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Older adults are more susceptible to fungal infections due to weak immunity. Opportunistic fungi target the elderly more and make colonies. Those who have undergone transplantation, chemotherapy or are under certain medications are more likely to be affected by fungal infections.

Though the symptoms of fungal infections in young and older people are the same, there are certain aspects of the infection that are unique to the elderly. In most cases, treatment with antifungal medicines may not be recommended because they are mostly nephrotoxic, i.e. harmful for kidneys. Even milder drugs need to be administered carefully because older adults have a tendency to get adverse reactions to antifungal drugs.

Here are some common fungal infections in the elderly:

1. Cutaneous candidiasis: This infection is caused by Candida albicans. It is usually found in folds of skin. Candidiasis is more common in older adults with diabetes or obesity. Other factors causing candidiasis are the use of antibiotics, immunosuppressive drugs, topical corticosteroids, poor nutrition, and immunosuppression. Candidiasis is usually well defined, red and slightly scaly skin with pustules. It most commonly occurs in the axilla, groin, breasts and under the stomach in obese persons. The skin may also crack and be macerated. Oral candidiasis or thrush may occur in a number of older adults. In these cases, a layer of plaque forms in the mouth cavity and the tongue over fungal infections. These may be very painful in some cases.

2. Angular Cheilitis:  When a fungal infection occurs on the joints of the mouth, it can cause very painful lacerations called angular cheilitis. It is very common in older adults. It is caused by the Candida fungus. Older adults with diabetes, immune disorders, and cancers of some types are more susceptible to getting angular cheilitis. Angular cheilitis is contagious and can spread by kissing or not washing hands after touching the affected area. A condition called dental stomatitis is related to cheilitis. In this, there is fungal infection beneath dentures.

3. Infection between finger webs: Fungal infection on the web spaces between fingers is called erosio interdigitalis blastomycetica or interdigital candidiasis. It happens most often on the web between the middle and ring fingers. In some cases, toes are affected, too. This type of fungal infection can be very painful. It is also contagious. People who work for a long time in wet conditions like launderers, dishwashers, bartenders, and homemakers are more susceptible to this fungal infection. In general, exposing skin to skin irritants and moisture for a long time can lead to the skin barrier to break down and allow entry to the fungus Candida. Rings are formed to hold moisture in the colony. Older adults with diabetes or those using immunosuppressive corticosteroids.

4. Nail fungus: The chance of contracting nail fungus or onychomycosis increases with age. Where 1% of younger people are likely to be affected by this, up to 19% of people in the age group of 60-79 years are susceptible to developing this infection. More men are affected by this condition than women. The causes of this infection are diabetes mellitus, psoriasis, heredity, peripheral vascular disease and the use of immunosuppressive drugs. Onychomycosis affects the toenail most often, though it can be found on the nails of the hand too. There are four types of onychomycosis: distal subungual onychomycosis, proximal subungual onychomycosis, white superficial onychomycosis, and candidal onychomycosis. In this condition, the affected nail becomes discolored and in some cases, friable.

5. Tinea Pedis: Tinea Pedis is also known as Athlete’s foot. It occurs commonly in older adults. It is found in the form of macerations between toe folds and scaly plaques on the feet. Tinea Pedis is also associated with dry skin (xerosis).

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