Powierzchowne zakażenia grzybicze Artykuł przeglądowy
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Opublikowane:
lis 30, 2025
Słowa kluczowe:
powierzchniowe zakażenia grzybicze, grzyby, grzybice, dermatofity, dermatologia
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Abstrakt
Powierzchowne zakażenia grzybicze są powszechne na całym świecie, wywołują je głównie dermatofity, drożdże (Candida spp.) oraz sporadycznie pleśnie niezwiązane z dermatofitami. Dotyczą one ok. 20–25% populacji, a czynnikami ryzyka są niedobory odporności, warunki środowiskowe oraz status społeczno-ekonomiczny. Klinicznie zakażenia grzybicze objawiają się jako dobrze odgraniczone, swędzące, łuszczące się zmiany na skórze gładkiej i skórze owłosionej głowy, jak również jako zmiany w obrębie płytek paznokciowych, powodują dyskomfort fizyczny oraz problemy psychospołeczne. Dermatofity dzieli się na antropofilne, zoofilne i geofilne, mają one unikalną epidemiologię i objawy kliniczne. Do najczęstszych zakażeń należą: tinea capitis, corporis, pedis, cruris, manuum, barbae oraz onychomikoza. Diagnostyka polega na badaniu klinicznym, które powinno być wsparte badaniem mykologicznym: mikroskopowym i/lub hodowlą, rzadziej PCR lub niekiedy zastosowaniem lampy Wooda. Leczenie polega przede wszystkim na stosowaniu miejscowych leków przeciwgrzybiczych, takich jak imidazole, alliloaminy i cyklopiroksolamina, a w nasilonych przypadkach stosuje się leki ogólnoustrojowe. Nowe formy leków przeciwgrzybiczych (np. nanożele) zwiększają skuteczność i poprawiają przestrzeganie terapii. Dokładna diagnoza i leczenie są niezbędne, by zapobiec nawrotom i powikłaniom.
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Jak cytować
Rychlik, K., Purzycka Bohdan, D., & Nowicki, R. J. (2025). Powierzchowne zakażenia grzybicze . Medycyna Faktów , 18(3(68), 430-437. https://doi.org/10.24292/01.MF.0325.15
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Bibliografia
1. Galili E, Taieb A, Shemer A et al. Epidemiology and Trends of Cutaneous Fungal Infections (2019–2022) in Israel: A Single Tertiary-Center Study. J Fungi. 2025; 11: 320. https://doi.org/10.3390/jof11040320.
2. Pilz JF, Schaller M, Köberle M et al. Emergence of Trichophyton tonsurans – A Retrospective Multicentre Study of the Dermatophyte Spectrum in Germany. Mycoses. 2025; 68(4): e70053. https://doi.org/10.1111/myc.70053.
3. de Oliveira Pereira F, Gomes SM, Lima da Silva S et al. The prevalence of dermatophytoses in Brazil: a systematic review. J Med Microbiol. 2021; 70(3). https://doi.org/ 10.1099/jmm.0.001321.
4. Havlickova B, Czaika VA, Friedrich M. Epidemiological trends in skin mycoses worldwide. Mycoses. 2008; 51(Suppl. 4): 2-15. https://doi.org/10.1111/j.1439-0507.2008.01606.x .
5. Araya S, Tesfaye B, Fente D. Epidemiology of dermatophyte and non-dermatophyte fungi infection in Ethiopia. Clin Cosmet Investig Dermatol. 2020; 13: 291-7. https://doi.org/10.2147/CCID.S246183.
6. Barac A, Stjepanovic M, Krajisnik S et al. Dermatophytes: Update on Clinical Epidemiology and Treatment. Mycopathologia. 2024; 189(6): 101. https://doi.org/10.1007/s11046-024-00909-3.
7. Zhou YB, Chao JJ, Ma L et al. Case Report: Itraconazole Oral Solution Continuous Therapy for Infantile Tinea Capitis. Am J Trop Med Hyg. 2024; 110: 965-7. https://doi.org/10.4269/ajtmh.23-0741.
8. Kieliger S, Glatz M, Cozzio A et al. Tinea capitis and Tinea faciei in the Zurich Area – An 8-Year Survey of Trends in the Epidemiology and Treatment Patterns. J Eur Acad Dermatol Venereol. 2015; 29: 1524-9. https://doi.org/10.1111/jdv.12908.
9. Agokeng DAJ, Dabou S, Kabtani J et al. Epidemiology of Tinea Capitis Among School‑Children in Dschang, Western Cameroon. Mycopathologia. 2024; 189: 51. https://doi.org/10.1007/s11046-024-00857-y .
10. Rychlik K, Sternicka-Rohde J, Nowicki RJ et al. Superficial Fungal Infections in Children – What Do We Know? J Clin Med. 2025; 14(20): 7380. https://doi.org/10.3390/jcm14207380.
