KARACHI: Plagued by chronic itching all over her body that has been giving her sleepless nights for the past many weeks, Gulnar, a woman in her late 20s, reported to a dermatologist for the first time at the government-run Sindh Institute of Skin Diseases (SISD) on Tuesday.

The small room where she stood waiting for her turn had many other patients with similar complaints. Her face looked pale and weary.

`It`s not just me at home suffering from chronic itching. My brother, his wife and their children have been living with this problem for the past many years. I developed it almost a year ago, she told Dawn.

A resident of Ibrahim Hyderi, Gulnar and her family have been to various doctors in her locality to get treated for the skin infection but so far they have found no cure.

`In fact, itching has worsened in my case as I am unable to carry on with routine life. Look, I have got red, raised spots and pimples all over my body, she said, showing her arm with a ringshaped red patch.

Pregnant with her second child, Sumaira, a resident of Korangi, had the same skin infection. `My whole family hadit butthey gotrecovered aftertheyused some medicines on doctor`s advice. However, I was told not to use them in pregnancy,` she said, adding that the rash also triggered a burning sensation.

According to Dr Mahwish Noorani at the SISD, both patients suffered from Tinea corporis caused by mould-like fungi called dermatophytes that thrive in warm, moist areas.`It`s more common in the summer though we are still getting patients with this contagious skin ailment.

Many of these cases involve pregnant women with extensive infection.

Ideally, oral medications should be avoided in pregnancy but at times the infection is so severe that we have no other option,` she said.

According to experts at the SISD, thenumber of patients reporting with fungal infections has increased dramatically over the years. They attribute this rise to increasing poverty, lack of basic amenities, especially persistent water shortage, low nutritional level, overcrowded and unhygienic living conditions, lack of ventilation at homes and high humidity in air.

`We all know that poverty hasincreased and there is a serious water crisis, especially in Karachi. In conditions where people can`t have proper meals and buy water to drink, how they could afford to bathe regularly?` said Dr Sadiq Sadruddin, a senior skin consultant.

Sharing the data of SISD, the only public sector health facility in the province solely dedicated to skin ailmentsand which receives patients from Balochistan as well, additional director of the institute Dr Iqbal Nabi Soomro said that a significant number of cases of the total 3,000 to 5,000 patients, who daily reported at the outpatient department, were of fungal infections.

`Earlier, we used to have 35pc patients with scabies and 10pc fungal infections.

But now we have 35pc fungal infection cases and the number of scabies patients has gone down to 15pc,` he said.

He was of the opinion that production of an effective formulation therapy for scabies at the institute, short duration of recovery (normally two weeks) and patient counseling at the institute had brought the number of scabies down.

`But fungal infections minimally require three to six weeks to recover. It can also relapse with more severity if patient fails to follow the recommended guidelines for treatment.

`Besides, often we get cases mishandled by general practitioners. In such cases, the infection loses its classic features but we know that it`s the fungus damaging the skin.` Experts, however, believe that a scientific study should be carried out to determine the factors behind the rise in fungal infections in the city. Besides, there is a dire need for government efforts to improve living conditions and creating public awareness on the importance of hygiene