Professor Dr. Md Uzire Azam Khan*


Fungal skin infections are common causes of skin disease in most age groups. They include three main diseases- dermatophytosis or ringworm infections, candidiasis, and pityriasis versicolor. Though these infections are rarely dangerous for life, they are important because of their world wide distribution. As Bangladesh is situated in the tropical region its people are susceptible to superficial fungal infection (SFI).[1] Rahman et al. (2011)[2] found 17.5% fungal infection in patients with skin ailments in rural areas of Bangladesh. In another study in Banganbandhu Sheikh Mujib Medical University Rahim et al (2012)[3] revealed Tinea rubrum as the most common etiological agent (80.6%) followed by T. mentagrophytes (8.2%) and Epidermophyton floccosum (5.2%). The incidence of fungal infections is increasing at an alarming rate, presenting an enormous challenge to healthcare professionals.[4] World Health Organization estimates dermatophytes affect about 25% of the world population.[5] It is also estimated that 30 to 70% of adults are asymptomatic carriers of these pathogens, and that the incidence of this disease increases with age.[5] Recently, clinical failure and relapses have been observed in patients treated with antifungals. Early recognition and treatment is essential to reduce morbidity and possibility of transmission.[5] Risk factors associated with SFI are extreme age, genetic factors, global warming, migration of laborers, increased frequency of wearing tight and synthetic clothing, obesity, poor hygiene conditions and some diseases such as diabetes mellitus and immunodeficiency.[6,7] The random abuse of topical steroid and antifungal combination creams by the patients, who mostly purchase them over the counter (OTC) or according to the advice of the practitioners is considered to be reasons for the sudden surge of this infection. If a cutaneous dermatophyte infection is initially treated with a topical corticosteroid the typical appearance of the infection may be altered making its diagnosis more difficult (ie, tinea incognito). So the use of combined antifungal and corticosteroid products that include medium or high potency corticosteroid is discouraged because corticosteroid therapy is not necessary for achieving cure and its use induces risk of corticosteroid induced skin atrophy.[8]

Keywords: Superficial fungal infection, responsibility, concern authority.

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