11. Stenderup JEB, Goandal NF, Saunte DML. Systematic Review of the Prevalence of Tinea Pedis in Children. Pediatr Dermatol. 2025; 42: 539-51. https://doi.org/10.1111/pde.15947.
12. Hawkins DM, Smidt AC. Superficial Fungal Infections in Children. Pediatr Clin N Am. 2014; 61: 443-55. https://doi.org/10.1016/j.pcl.2013.12.003.
13. Gupta AK, Stec N, Summerbell RC et al. Onychomycosis: a review. J Eur Acad Dermatol Venereol. 2020; 34(9): 1972-90. https://doi.org/ 10.1111/jdv.16394.
14. Elewski BE. Onychomycosis: Pathogenesis, Diagnosis, and Management. Clin Microbiol Rev. 1998; 11(3): 415-29. https://doi.org/10.1128/cmr.11.3.415.
15. Shah AA, Mirza R, Sattar A et al. Unveiling onychomycosis: Pathogenesis, diagnosis, and innovativetreatment strategies. Microb Pathog. 2025; 198: 107111. https://doi.org/10.1016/j.micpath.2024.107111.
16. Zhao D, Chen B, Wang YT et al. Topical clotrimazole cream for the treatment of tinea cruris A retrospective study. Medicine. 2020; 99(47): e23189. https://doi.org/10.1097/MD.0000000000023189.
17. Caplan AS, Gold JAW, Smith DJ et al. Diagnosis and Management of Tinea Infections. Am Fam Physician. 2025; 112(4): 382-92.
18. Suphatsathienkul P, Jirawattanadon P, Matthapan L et al. Tinea manuum: a 5 year retrospective study of demographic data, clinical characteristics, and treatment outcomes. Sci Rep. 2025; 15(1): 3380. https://doi.org/10.1038/s41598-025-87011-w.
19. Jaiswal SJ, Uprety SU, Thapa PT et al. The Crease Scale Sign as a Diagnostic Aid in Tinea Manuum. JEADV Clinical Practice. 2025; 1-2. https://doi.org/10.1002/jvc2.70161.
20. García-Rodríguez V, Iglesias-Sancho M, Martín-García M. A Case of Inflammatory Tinea Barbae Acquired by a Barber Shop Client. Actas Dermosifiliogr. 2025; 116(9): 1015-17. https://doi.org/10.1016/j.ad.2025.07.011.
21. Tanabe H. A Case of Tinea Barbae due to Trichophyton mentagrophytes presenting as a Tumor. Med Mycol J. 2024; 65(4): 93-8. https://doi.org/10.3314/mmj.24-00018.
22. Gaudiello F, Tommasino N, D’Ascenzo S et al. Atypical forms of pityriasis versicolor: Case series and literature review. JAAD Case Reports. 2025; 64: 40-5. https://doi.org/10.1016/j.jdcr.2025.06.047.
23. Sellera FP, Ollhoff RD, Pogliani FC. Malassezia [mal″ə-sē′zhə]. Emerg Infect Dis. 2025; 31(10): 2063. https://doi.org/10.3201/eid3110.221743.
24. Jasiuk A, Wiekiera M, Madeja N et al. Diagnosis and Treatment of Pityriasis Versicolor: A Review of Current Methods and Research Findings. Quality in Sport. 2025; 44: 62963. https://doi.org/10.12775/QS.2025.44.62963.
25. Ugalde-Trejo NX, Delgado-Moreno KP, Bonifaz A. Tinea Incognito. Curr Fungal Infect Rep. 2025; 19: 2.
26. Zacharopoulou A, Tsiogka A, Tsimpidakis A et al. Tinea Incognito: Challenges in Diagnosis and Management. J Clin Med. 2024; 13: 3267.
27. Sun D, Lu J, Liu T et al. Wood’s lamp for early detection of Microsporum Canis tinea capitis in children. Photodiagnosis and Photodynamic Therapy. 2025; 51: 104428. https://doi.org/10.1016/j.pdpdt.2024.104428.
28. Rychlik K, Sternicka J, Zabłotna M et al. Superficial Fungal Infections in the Pediatric Dermatological Population of Northern Poland. J Fungi. 2025; 11(7): 533. https://doi.org/10.3390/jof11070533.
29. Wei L, Qiao J. Mini-Review: The Diagnostic Methods of Tinea Capitis. Mycopathologia. 2023; 188: 563-9. https://doi.org/10.1007/s11046-023-00731-3.
30. Fazolin Petrucelli M, Heinzen de Abreu M, Michelotto Cantelli BA et al. Epidemiology and Diagnostic Perspectives of Dermatophytoses. J Fungi. 2020; 6: 310. https://doi.org/10.3390/jof6040310.
