Fungal skin diseases in children of different ages are quite common. The skin of the child is very sensitive and susceptible to infections, especially during the first years of life. Children are constantly in contact with environmental objects, with pets, try on the shoes of their parents and acquaintances, and poorly observe hand hygiene. All of these factors contribute to infection.
Fungi are microorganisms that are found in the environment, on the skin, in the oral cavity, in the hair growth zone of people and animals. Under normal conditions, they are harmless, but with weakened immunity and excessive reproduction can cause skin damage in children.
Fungal infection in children can affect the hair, nails, skin of the chest, abdomen, back, limbs. Depending on where the colony is localized, and on the type of pathogen, the following types of disease are distinguished:
- Ringworm. It affects the scalp, penetrates the hair follicles. Signs are rounded, itchy rashes in the scalp. The hair in this area becomes brittle, brittle.
- Dermatomycosis of the skin. May appear on any part of the baby’s body, including the face. It is characterized by the appearance of an itchy ring-shaped rash on the skin.
- Inguinal epidermophytosis. Most often occurs in a small child who wears diapers, but can be found in the area of fat folds in obese children. It is manifested by symmetrical irritation and redness of the perineum, where the skin is in contact with the diaper.
If unpleasant skin symptoms persist after applying emollient cream, then this indicates the presence of a fungal infection.
There are several factors that can trigger the development of mycosis:
- One of the common causes of infection is increased sweating, which leads to the growth and reproduction of the fungus. Overweight children and teenagers involved in sports are predisposed to the disease.
- The disease can occur when wearing tight synthetic clothing that prevents air from reaching the skin.
- Pathogenic fungi are easily transferred to household items (pillowcases, towels, shoes, pillows, soap). A child may become infected by direct contact (putting on someone else’s shoes, clothes, using a common pillow, soap).
- Excessive intake of antibacterial agents, cytostatics, hormonal drugs, chronic and inflammatory diseases lead to an increase in fungal infection due to suppressed immunity.
- Since the fungus grows well in warm and humid conditions, a child can become infected when visiting a bathhouse, swimming pool, gym, kindergarten.
- You can get infected by stroking a dog or cat, because fungi sometimes live on the hair of pets.
- The disease can be transmitted from person to person through direct contact.
- Untimely replacement of diapers can lead to a fungal infection in the groin of the baby. Wet diapers create excess moisture in the perineum and lead to the growth of a pathogenic fungus.
Description of symptoms depends on the form and location of the disease:
- A characteristic symptom for a fungal infection on the skin of the face and body is the appearance of a scaly rash of a ring-shaped shape with pustules and a clear outline. With the progression of the disease, the number of elements increases, the area of the lesion increases.
- A feature of a fungal infection of the scalp in a child is the appearance of itchy bald spots with the remains of broken dull hair.
It is not difficult to diagnose a skin fungus, sometimes an external examination is enough. At the reception, the doctor asks the child or his parents about the development of the disease, assesses the nature of the rashes.
To confirm the diagnosis, scraping is taken from the changed areas in order to conduct a microscopic examination.
The approach to the treatment of the disease depends on the patient's age, location and severity of the infection. For therapy, ointments, creams, tablets, shampoo with fungicidal and fungistatic properties can be used.
It is important not to let the child comb the rashes, this can lead to the spread of foci of mycosis and secondary infection.
Causes and factors of the appearance of mycoses
The insidiousness of the infection is that the spores of the fungus that causes mycoses are found everywhere: in the soil, in rooms, wherever it is warm, damp and dark. In the dried state, they remain for a long time, withstand temperatures from –50 to + 70ºС. The baby can become infected in its own room if someone from close relatives is a carrier of the infection.
Children of 1 year old, whose thermoregulation system is not yet balanced, often have wet hands and feet, and these are good conditions for the development of mycoses. At risk are sick children whose immune system is not able to cope with the attack of fungi. The factors provoking the disease include:
- Frequent visits to the baths, saunas, water park without shoes.
- Wearing someone else’s shoes, sock, tights. The fungus can persist for a long time in winter shoes and penetrate the skin in case of a failure of the body's defenses.
- Tight boots and boots made of artificial material that does not allow air to pass through - the fungus penetrates into the skin and spreads much faster.
- Wearing shoes is off-season. Infection can result from both hypothermia of the legs, and long wearing of insulated shoes in the room. It is very harmful to go in boots from a cold to a warm room several times.
- The presence of wounds and abrasions on the skin: to prevent infection, any damage must be treated in a timely manner.
- Improper nail care. Too long or short, damaged nails increase the risk of disease.
- Cardiovascular disease, diabetes. The latter at times increases the risk.
- Lack of vitamins, excess carbohydrates in the diet.
- Taking antibiotics for a long time.
