Fungal infections

B35.0-6/B35.8-9/B36.0-3/B36.8-9/B40.3/B45.2/B46.3

• Description
• General measures
• Medicine treatment
• Referral

DESCRIPTION

The skin may be infected by fungi and the clinical presentation varies with organism, body site infected, and the body’s response to the infection.

GENERAL MEASURES

Manage predisposing factors, i.e. occlusion, maceration and underlying conditions such as diabetes mellitus, eczema, immunocompromising conditions, etc.
Advise patient regarding spread of infection and exposure in communal, shared facilities (dermatophytes).

MEDICINE TREATMENT

Yeast and dermatophytes (fungal infection of the skin):

• Imidazole, e.g.:
  • Clotrimazole 1%, topical, apply 8 hourly until clear of disease (i.e. for at least 2 weeks after the lesions have cleared).

Pityriasis versicolor: B36.0

• Selenium sulfide 2.5% suspension, applied once weekly to all affected areas.
  • Allow to dry and leave overnight before rinsing off.
  • Repeat for 3 weeks.

Systemic antifungal therapy

Topical treatment is generally ineffective for dermatophyte hair and nail infections.
Systemic therapy may be indicated for immunocompromised individuals with extensive skin infection
Recurrent infections are not uncommon if repeat exposure is not prevented.

• Fluconazole, oral, 200 mg weekly for 6 weeks.
  • For onychomycosis, 200 mg weekly for 6 months.

LoEI [14]

REFERRAL

• Non-responsive infections.
• Systemic infections.