A dermatomycosis (from Greek δέρμα, derma, "skin", and ancient Greek μύκης, mykes, "mushroom", and the suffix -ose ) is caused by growing on the skin of humans and animals, fungi disease. The most common are major fungal diseases that attack the horny substance, they are called dermatophytosis. In addition, fungal diseases occur that affect deeper skin layers. In a broader sense are also diseases caused by yeasts or molds in which they are opportunistic pathogens, with added counted.
A fungal skin disease manifested by itchy, slightly red and scaly areas of skin and oozing blisters. Despite the sometimes very strong itching you should avoid to scratch. Not only you increase the risk of transmitting the disease through the fingers to other areas of the body, but also allows for emerging small wounds and skin cracks and the fungus to penetrate into deeper skin layers. In addition, it may lead to secondary infections with bacteria that can adversely affect the Abheilungschancen.
Crucial for the development of dermatomycoses is the balance between the aggressiveness of the fungus and the immune system of the infected host. There are types of fungi that always cause an infestation by healthy tissue (eg Histoplasma capsulatum ), is' good immune status " the spread is limited. Lack of hygiene, especially at the foot of a lack of regular cleaning of the metatarsal and in the intermediate region, promotes the development of athlete's foot, but is often not the trigger. Excessive washing again, especially with soap-containing agents, destroying the acid mantle of the skin and thus obstruct the normal defense.
Furthermore important is the internal (endogenous ) functional status of the affected area and also the condition of the entire host. In case of injury, impaired blood flow or other pathological changes can occur so -called secondary mycoses. Such fungal disease does not occur in healthy conditions, the fungal species involved therein are thus only potentially pathogenic (optional pathogenic).
Extremely important include external (exogenous ) factors: Mushrooms mainly proliferate in warm, humid environment. The beneficiaries mycoses of the feet too by the excessive sweating of the feet, it is also called by sweaty.
Medically relevant skin fungi are divided into three groups (DHS system):
- Epidermophyton - this fungus spreads to the cornea, he is known as athlete's foot.
- Microsporum canis - resulting in patchy hair loss with scaly skin and hair stumps that are left as black dots.
- Trichophyton - spreads in the cornea, the hair follicles and to the surrounding connective tissue. Is accompanied by the formation of abscesses. All stages from superficial to deeper layers of skin infection are possible, it usually circular or garland- shaped skin infestation. The life outside the body of the spores is several months. Trichophyton is the most common Fadenpilzart in Europe. The fungus can spread to the nails ( " nail fungus ").
The diagnosis of dermatophytosis has been difficult and time consuming. None of the detection method alone yielded reliable results. The molecular detection of pathogen-specific gene segments opens up the possibility of a secure and reliable diagnosis in suspected dermatophytosis. The combination of different methods was imperative as the "gold standard " is still considered the combination of direct detection and fungal culture.
The molecular diagnostics for instant dermatophytes from native material of patients with suspected dermatophytosis by polymerase chain reaction ( PCR) is becoming increasingly important. PCR reproduced here Pathogen- specific DNA sequences, which are located in so-called Markergenbereichen Dermatomykoseerreger the respective species-specific, and allow differentiation. The detection is performed eg by means of agarose gel electrophoresis followed by gel documentation. An easy- to-handle, routinely capable and reliable diagnosis of major Dermatomykoseerreger within a few hours is thus possible. The advantages of such a multi- parameter analysis include the enormous time savings, the resulting therapeutic added value, the reliability of the methodology also in mixed samples and the standardization of objective results. With the availability of an approved in vitro diagnostic medical device ( CE-IVD ) for human diagnostics all conditions have been created to exploit these advantages in the general medical laboratory routine.
Agents against dermatophytes
Agents against fungal diseases are called antifungals. To the active compounds, which are effective against the main fungal diseases include:
- Benzoic acid
- Ciclopirox or its ethanolamine salt ciclopiroxolamine
Portuguese researchers have shown that lavender oil already several yeast and filamentous fungi kills in low concentrations, can cause skin and nail fungal diseases in humans.
Notes on treatment
Treatment must be consistently and thoroughly with demonstrably effective antifungal agents. For use in the hair area, such as on the scalp, are an alternative to ointments liquid assets, such as with bifonazole, available. Treatment with saline or Essigfußbädern shows in some cases a rapid fungicidal ( fungicidal ) action - the itching disappears after the first application. Medication must always be used in the longer term, until a success occurs.
Fungal diseases are generally very persistent. Even after resolution of obvious symptoms, the treatment must be continued for some time (at least 6 weeks), so that the re-emergence of fungal infection is avoided. Particularly important is the disinfection of geratenen with the skin contact textiles and shoes. Stockings should be washed, for example, at least 60 ° C, as this could survive fungal spores and cause a new infection.
Shoes can be sprayed with a commercially available clotrimazole -containing spray and disinfect it. Also, formaldehyde is suitable for disinfection. Alcohols can be used for surface disinfection, but are in textiles or shoes usually too low effective.