Types of disease
There are several forms of pathogens of fungal infections:
- Candida mushrooms. Parasitize on the surface of the mucous membranes of the mouth, rectum and genitals.
- Trichophytosis. Destroy the integrity of the skin, nails and mucous membranes.
- Cryptococcosis. Infection affects the internal organs.
- Aspergillosis. The infection develops in the lungs and manifests itself in disguise as a cold.
How does infection happen?
The causative agents of the disease are easily transmitted from one person to another. An infected person leaves spores of the fungus along with dead skin particles that persist at home for a long time.
In seven to eight cases out of ten, the fungus is transmitted to the child from one of the households.
A newborn can become infected in utero, a baby through a common bed. A grown one-year-old baby catches the infection, licking objects. Yeast enters the baby’s mouth through common dishes or if the mother licks the nipple and gives it to the baby.
With ringworm, the baby can become infected by touching a sick animal. City birds, such as pigeons, also carry infections.
At 2 years, the baby begins to attend DOW. In kindergarten, if hygiene is not followed, the infection quickly spreads between the children.
Students take on the infection by trying on the shoes of a sick person. Spores of the fungus can be in winter shoes for a long time, as soon as the immune system fails, infection occurs.
With bruises and cuts, minor damage increases the risk of infection.
Aspergillosis infection can occur by inhalation of dust containing fungal micelles. They can get sick when visiting untreated rooms: old baths, bathrooms.
The nail fungus in a child can leak unnoticed and appear when the disease has passed to the stage that urgently requires intervention. Symptoms depend on the type of infection and the length of time from the onset of infection:
Types of Mycosis
In nature, there are four types of mycosis:
- Keratomycosis - infection of certain areas of the skin, including the scalp (in the form of lichen or flaky skin): head, foot, nails,
- Candidiasis - rashes on the genitals or internal organs, on the mucous membrane of the mouth (irritation of the tonsils, throat) and nasal cavity,
- Deep mycosis - the skin surface, part of the internal organs (feet, arms, legs, head area, nail plates, etc.) are affected
- Dermatomycosis - an infection affects areas of the skin (feet, legs, arms, nail plates, etc.), throat, tonsils, head.
Most often, infected feet, an area of the head, arms and face are affected. The question is, where does such an insidious disease come from in young patients?
Mycosis of the skin (arms, legs, scalp, etc.) and nasopharynx (throat, tonsils) has a number of reasons:
- Long-term medical treatment,
- Bad ecology (increased radiation, polluted airspace),
- Improper nutrition (increased consumption of sweet, salty, etc.),
- The presence of congenital diseases,
- Non-compliance with hygiene.
Often fungal infections occur in premature babies due to intensive therapy with drugs, including antibiotics.
There are no few cases when the cause of mycosis in a child is domestic animals. Cats, dogs and a number of other pets are carriers of infection, so with close contact, children may well become infected from them.
Mycosis is accompanied by the following symptoms:
- Itching, burning, redness of smooth skin,
- With candidiasis, there is a lesion of the tonsils, throat,
- The appearance of cracks on the surface of the skin, which subsequently begin to peel off,
- Affected areas of the skin acquire a scaly appearance
- Red or gray spots appear on the scalp, accompanied by burning and itching,
- The appearance of red blisters on the surface of the skin.
Thrush also belongs to mycosis. It appears in children at an early age. It is characterized by the presence of white plaque over the affected areas of the skin. With mechanical action, this area may begin to bleed. Infants develop a rash in places of close contact with a diaper or diaper.
More often in nature, the child has mycosis of smooth skin: microsporia, mycosis of the feet (hands, nails), epidermophytosis, lichen, candidiasis and trichophytosis.
When the first symptoms appear, you should consult your pediatrician. Because in case of mycosis, it is very important to start timely treatment.
The main preventive measure of mycosis is the observance of complete hygiene.
Before making contact with a newborn baby, you must wash your hands thoroughly, because through them the fungus can get to the baby. Further, the disease is highly likely to spread on the skin (on a hairy or smooth surface) or in the nasopharynx (tonsil affection). If there is a tendency to a similar disease, doctors prescribe the drug Nystatin for prevention. However, its 100% effectiveness has not yet been proven.
Premature babies taking medications and antibiotics are at increased risk. To prevent disease, they are given fluconazole during the first two weeks of their life. But such therapy is prescribed only by a doctor, because this drug is not recommended for children under 16 years of age.
Mycosis is not a simple disease. To cope with it without serious consequences, you need to start treatment on time. And then the child in the future will avoid the problems associated with this disease.
