Dermatomycoses B36.9

Infections of the skin and/or hair and/or nails caused by fungi Dermatomycoses may have accompanied man since the beginning of his phylogeny. Mycoses of the skin are one of the most common human diseases worldwide (4th place in a worldwide diagnostic statistic). Dermatophytes have adapted optimally to humans and are the cause of endemic dermatophytosis (tinea) worldwide.

Main pathogens of a dermatophytosis (tinea) are dermatophytes such as Trichophyton spp., Mikrosporum spp. and Epidermophyton floccosum. The 3 genera differ in the form of spores or macroconidia:

• Trichophyton (thin-walled, smooth, four to six partitions)
• Microsporum (thick and rough walls, at least five partitions)
• Epidermophyton (thick-walled, approximately pear-shaped, up to seven septums).

Dermatomycoses caused by yeasts and moulds are distinct from dermatophytoses:

• Yeasts or shoot fungi (see also candidiasis, pityriasis versicolor, white piedra, pityrosporum folliculitis)
• moulds (see also black piedra, Tinea nigra palmaris et plantaris, aspergillosis).

Most frequently Candida and Pityrosporum species appear as pathogens, more rarely moulds. A clear distinction between yeasts, dermatophytes and other fungi is important with regard to the choice of antifungal agent, as the effectiveness of antifungal agents is not identical against all fungal groups.

In a larger Japanese study on 36,000 general outpatients, the proportion of dermatomycoses was 8.2%.

In the clientele of dermatomycosis patients the distribution was as follows:

• Tinea pedis: 64% (m:f=1:1)
• Tinea corporis: 6.8% (m:w=1:1)
• Tinea cruris: 3.7% (m:w=4:1)
• Tinea manuum: 1,4% (m:w=1:1)
• Tinea capitis: 0,5% (m:w=4:1)

According to the respective clinical picture and pathogen, see below Candidosis, pityriasis versicolor, piedra, white, pityrosporum folliculitis, tinea, piedra, black, tinea nigra palmaris et plantaris, aspergillosis.

1. Hay RJ et al(2014) The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions.J Invest Dermatol 134:1527-1534
2. Nenoff, P et al (2014) Mycology - An Update Part 2: Dermatomycoses: Clinical picture and diagnostics. JDDG 12:749-778
3. Sei Y (2015) 2011 Epidemiological Survey of Dermatomycoses in Japan. Med Mycol J 56:J129-135