31. Gupta AK, Wang T, Lincoln SA et al. Molecular Identification of Etiological Agents in Fungal and Bacterial Skin Infections: United States, 2020–2024. Infect Dis Rep. 2024; 16: 1075-83.
32. Begum J, Mir NA, Lingaraju MC et al. Recent advances in the diagnosis of dermatophytosis. J Basic Microbiol. 2020; 60: 293-303.
33. Rezabek GH, Friedman AD. Superficial fungal infections of the skin. Diagnosis and current treatment recommendations. Drugs. 1992; 43: 674-82.
34. Al-Janabi AAHS, Al-Khikani FHO, Badali H et al. In Vitro Susceptibility Patterns of Clinically Important Trichophyton and Epidermophyton Species against Nine Antifungal Drugs. Mycoses. 2015; 58: 303-7.
35. Zha M, Usaine R. Common Skin Conditions in Children and Adolescents: Nonbacterial Infections. FP Essent. 2024; 541: 20.
36. Kotsulwar NA, Nagoba SN, Malshette RB et al. Formulation, Development and Evaluation of Ciclopirox Olamine Nanogel for the Treatment of Cutaneous Candidiasis. J Neonatal Surg. 2025; 14(32s): 7848-60.
2. Pilz JF, Schaller M, Köberle M et al. Emergence of Trichophyton tonsurans – A Retrospective Multicentre Study of the Dermatophyte Spectrum in Germany. Mycoses. 2025; 68(4): e70053. https://doi.org/10.1111/myc.70053.
3. de Oliveira Pereira F, Gomes SM, Lima da Silva S et al. The prevalence of dermatophytoses in Brazil: a systematic review. J Med Microbiol. 2021; 70(3). https://doi.org/ 10.1099/jmm.0.001321.
4. Havlickova B, Czaika VA, Friedrich M. Epidemiological trends in skin mycoses worldwide. Mycoses. 2008; 51(Suppl. 4): 2-15. https://doi.org/10.1111/j.1439-0507.2008.01606.x .
5. Araya S, Tesfaye B, Fente D. Epidemiology of dermatophyte and non-dermatophyte fungi infection in Ethiopia. Clin Cosmet Investig Dermatol. 2020; 13: 291-7. https://doi.org/10.2147/CCID.S246183.
6. Barac A, Stjepanovic M, Krajisnik S et al. Dermatophytes: Update on Clinical Epidemiology and Treatment. Mycopathologia. 2024; 189(6): 101. https://doi.org/10.1007/s11046-024-00909-3.
7. Zhou YB, Chao JJ, Ma L et al. Case Report: Itraconazole Oral Solution Continuous Therapy for Infantile Tinea Capitis. Am J Trop Med Hyg. 2024; 110: 965-7. https://doi.org/10.4269/ajtmh.23-0741.
8. Kieliger S, Glatz M, Cozzio A et al. Tinea capitis and Tinea faciei in the Zurich Area – An 8-Year Survey of Trends in the Epidemiology and Treatment Patterns. J Eur Acad Dermatol Venereol. 2015; 29: 1524-9. https://doi.org/10.1111/jdv.12908.
9. Agokeng DAJ, Dabou S, Kabtani J et al. Epidemiology of Tinea Capitis Among School‑Children in Dschang, Western Cameroon. Mycopathologia. 2024; 189: 51. https://doi.org/10.1007/s11046-024-00857-y .
10. Rychlik K, Sternicka-Rohde J, Nowicki RJ et al. Superficial Fungal Infections in Children – What Do We Know? J Clin Med. 2025; 14(20): 7380. https://doi.org/10.3390/jcm14207380.
11. Stenderup JEB, Goandal NF, Saunte DML. Systematic Review of the Prevalence of Tinea Pedis in Children. Pediatr Dermatol. 2025; 42: 539-51. https://doi.org/10.1111/pde.15947.
12. Hawkins DM, Smidt AC. Superficial Fungal Infections in Children. Pediatr Clin N Am. 2014; 61: 443-55. https://doi.org/10.1016/j.pcl.2013.12.003.
13. Gupta AK, Stec N, Summerbell RC et al. Onychomycosis: a review. J Eur Acad Dermatol Venereol. 2020; 34(9): 1972-90. https://doi.org/ 10.1111/jdv.16394.
14. Elewski BE. Onychomycosis: Pathogenesis, Diagnosis, and Management. Clin Microbiol Rev. 1998; 11(3): 415-29. https://doi.org/10.1128/cmr.11.3.415.
15. Shah AA, Mirza R, Sattar A et al. Unveiling onychomycosis: Pathogenesis, diagnosis, and innovativetreatment strategies. Microb Pathog. 2025; 198: 107111. https://doi.org/10.1016/j.micpath.2024.107111.
