Is My Skin Condition a Fungal Infection? Expert Advice Needed

Doctor Wu, could my skin issue be a fungal infection? Can I purchase medication at the pharmacy for self-treatment?

Dear Dr.
Wu/Director,
In recent years, my skin has developed red, spot-like rashes every autumn and winter.
I have attached a photo of the affected area for your review: https://photos.app.goo.gl/uGDcMxejaA4oFQwJ6.
Initially, I thought the spots were scattered, but upon closer inspection, I noticed that the red dots/patches actually form circles that do not connect.
These circles vary in size and are interspersed across the dorsum of my feet and calves.
In severe cases, the entire lower extremities (including the buttocks) exhibit these red dots/patches, although they are smaller and lighter in color.
The areas from the toes to the soles are more intensely red.
Typically, there is little itching, but it becomes more pronounced in colder, drier conditions.
Some spots also appear on my wrists.
Each red dot/patch spreads very slowly, but the rate of spread varies, with the sides of the calves and the calf area being more prone to enlargement.
I wonder if this could be related to the thermal clothing made of polyester fibers that I wear in the autumn and winter, which may not be breathable.
I have had skin issues since childhood, including conditions like dyshidrotic eczema and psoriasis, and my skin has always had problems that have not been resolved.
I would appreciate your professional insights on this matter.
Thank you!

Miss Tang, 30~39 year old female. Ask Date: 2021/01/10

Dr. Wu Yuxin reply Dermatology

Medical regulations state that "a physician must personally examine a patient before providing treatment or prescribing medication..." Therefore, online diagnosis is also not permissible.
If you are experiencing significant distress, it is advisable to seek medical attention as soon as possible.

Reply Date: 2021/01/10

More Info

Based on the symptoms you've described, it is possible that your skin condition could be related to a fungal infection, but it is also important to consider other dermatological conditions that could present similarly. The circular red spots you mentioned, especially if they are not itchy and tend to appear in colder, drier weather, could indicate a few different issues.

Fungal infections, such as tinea corporis (ringworm), can present as circular, red, and scaly patches on the skin. These patches often have a clearer center and can be itchy, but not always. The fact that your symptoms worsen in cold and dry conditions could suggest a combination of factors, including dry skin or a reaction to the materials of your clothing, particularly if you are wearing synthetic fabrics like polyester that do not allow the skin to breathe.

Given your history of skin conditions such as eczema (often referred to as "富貴手" or "wealthy hand" dermatitis) and psoriasis, it is also possible that what you are experiencing could be a flare-up of one of these chronic skin conditions. Eczema can lead to dry, red patches that may become more pronounced in colder weather, while psoriasis can also present as red, scaly patches that may be circular or oval in shape.

To determine the exact cause of your skin condition, a thorough examination by a dermatologist is essential. They may perform a physical examination and possibly a skin scraping or biopsy to rule out fungal infections or other skin disorders.
In the meantime, here are some general recommendations that may help alleviate your symptoms:
1. Moisturize Regularly: Use a good quality, fragrance-free moisturizer to keep your skin hydrated, especially during the colder months when the air tends to be drier.

2. Choose Breathable Fabrics: Opt for natural fibers like cotton instead of synthetic materials that can trap moisture and heat against the skin, potentially exacerbating irritation.

3. Avoid Hot Showers: Hot water can strip the skin of its natural oils, leading to increased dryness. Try to take lukewarm showers and limit your bathing time.

4. Use Gentle Cleansers: Choose mild, fragrance-free cleansers that won’t irritate your skin. Avoid harsh soaps that can exacerbate dryness.

5. Monitor for Changes: Keep an eye on your skin condition and note any changes or patterns, such as when the symptoms worsen or improve. This information can be helpful for your dermatologist.

6. Consider Allergy Testing: If you suspect that your clothing or other environmental factors may be contributing to your skin issues, discussing allergy testing with your dermatologist could be beneficial.

In conclusion, while your symptoms could potentially indicate a fungal infection, they may also be related to other dermatological conditions or environmental factors. A professional evaluation is crucial for an accurate diagnosis and appropriate treatment plan. Please consult with a dermatologist as soon as possible to address your concerns and receive tailored advice for your skin condition.

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