Fungal infections Dr.Majdy Naim. Majdy Naim Fungal infections of the skin2 Fungal infections Superficial fungal infections ( affecting the skin primarily.
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Fungal infections
Dr.Majdy Naim
Majdy Naim Fungal infections of the skin
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Fungal infections
Superficial fungal infections ( affecting the skin primarily )
Deep fungal infections ( starting in the internal organs and involve the skin secondarily )
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Superficial fungal infections
Dermatophytes Epidermophyton Trichophyton Microsporum
Yeasts Candida Malassezia furfur
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Classification of dermatophytic infections Tinea capitis Tinea corporis ( Tinea circinata ) Tinea faceie Tinea barbae Tinea cruris Tinea pedis Onychomycosis
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Tinea capitis
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Tinea capitis
In general 3 types1. Scaly
2. Kerion
3. Black-dot
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Scaly ringworm
In school children Single or multiple round patches with fine grayisch-white scales The hairs in this area become loos and break off leaving stumps about 3 mm long These stumps are easily pulled out Mainly due to Trichophyton violaceum and Microsporum canis
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Kerion
The patches form follicular pustules, or boggy swelling like an abscess
Causes fall out of the hair May end by scaring and permanent baldness Usually due to fungi of an animal origin
( mainly Trichophyton verrucosum and microsporum canis )
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Kerion
Dr. Majdy Naim
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Kerion ( after 4months therapy)
Dr. Majdy Naim
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Kerion differs from an abscess in:
Less painfull Absence of general symptoms Contains no pus Kerion should not be incised
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Black-dot
The hairs do not form stumps but break of nesr the surface of the follicles
May show slight scaling Caused by Trichophyton violaceum
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Tinea capitis (mode of infection)
Direct Man to Man Animal
Indirect Use of patient‘s fomites Friseur
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Diagnosis of tinea capitis
Clinical examination Woods Light Microskopic examination ( KOH) Culture (Sabourauds agar medium)
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Treatment of tinea capitis
Systemic therapy Essential Griseofulvin for 8 weeks Terbenafen (Lamisil) 6 weeks
Topical therapy Alone useless Antifugal ceams Antifugal shampoo
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Tinea corporis
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Tinea corporis
Seen in any age, but children are most susceptible
Caused by almost all species of trichophyta and microspora
Lesions are annular with central healing and active edge
They are single or multiple, and can be itchy
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Treatment
Topical antifungul By localized moderate cases
Systemic antifungal By extensive or resistant cases
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Tinea Facei
Face except moustache and beard area in adult male
Any part of the face in children
May be steroid modified
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Tinea barbae Deep fungus
infection Adult men Mostly by animal
farmers
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Tinea cruris
More frequently during the summer months most cases caused by Epidermophyton
floccosum and Trichphyton rubrum Affect the upper and inner surface of the
thighs Often extend into the gluteal folds and onto
the buttocks Itching occurs especially in acute types
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Tinea Cruris
AcuteSubacuteChronic
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Tinea Cruris
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Tinea crurisDifferential diagnosis Simple intertrigo Seborrheic dermatitis Candidiasis Erythrasma Flexural psoriasis Contact dermatitis
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Treatment
Topical antifungul By mild to moderate cases
Systemic antifungal By extensive or resistant cases
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Tinea pedis
Most common fungus infection In general a disease of adult life Often in summer months The mode of infection is usually by using
infected socks, shoes or other towels, also from wet floor-boards
Caused mainly Trichophyton interdigitale, T. rubrum Epidermophyton floccosum
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Tinea pedis (Athletes foot)
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Tinea pedis
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Dermatophyte infections
Keratinised epithelium: Tinea corporis Tinea faciale Tinea cruris Tinea manus Tinea pedis
Nails: Tinea unguium (Onychomycosis )
Hairs: Tinea capitis Tinea barbae
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Onychomycosis
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Onychomycosis
Nail may show discoloration, thickining, cracking, subungular hyperkeratosis or onycholysis
One or more nails are involved
May be associated with tinea pedis
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Tinea manuum
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Yeasts infection
Candidiasis Tinea versicolor
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Candidiasis
80 % Candida albicans
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Oral candidiasis
•Thrush
•Angular cheilitis
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Candidiasis
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Candidiasis
Oral candidiasis Thush,Angular stomatitis,Candidal glossitis,Black hairy
tongue Intertriginous candidiasis Genital candidiasis
Vulvovaginal candidiasis, Candidial balanoposthitis Candidal paronychia Napkin candidiasis
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Predisposing factors
Trauma Friction Moisture and sweating Drugs Conditions associated with low resistance
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Pityriasis versicolor
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Pityriasis versicolor
Very common superfacial mycotic infection Caused by malassezia furfur Commonly affects young adults Climatic factors and familial predisposition
appear to be important
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Treatment
Short application of selenium sulfate (10-15 min) for 2 weeks
Topical antifungals as shampoo or cream Systemic antifungals
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