Superficial fungal infections Review article
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Published:
Nov 30, 2025
Keywords:
superficial fungal infections, fungi, mycoses, dermatophytes, dermatology
Main Article Content
Abstract
Superficial fungal infections are common worldwide, mainly caused by dermatophytes, yeasts (Candida spp.), and occasionally non-dermatophyte molds. They affect about 20–25% of the population, with risk factors including immune deficiencies, environmental conditions, and socioeconomic status. Clinically, they present as well-demarcated, itchy, scaly lesions on smooth skin and the scalp, as well as changes in the nail plates, causing physical discomfort and psychosocial problems. Dermatophytes are classified as anthropophilic, zoophilic, or geophilic, each with unique epidemiology and clinical features. Common infections include tinea capitis, corporis, pedis, cruris, manuum, barbae, and onychomycosis. Diagnosis is based on a clinical examination, which should be supported by microscopic analysis and/or culture, and less commonly by PCR or, in some cases, the use of a Wood’s lamp. Treatment primarily involves the use of topical antifungal agents, such as imidazoles, allylamines, and ciclopiroxolamine, while in severe cases, systemic antifungal therapy is employed. New formulations of antifungal drugs (e.g., nanogels) enhance efficacy and improve treatment adherence. Accurate diagnosis and treatment are essential to prevent recurrences and complications.
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Rychlik, K., Purzycka Bohdan, D., & Nowicki, R. J. (2025). Superficial fungal infections. Medycyna Faktow (J EBM), 18(3(68), 430-437. https://doi.org/10.24292/01.MF.0325.15
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References
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.