Fungal Skin Infections.

Candidal diaper dermatitis is the most common fungal infection of childhood. This yeast infection almost always secondarily invades diaper-area skin that has been damaged by an irritant contact dermatitis from maceration, urine, and/or stool. Children in the preschool-age group who no longer wear diapers are more likely to develop tinea infections, particularly tinea capitis. Tinea refers to dermatophyte infections in the epidermis and areas high in keratin, such as the hair and nails. In prepubertal children, tinea capitis and tinea corporis are most common; in adolescence, tinea pedis (TP), tinea cruris, and tinea unguium (onychomycosis) are more common. (1) Yeast infections other than candidal diaper dermatitis, including pityriasis versicolor (PV) (formerly known as tinea versicolor) and mucocutaneous candidiasis (MC), may also occur. Chronic MC (CMC) is a rare, usually inherited disorder. PVis a common infection in adolescents and adults that usually affects the sebum-prone areas (face, chest, back). Fungal infections can be a substantial source of morbidity in the pediatric population, accounting for about 15% of pediatric outpatient visits in the United States. (2) This article reviews the epidemiology and clinical presentations of tinea infections (capitis, corporis, pedis, cruris, unguium), PV, and MC in children. The AUTHOR DISCLOSURE Dr A. Gupta has disclosed that he is on the Speakers’ Bureaus of Valeant, Janssen, Novartis, and Bayer; he is a consultant for Anacor, Sandoz, and Moberg Pharma; and he is a clinical trials investigator for Valeant Canada, Nuvolase, Bristol Meyers Squibb, Eli Lilly, Merck, Novartis, Janssen, and Allergan. Ms MacLeod and Dr Foley have disclosed that they are employees of Mediprobe Research, Inc, which conducts clinical trials under the supervision of Dr. A. Gupta. Drs G. Gupta and Fallon Friedlander have disclosed no financial relationships relevant to this article. This commentary does contain a discussion of an unapproved/ investigative use of a commercial product/ device.