Fungal skin diseases in children develop with damage to smooth skin and its appendages (hair and nails) with parasitic mushrooms. In dermatology, mycoses account for 37-40% of all skin diseases. There is a tendency towards an increase in the number of children in whom fungal skin diseases develop simultaneously with other dermatoses - atopic dermatitis, eczema, psoriasis, and pyoderma. The danger of fungal skin diseases lies in the toxic and sensitizing effect of fungi on the children's body, which provokes the development of allergic reactions, weakened immunity, and aggravation of chronic pathology.
Causes of fungal skin diseases in children
The prevalence of dermatomycosis among all fungal diseases is due to the constant close contact of the skin with the environment. The causative agents of fungal skin diseases in children are widespread in nature, have great diversity and high resistance to external factors. Fungal skin diseases in children are usually noted in the form of sporadic cases, epidemic outbreaks are more characteristic of dermatophytosis of the scalp.
The source of anthropophilic dermatomycosis (trichophytosis) is a sick person, bestial (microsporia) is a sick animal (stray cats and dogs, cows, horses), rarely found geophilic - soil. Infection occurs with direct contact of the child with the patient’s skin and hairline or through household items seeded with mushrooms and their spores (towels, washcloths, combs, toys, hats, shoes). Most often, fungal skin diseases infect children in swimming pools, showers and baths, on beaches, in hairdressers, organized by children's groups.
Features of children's skin (hydrophilicity, increased vascularization, decreased bactericidal action of sweat and sebaceous glands, slight vulnerability), immaturity of the immune system facilitate the penetration of the pathogen into the epidermis, contributing to the rapid development of fungal diseases in children.
A decrease in the body’s defenses can be triggered by poor ecology, stress, vitamin deficiency, prolonged use of antibiotics, dysbiosis, endocrinopathies and chronic infections. With immunodeficiency, conditionally pathogenic fungi that normally live on the skin of a child can transform into a pathogenic form and cause a fungal disease (for example, Malassezia furfur, the causative agent of colorful lichen).
Symptoms of fungal skin diseases in children
The nature and severity of the symptoms of fungal skin diseases in children depend on the type and virulence of the pathogen, the location and area of the lesion, and the reactivity of the body. Of the fungal skin diseases in children, the most common and contagious are microsporia and trichophytosis (ringworm), occurring with a predominant lesion of smooth skin and scalp.
Microsporia in most cases (99%) is caused by the zoo anthropophilic fungus Microsporum canis, rarely by the anthropophilic M.ferrugeneum. It usually occurs in children of preschool and primary school age, proceeds with the formation of a few, rounded, clearly defined foci with hair broken off at a height of 4-5 mm from the skin level. Within the lesion, the skin is covered with small grayish-white scales. On smooth skin, microsporia is manifested by concentric erythematous-squamous plaques surrounded by a roller of small vesicles and serous crusts.
In young children, superficial trichophytosis of the scalp caused by anthropophilic trichophytons (Trichophyton tonsurans and T. violaceum) is more often observed, accompanied by loss of color, elasticity and shine of hair, breaking them off at the skin level (hemp in the form of black dots), the formation of clear, round bald spots covered with small scaly elements. The clinical signs of trichophytosis on smooth skin resemble the manifestations of microsporia. For the infiltrative suppurative form, perifolliculitis and deep follicular abscesses are characteristic.
Multicolored (pityriasis) lichen is observed in older children, characterized by the appearance on the skin of the back and chest (less often of the neck, abdomen and extremities) of finely flaky cream, light brown or yellowish pink irregular spots, prone to peripheral growth. The disease is slightly contagious, has a chronic relapsing course, the affected areas of the skin do not sunbathe (secondary leukoderma).
When Achorion schonleini is affected by a fungus, a rare fungal skin disease develops in children - favus (scab), which usually manifests itself on the scalp by the formation of cheekbones (favous shields) - dry thick crusts of a yellowish or light brown color with raised edges and a depressed center, emitting a stagnant unpleasant smell. The hair affected by the fungus becomes thinner, becomes like a tow, and is pulled out together with the root. Favus can result in nesting or continuous cicatricial atrophy of the skin and the death of hair follicles.
Rubromycosis caused by the anthropophilic pathogen T. rubrum occurs in children aged 7-15 years, manifests itself as dry skin of the feet and hands, clear pink-red, finely scaly foci with a scalloped edge, damage to the nails.
With epidermophytosis in the interdigital folds and on the sole of the feet, slight redness, peeling, moderate weeping, cracks and vesicles, hyperkeratosis, accompanied by itching, are observed.
For various types of onychomycosis, thickening, change in the shape and color of the nail plate with its gradual destruction, onycholysis, and damage to the nail roll are characteristic.
Candidiasis in children is most often manifested by thrush - a white cheesy coating on the tongue, gums, cheeks.Vesicular eruptions and extensive superficial ulcerations, accompanied by itching and burning, can also occur in the area of natural skin folds.
After suffering a fungal skin disease in children, there is no stable immunity and re-infection of the child with the same type of fungus can occur.
