Skin Fungal Infections in Children: Diagnostic Challenges
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PEDIATRIC FUNGAL INFECTIONS (D CORZO LEON, SECTION EDITOR)
Skin Fungal Infections in Children: Diagnostic Challenges Maria Teresa García-Romero 1 & Gabriela Sánchez-Cardenas 2 & Silvia Angélica Carmona-Cruz 1 & Mónica Fernández-Sánchez 3 Accepted: 12 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Children are usually affected by superficial mycoses; however, subcutaneous mycoses are rarer and difficult to diagnose since their presentation, risk factors, epidemiology, and probably pathophysiology sometimes differ from adults. This article provides an updated overview of skin fungal infections affecting children, their clinical manifestations, and practical approaches for a correct diagnosis and management. Recent Findings Skin fungal infections in children have increased in number in the last decades. The majority of children suffer from one at least one time during infancy. This is probably the result of changing lifestyles, and immunosuppression (such as HIV, transplants, neoplastic diseases, and iatrogenic immunosuppression). Summary Children can suffer from a superficial fungal infection (skin, nails, and hair), which usually is easily diagnosed and amenable to treatment; but subcutaneous fungal infections may cause difficulties in diagnosis and treatment. The incidence rate is increasing at an alarming rate and available treatments should be chosen carefully in order to avoid future resistance. Keywords Skin infections . Fungal infections . Infections in children . Superficial mycosis . Subcutaneous mycosis
Introduction Fungal infections are common in humans, causing a wide range of diseases, and children are frequently affected. There are thousands of fungi on earth, but few of them are pathogenic. These fungi can invade superficial tissues causing infections involving the outer layer of the skin and subcutaneous tissue, or be disseminated, causing systemic infections involving the lungs, heart, brain, kidneys, and other viscera. Generally, mycoses are acquired from the environment (soil, plants) since fungi are saprophytes in the form of free spores and filaments. [1, 2] Subcutaneous mycoses usually have an
This article is part of the Topical Collection on Pediatric Fungal Infections * Mónica Fernández-Sánchez [email protected] 1
Department of Dermatology, National Institute of Pediatrics, Mexico City, Mexico
2
American British Cowdray Medical Center, Mexico City, Mexico
3
Department of Dermatology, National Institute of Respiratory Diseases, Calz. de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080 Mexico City, Mexico
associated previous skin trauma with inoculation of the fungus while systemic mycoses usually are acquired through the respiratory tract, gastrointestinal tract, or blood vessels (rarely from direct inoculation of the skin) with lymphatic or hematogenous dissemination. There is evidence of natural resistance by the host mediated by genetics, hormonal, and nutritional factors as well as sex and age. Skin
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