infection does occur, it’s usually because the circulation in the area is poor, or the immune system is suppressed for reasons like diabetes, stress, cancer, nutritional deficiencies, or medications.
In the photo above, the epidermis (top layer of skin) is infiltrated by numerous fungal hyphae (black arrows). The skin cells can be identified by the presence of their oval-shaped pale blue-gray nuclei (white arrows). The fungi are a bright magenta color in this PAS (periodic Acid Schiff) stain which is commonly used by Pathologists to see fungus clearly. The uppermost layers of skin with the highest number of fungal elements would likely appear flaky (green arrow) to the patient and their doctor.
Luckily, this type of fungal infection cannot spread to internal organs, but it is contagious and can also lead to infection in other areas of the skin. The treatment is simple and usually consists of topical application of antifungal creams or ointments for a number of weeks. Keep in mind that infected toenails can take longer to cure and there are many home remedies that are effective and inexpensive.
Dr. Culton MD