Pathogenesis

The normal skin is generally resistant to invasion by dermatophytes. Some species, however are relatively virulent and can even cause epidemic disease, especially in children. In conditions of excessive moisture, dermatophytes can invade keratinized structures, including the epidermis down to the level of the keratin-producing cells. A keratinase enables them to dissolve keratin and use it as a nutrient. Hair is invaded at the level of the hair follicle because the follicle is relatively moist. Fungal products diffuse into the dermis and provoke an immune reaction, which probably explains why adults tend to be more resistant to infection than children. It also explains why some people develop the allergic "id" reactions.

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