Treatment of fungal skin diseases in children
Course treatment of fungal skin diseases in children is carried out on an outpatient basis, and in the absence of effect, the presence of concomitant pathology and severe course - in a specialized hospital. In the treatment of fungal skin diseases in children, monotherapy or a combination of external and systemic antimycotics, antihistamines and glucocorticoid drugs, immunostimulants, multivitamins, physiotherapy are used.
Every day, they treat the affected areas of the skin with antiseptic solutions (furatsilina, potassium permanganate, boric acid), carry out drug treatment of the feet and nail plates (with hyperkeratosis with keratolytic agents), the hair in the lesion is shaved off, the crusts are removed.
For fungal infections of skin folds, hands and feet in children, antifungal pastes, ointments, creams, emulsions with terbinafine, naphthyne, clotrimazole, miconazole, ketoconazole, sulfur-tar, salicylic, naphthalan ointments are used. When a bacterial infection is attached, antimycotic ointments containing antibiotics and corticosteroids are prescribed. In severe and common dermatophytosis, damage to hair and nails, additional administration of systemic antimycotics (griseofulvin, itraconazole, fluconazole) is additionally indicated. If necessary, laser treatment of fungal lesions of the skin and nails, surgical removal of the nail plate are performed.
The treatment of fungal skin diseases in children is lengthy and continues until clinical manifestations and negative control tests for fungi are resolved.
Prediction and prevention of fungal skin diseases in children
Many fungal skin diseases in children have a persistent course and require long-term systematic treatment, however, with the exact observance of the recommendations, they have a favorable prognosis. Untreated fungal skin diseases in children acquire a chronic relapsing form and can continue into adulthood.
Prevention of the spread of fungal skin diseases in children includes quarantine measures in children's institutions, disinfection of premises, household items, clothes, shoes, manicure and hairdressing supplies, eliminating contact of a child with stray animals, following personal hygiene rules, proper skin care, and normalizing immunity.
The structure of the nails is changing. They can become yellowish, gray, and in the stage of a severely neglected disease, blacken, become thicker or, conversely, thinner.
The baby's nails are folded, stripes appear on them. The areas of skin around them turn red, swell, and seals, sores, and peeling may be observed. Gradually, the disease covers all the nails, in the elderly and children it occurs on the hands.
First, it affects the delicate skin between the toes, then gradually spreads throughout the foot. The foot becomes cracked, the skin coarsens and the wounds become deep. At this stage, pain occurs when walking.
It appears in the form of white plaque in the tongue and throat, on the mucous membranes of the genitals. The areas of skin under the layer of secretions are red, inflamed and painful.
In severe cases, the fungus penetrates into the internal organs: lungs, kidneys and causes a malfunction in their functioning.
Forms and stages of the disease
With onychomycosis, the fungus captures the surface gradually. At the initial stage, a tiny white or yellowish opaque spot appears on the nail plate. Over time, it grows throughout the nail, it thickens and separates from the nail bed. This form of the disease is called distal subungual and is observed most often.
With a white surface form, the nails are folded, a coating appears on their surface. In the initial stage, the fungus is easy to cure.
Pathological proximal subungual form occurs in patients with HIV infection. It affects the plate, which becomes white and opaque.
If you do not treat a fungal infection, it goes into a total dystrophic form, in which the damaged nail must be removed.
The main remedy used against fungal infections has long been wine vinegar.
- The popular method of treatment is as follows: the socks soaked in it are put on the baby for the night, and removed in the morning.
- Herbs have antimycotic effect: calamus, celandine, burdock root. A decoction of chamomile will relieve itching and inflammation. On the surface affected by the fungus apply onion juice, garlic.
- An inexpensive method will help cure the disease - salt and soda baths. Soda can be used as follows: mix with water until a mushy mass and apply on the nail.
- It has long been customary to lubricate the affected area with iodine; tea tree oil has a strong antifungal effect.
Tip. Sweets and carbohydrate-rich foods contribute to the growth of fungal colonies. Traditional healers recommend adding vegetable salads with fresh herbs to the food. It helps with fungal diseases beetroot and carrot juice.
When a fungus appears on the scalp, a special antifungal shampoo containing ketoconazole (Nizoral) is used. When using, you must strictly follow the instructions, try to avoid getting the product in your eyes.
Mycosis of the trunk and limbs can be treated with antifungal ointments (Biconazole, Clotrimazole). The product should be applied to the affected area in accordance with the instructions. Typically, treatment is 4 to 8 weeks. It is important to complete the entire course, even if the symptoms disappear earlier.
In case of a more severe infection, in addition to external agents, oral medications in the form of tablets (Ketoconazole, Griseofulvin) will be required. Drugs are prescribed and used only on the recommendation of the attending physician.