HISTORY

Fungal organisms have a long history of human infection. The “tinea” infections have historically been refered to as “ringworm”, because of the presentation of lesions as circular or oval areas of clearing within a red, scaly, elevated “ring”. It has only been with the developments in science and medicine in the industrial age that the causal agents were recognized as being microscopic fungi. Taxonomy has only distinguished the dermatophyte organisms most frequently associated with fungal infection (Trichophyton sp., Microsporum sp. and Epidermophyton sp.) since 1934.

In 1958 the first effective oral antifungal agent, griseofulvin, was developed. Following the success of griseofulvin, other oral medications continued to be researched. Ketoconazole was the next major antifungal agent, released in the United States in 1981, followed by fluconazole, terbinafine, and itraconazole within the next decade. These medications are typically classified as azoles (itraconazole, fluconazole, intraconazole, oxiconazole, spectozole, sertaconazole, chlotrimazole, miconazole, bifonazole, sulconazole, ketoconazole) or allylamines (terbinafine, butenafine, naftifine).

Besides the common dermatophyte infections, superficial fungal infections may also result from the Malassezia species of yeast. Malassezia was first recognized as a pathogen in 1846; however, laboratory culture was unsuccessful until 1927, when the lipid requirement of the species was recognized. Initially only two species under the genus name Pityrosporum were described, and only three species were recognized as of 1970.