16. Zhao D, Chen B, Wang YT et al. Topical clotrimazole cream for the treatment of tinea cruris A retrospective study. Medicine. 2020; 99(47): e23189. https://doi.org/10.1097/MD.0000000000023189.
17. Caplan AS, Gold JAW, Smith DJ et al. Diagnosis and Management of Tinea Infections. Am Fam Physician. 2025; 112(4): 382-92.
18. Suphatsathienkul P, Jirawattanadon P, Matthapan L et al. Tinea manuum: a 5 year retrospective study of demographic data, clinical characteristics, and treatment outcomes. Sci Rep. 2025; 15(1): 3380. https://doi.org/10.1038/s41598-025-87011-w.
19. Jaiswal SJ, Uprety SU, Thapa PT et al. The Crease Scale Sign as a Diagnostic Aid in Tinea Manuum. JEADV Clinical Practice. 2025; 1-2. https://doi.org/10.1002/jvc2.70161.
20. García-Rodríguez V, Iglesias-Sancho M, Martín-García M. A Case of Inflammatory Tinea Barbae Acquired by a Barber Shop Client. Actas Dermosifiliogr. 2025; 116(9): 1015-17. https://doi.org/10.1016/j.ad.2025.07.011.
21. Tanabe H. A Case of Tinea Barbae due to Trichophyton mentagrophytes presenting as a Tumor. Med Mycol J. 2024; 65(4): 93-8. https://doi.org/10.3314/mmj.24-00018.
22. Gaudiello F, Tommasino N, D’Ascenzo S et al. Atypical forms of pityriasis versicolor: Case series and literature review. JAAD Case Reports. 2025; 64: 40-5. https://doi.org/10.1016/j.jdcr.2025.06.047.
23. Sellera FP, Ollhoff RD, Pogliani FC. Malassezia [mal″ə-sē′zhə]. Emerg Infect Dis. 2025; 31(10): 2063. https://doi.org/10.3201/eid3110.221743.
24. Jasiuk A, Wiekiera M, Madeja N et al. Diagnosis and Treatment of Pityriasis Versicolor: A Review of Current Methods and Research Findings. Quality in Sport. 2025; 44: 62963. https://doi.org/10.12775/QS.2025.44.62963.
25. Ugalde-Trejo NX, Delgado-Moreno KP, Bonifaz A. Tinea Incognito. Curr Fungal Infect Rep. 2025; 19: 2.
26. Zacharopoulou A, Tsiogka A, Tsimpidakis A et al. Tinea Incognito: Challenges in Diagnosis and Management. J Clin Med. 2024; 13: 3267.
27. Sun D, Lu J, Liu T et al. Wood’s lamp for early detection of Microsporum Canis tinea capitis in children. Photodiagnosis and Photodynamic Therapy. 2025; 51: 104428. https://doi.org/10.1016/j.pdpdt.2024.104428.
28. Rychlik K, Sternicka J, Zabłotna M et al. Superficial Fungal Infections in the Pediatric Dermatological Population of Northern Poland. J Fungi. 2025; 11(7): 533. https://doi.org/10.3390/jof11070533.
29. Wei L, Qiao J. Mini-Review: The Diagnostic Methods of Tinea Capitis. Mycopathologia. 2023; 188: 563-9. https://doi.org/10.1007/s11046-023-00731-3.
30. Fazolin Petrucelli M, Heinzen de Abreu M, Michelotto Cantelli BA et al. Epidemiology and Diagnostic Perspectives of Dermatophytoses. J Fungi. 2020; 6: 310. https://doi.org/10.3390/jof6040310.
31. Gupta AK, Wang T, Lincoln SA et al. Molecular Identification of Etiological Agents in Fungal and Bacterial Skin Infections: United States, 2020–2024. Infect Dis Rep. 2024; 16: 1075-83.
32. Begum J, Mir NA, Lingaraju MC et al. Recent advances in the diagnosis of dermatophytosis. J Basic Microbiol. 2020; 60: 293-303.
33. Rezabek GH, Friedman AD. Superficial fungal infections of the skin. Diagnosis and current treatment recommendations. Drugs. 1992; 43: 674-82.
34. Al-Janabi AAHS, Al-Khikani FHO, Badali H et al. In Vitro Susceptibility Patterns of Clinically Important Trichophyton and Epidermophyton Species against Nine Antifungal Drugs. Mycoses. 2015; 58: 303-7.
35. Zha M, Usaine R. Common Skin Conditions in Children and Adolescents: Nonbacterial Infections. FP Essent. 2024; 541: 20.
36. Kotsulwar NA, Nagoba SN, Malshette RB et al. Formulation, Development and Evaluation of Ciclopirox Olamine Nanogel for the Treatment of Cutaneous Candidiasis. J Neonatal Surg. 2025; 14(32s): 7848-60.