The dermatophytes are a group of fungi that invade and grow in the dead keratin of skin, hair, and nails. Dermatophytes are, by far, the most prevalent of the 3 major classes of superficial infections. They tend to grow outwards on skin, producing a ringlike pattern, hence the term "ringworm". They are very common and affect different parts of the body. Clinically, dermatophytosis infections, also known as tinea, are classified according to the body regions involved. The type and severity of the host response is often related to the species and strain of the dermatophyte causing the infection. Table reprinted with permission from David Ellis, Bsc (Hons), MSc, Ph D, FASM, FRCPA (Hon), Affiliate Associate Professor, The University of Adelaide ( The dermatophytes are the only fungi that have evolved a dependency on human or animal infection for the survival and dissemination of their species. (Open Table in a new window) Dermatophytes are keratinophilic fungi and have the ability to invade keratinized tissue (eg, hair, nails, any area of the skin). The infection may spread from person to person (anthropophilic), animal to person (zoophilic), or soil to person (geophilic). They invade, infect, and persist in the stratum corneum of the epidermis and rarely penetrate below the surface of the epidermis and its appendages. Fluconazole is indicated in the treatment of mycoses caused by Candida, Cryptococcus and other susceptible yeast, in particular: 1. The treatment of partners who present with symptomatic genital candidiasis should be considered. Prevention of fungal infections in patients predisposed to such infections as a result of chemotherapy or radiotherapy, including bone transplant patients. Dermatomycosis, including infections such as Tinea pedis, Tinea corporis, Tinea cruris, Tinea versicolor. Mucosal candidiasis: These include oropharyngeal candidiasis, oesophageal, non-invasive bronchopulmonary infections, candiduria, mucocutaneous candidiasis and chronic atrophic oral candidiasis (denture sore mouth). Fluconazole is not indicated for nail infections and tinea capitis. Consideration should be given to official guidance on the appropriate use of antimycotic agents. Both normal hosts and immunocompromised patients may be treated. Before initiating treatment, samples should be taken for microbiological analysis and the suitability of the therapy should be subsequently confirmed (see sections 4.2 and 5.1) In some patients with severe crytococcoal meningitis, the mycological response during fluconazole treatment may be slower that during other treatments (see section 4.4) The daily dose of fluconazole will depend on the nature and severity of the fungal infection. 2 Systemic candidiasis (including disseminated deep infections and peritonitis). Acute cryptococcal meningitis in adults, including patients with AIDS, transplanted patients or other patients with other causes of immunosuppression. Most cases of vaginal candidiasis respond to a single dose treatment. The treatment of those types of infection requiring multiple doses of the drug should be continued until the clinical parameters or laboratory tests indicate that the active fungal infection has subsided. An inadequate treatment period may cause relapses of the active infection. Patients with AIDS and cryptococcal meningitis or recurrent oral candidiasis usually require maintenance treatment to prevent relapses.
Tinea capitis caused by the species of genera Trichophyton and Microsporum is the most common pediatric dermatophyte infection. The age predilection is believed to result from the lack of certain florae and fungistatic sebum in this age group. Signs and symptoms. Infections on the body may give rise to typical enlarging raised red rings of ringworm. Infection on the skin of the feet may cause athlete's foot and in the groin, jock itch.