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Feature Article

Fungal infections of the skin: a guide for GPs

Alan Watson

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Abstract

Fungal infections of the skin are a common diagnostic and therapeutic problem seen in general practice. Over-the-counter availability of all antifungal preparations has increased the need for GPs to be aware of partially treated or inappropriately treated fungal infections.

Key Points

  • Increased availability of antifungals means that GPs will see more patients partially treated for, or incorrectly diagnosed with, fungal disease.
  • Beware of diagnostic pitfalls, including ring-shaped lesions that usually are not fungal and lesions that are altered by treatment.
  • Topical therapy often fails because of insufficient treatment time, inadequate area of application, involvement of hair follicles and difficult-to-treat areas, such as the plantar surface of the foot.
  • Rural practitioners should be aware of infection with animal- or soil-based fungi that produce a more dramatic inflammatory reaction in humans (kerion).

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