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    Superficial Mycoses: Paramasari D PHD Darukutni DR

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    Sheilla Elfira
    This document summarizes several types of superficial mycoses (fungal infections of the skin and its appendages). It describes the etiology, clinical manifestations, diagnosis, and treatment of dermatophytosis (ringworm infections caused by dermatophyte fungi), pityriasis versicolor (fungal infection of the skin caused by Malassezia furfur), keratomycosis (fungal infection of the cornea), tinea nigra (superficial fungal infection caused by Hortae werneckii), and both black piedra and white piedra (fungal infections of the scalp and facial/body hair, respectively). Diagnosis involves microscopic examination of skin or hair samples and sometimes

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    Superficial Mycoses: Paramasari D PHD Darukutni DR

    Uploaded by

    Sheilla Elfira
    30 views50 pages
    This document summarizes several types of superficial mycoses (fungal infections of the skin and its appendages). It describes the etiology, clinical manifestations, diagnosis, and treatment of dermatophytosis (ringworm infections caused by dermatophyte fungi), pityriasis versicolor (fungal infection of the skin caused by Malassezia furfur), keratomycosis (fungal infection of the cornea), tinea nigra (superficial fungal infection caused by Hortae werneckii), and both black piedra and white piedra (fungal infections of the scalp and facial/body hair, respectively). Diagnosis involves microscopic examination of skin or hair samples and sometimes

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    This document summarizes several types of superficial mycoses (fungal infections of the skin and its appendages). It describes the etiology, clinical manifestations, diagnosis, and treatment of dermatophytosis (ringworm infections caused by dermatophyte fungi), pityriasis versicolor (fungal infection of the skin caused by Malassezia furfur), keratomycosis (fungal infection of the cornea), tinea nigra (superficial fungal infection caused by Hortae werneckii), and both black piedra and white piedra (fungal infections of the scalp and facial/body hair, respectively). Diagnosis involves microscopic examination of skin or hair samples and sometimes

    Copyright:

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    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    30 views50 pages

    Superficial Mycoses: Paramasari D PHD Darukutni DR

    Uploaded by

    Sheilla Elfira
    This document summarizes several types of superficial mycoses (fungal infections of the skin and its appendages). It describes the etiology, clinical manifestations, diagnosis, and treatment of dermatophytosis (ringworm infections caused by dermatophyte fungi), pityriasis versicolor (fungal infection of the skin caused by Malassezia furfur), keratomycosis (fungal infection of the cornea), tinea nigra (superficial fungal infection caused by Hortae werneckii), and both black piedra and white piedra (fungal infections of the scalp and facial/body hair, respectively). Diagnosis involves microscopic examination of skin or hair samples and sometimes

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    SUPERFICIAL MYCOSES

    Paramasari D phD Darukutni dr

    SUPERFICIAL MYCOSES
    Dermatophytosis Pityriasis versicolor Keratomycosis Tinea nigra Black piedra White piedra

    DERMATOPHYTOSIS (=Tinea = Ringworm)


    Infection

    of the skin, hair or nails caused by a group of keratinophilic fungi, called dermatophytes

    Microsporum Epidermophyton Trichophyton

    Hair, skin Skin, nail Hair, skin, nail

    DERMATOPHYTES
    Digest

    keratin by their keratinases Resistant to cycloheximide Classified into three groups depending on their usual habitat

    DERMATOPHYTES
    ANTROPOPHILIC
    GEOPHILIC

    Trichophyton rubrum...

    ZOOPHILIC

    Microsporum gypseum...

    Microsporum canis: cats and dogs Microsporum nanum: swine Trichophyton verrucosum: horse and
    swine

    DERMATOPHYTOSIS Pathogenesis and Immunity


    Contact

    and trauma Moisture Crowded living conditions Cellular immunodeficiency (chronic inf.) Re-infection is possible (but, larger inoculum is needed, the course is shorter )

    DERMATOPHYTOSIS Clinical Classification


    Infection

    is named according to the anatomic location involved: a. Tinea barbae e. Tinea pedis (Athletes foot) b. Tinea corporis f. Tinea manuum c. Tinea capitis g. Tinea unguium d. Tinea cruris (Jock itch)

    DERMATOPHYTOSIS Clinical manifestations


    Skin:

    Circular, dry, erythematous, scaly, itchy lesions Hair: Typical lesions,kerion, scarring, alopecia Nail: Thickened, deformed, friable, discolored nails, subungual debris accumulation Favus (Tinea favosa)

    DERMATOPHYTOSIS Transmission
    Close

    human contact Sharing clothes, combs, brushes, towels, bedsheets... (Indirect) Animal-to-human contact (Zoophilic)

    DERMATOPHYTOSIS Diagnosis
    I. Clinical Appearance Wood lamp (UV, 365 nm) II. Lab A. Direct microscopic examination (10-25% KOH) Ectothrix/endothrix/favic hair

    Tinea corporis

    Tinea capitis

    Gray patch tinea capitis

    Tinea cruris

    Tinea favosa

    kandidosis

    kandidosis

    kandidosis

    kandidosis

    DERMATOPHYTOSIS Diagnosis
    B. Culture Mycobiotic agar Sabouraud dextrose agar

    DERMATOPHYTES Identification
    A. Colony characteristics B. Microscopic morphology

    Macroconidium Microconidium Microsporum---- fusiform---------------(+) Epidermophyton clavate-----------------(-) Trichophyton-- -(few)cylindrical/ --- --(+) clavate/fusiform single, in clusters

    DERMATOPHYTES Identification
    C. Physiological tests
    In

    vitro hair perforation test Special amino acid and vitamin requirements Urea hydrolysis Growth on BCP-milk solids-glucose medium Growth on polished rice grains Temperature tolerance and enhancement

    DERMATOPHYTOSIS Treatment
    Topical

    Miconazole, clotrimazole, econazole, terbinafine... Oral Griseofulvin Ketaconazole Itraconazole Terbinafine

    PITYRIASIS VERSICOLOR
    Superficial

    chronic infection of Stratum corneum Etio: Malassezia furfur


    (Lipophilic yeast) Clinical findings: Hyperpigmented or depigmented maculae on chest, back, arms, abdomen

    (Pityrosporum orbiculare)

    Tinea versicolor

    Tinea versicolor

    PITYRIASIS VERSICOLOR
    Systemic

    infection (parenteral lipid solution) Micr.: Short hyphae, yeast cells Culture: Yeast (suppl.: olive oil) Treatm.: Topical selenium sulfide Oral ketaconazole Oral itraconazole

    KERATOMYCOSIS (=Mycotic keratitis)


    Posttraumatic

    corneal inf. Etio: Saprophytic fungi (Aspergillus, Fusarium,


    Clinical

    / postsurgical

    Alternaria, Candida), Histoplasma capsulatum


    findings: Corneal ulcer

    KERATOMYCOSIS
    Micr.:

    Hyphae in corneal scrapings


    Surgery (keratoplasty) Topical pimaricin Nystatin Amphotericin B

    Treatm.:

    TINEA NIGRA
    Superficial

    chronic infection of Stratum corneum Etio: Hortae (Exophiala) werneckii (pigmented) Frequent in tropical areas Clinical findings: Brownish maculae on palms, fingers, face

    Tinea nigra

    TINEA NIGRA
    Micr.:Septate

    hyphae and yeast cells (brown in color) Culture: Black colonies


    Treatm.:

    Topical salicylic acid, tincture of iodine

    BLACK PIEDRA
    Fungal Etio:

    Piedraia hortae

    infection of the scalp hair

    Frequent in tropical areas Clinical findings: Discrete, hard, dark brown to black nodules on the hair

    BLACK PIEDRA
    Micr.

    Septate pigmented hyphae, and asci; unicellular and fusiform ascospores with polar filament(s) Culture: Brown to black colonies Treatm.: Topical salicylic acid, azol cremes

    WHITE PIEDRA
    Fungal

    infection of facial, axillary or genital hair Etio: Trichosporon (yeast) Frequent in tropical and temperate zones

    WHITE PIEDRA
    Clinical

    findings: Soft, white to yellowish nodules loosely attached to the hair Intertwined septate hyphae, blasto- and arthroconidia Soft, creamy colonies
    Shaving, azoles

    Micr.:

    Culture:
    Treatm.:

    Coba bandingkan

    keratomikosis

    keratomikosis

    Tinea imbricata

    Piedra hitam

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