Superficial mycosis Superficial mycosis Maculae Maculae Papule Papule Vesicle Vesicle Bulla Bulla Pustule Pustule Nodule Nodule Fistula Fistula Scale Scale
Feb 25, 2016
Superficial mycosisSuperficial mycosis
MaculaeMaculaePapulePapuleVesicleVesicleBullaBullaPustulePustuleNodule Nodule FistulaFistulaScaleScale
Superficial mycosisSuperficial mycosis
DefinitionDefinitionFungiFungi Pityriasis versicolorPityriasis versicolor Tinea nigraTinea nigra PiedraPiedra
BacteriaBacteria ErythrasmaErythrasma Trichomycosis axillarisTrichomycosis axillaris
Superficial mycosisSuperficial mycosis
OtomycosisOtomycosisKeratomycosisKeratomycosisPitted keratolysisPitted keratolysisDermatophylosis Dermatophylosis
Pityriasis versicolorPityriasis versicolor
Tinea versicolorTinea versicolorMaculaeMaculaeMalassezia sppMalassezia sppNormal floraNormal floraBoys & girlsBoys & girlsAfter maturationAfter maturationBeautyBeautyWarm & humidity Warm & humidity SeasonSeason
Pityriasis versicolorPityriasis versicolor
Conditions:Conditions: HealthHealth SweatSweat Greasy skinGreasy skin IC.IC. Chronic bacterial infectionsChronic bacterial infections SteroidsSteroids
Pityriasis versicolorPityriasis versicolorClinical manifestations:Clinical manifestations: MaculaeMaculae White, cream, pink, red, White, cream, pink, red,
brownbrown PositionPosition ScaleScale PainlessPainless Not itchingNot itching
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Pityriasis versicolorPityriasis versicolor
Differential diagnosis:Differential diagnosis: VitiligoVitiligo ChloasmaChloasma
Pityriasis versicolorPityriasis versicolor
Laboratory diagnosis:Laboratory diagnosis:
SamplingSampling ScalpelScalpel Scathe tapeScathe tape Wood ́s lampWood ́s lamp
DirectDirect
Culture Culture
Pityriasis versicolorPityriasis versicolor
TreatmentTreatment Selenium sulfide Selenium sulfide Clotrimazole Clotrimazole
Tinea nigraTinea nigra
Phaeoanellomyces werneckiiPhaeoanellomyces werneckii Exophiala werneckiiExophiala werneckii
EcologyEcologyPalmPalmTinea nigra palmarisTinea nigra palmaris
Tinea nigraTinea nigra
Clinical manifestation:Clinical manifestation:
Annular Annular CentrifugeCentrifugeRegular or irregularRegular or irregular
PainlessPainless
No itching No itching
Tinea nigraTinea nigra
Differential diagnosis:Differential diagnosis: Malignant melanomaMalignant melanoma Silver nitrateSilver nitrate
Tinea nigraTinea nigra
Laboratory diagnosis:Laboratory diagnosis: Sampling:Sampling:
Scalpel & KOH10%Scalpel & KOH10% Direct:Direct:
HyphaeHyphaeChlamydioconidiaChlamydioconidia
Culture:Culture:SS
Tinea nigraTinea nigra
TreatmentTreatment Keratolytic ointmentKeratolytic ointment
whitfieldwhitfield
PiedraPiedra
HairHairNodule Nodule Bread, groin, axillarBread, groin, axillarWhite & blackWhite & black
PiedraPiedra
Clinical manifestation:Clinical manifestation: White piedra:White piedra:
Trichosporon beigeliiTrichosporon beigelii BasidiomycetesBasidiomycetes
NoduleNodule Bread, head, pubisBread, head, pubis White, brown, yellow, White, brown, yellow, Soft Soft
PiedraPiedra
Clinical manifestation:Clinical manifestation: Black piedra:Black piedra:
Piedra hortaePiedra hortae AscomycetesAscomycetes
NoduleNodule HeadHead ThickThick Black to brown Black to brown
PiedraPiedra
Differential diagnosis:Differential diagnosis: Pediculosis Pediculosis
PiedraPiedra
Laboratory diagnosis:Laboratory diagnosis: Sampling:Sampling:
Sesser & KOH10%Sesser & KOH10% Direct:Direct:
White:White: hyphae & arthroconidia hyphae & arthroconidiaBlack:Black: ascus & ascospore ascus & ascospore
Culture:Culture:SS
PiedraPiedra
Treatment:Treatment: ScrapingScraping Clotrimazole Clotrimazole
ErythrasmaErythrasma
BacteriaBacteriaCorynebacterium minutissimumCorynebacterium minutissimumChronicChronicIntertrigenousIntertrigenous
ErythrasmaErythrasma
Clinical manifestation:Clinical manifestation: MaculaeMaculae
Red or brownRed or brown
ScaleScale
ItchingItching
No inflammationNo inflammation
Superficial mycosisSuperficial mycosis
ErythrasmaErythrasma
Superficial mycosisSuperficial mycosis
ErythrasmaErythrasma
Superficial mycosisSuperficial mycosis
ErythrasmaErythrasma
Superficial mycosisSuperficial mycosis
ErythrasmaErythrasma
ErythrasmaErythrasma
Differential diagnosis:Differential diagnosis: Pityriasis versicolorPityriasis versicolor CandidiasisCandidiasis Tinea crurisTinea cruris
ErythrasmaErythrasma
Laboratory diagnosis:Laboratory diagnosis: Sampling:Sampling:
Scalpel & simple stainingScalpel & simple staining Direct:Direct:
StrandStrand Culture:Culture:
BHI, Blood agarBHI, Blood agar Wood ́s lampWood ́s lamp
ErythrasmaErythrasma
TreatmentTreatment Erythromycin Erythromycin
Trichomycosis axillarisTrichomycosis axillaris
BacteriaBacteriaCorynebacterium tenuisCorynebacterium tenuisNodule Nodule HairHair Axillaries & pubisAxillaries & pubis RedRed YellowYellow blackblack
Trichomycosis axillarisTrichomycosis axillaris
Differential diagnosis:Differential diagnosis: PediculosisPediculosis
Trichomycosis axillarisTrichomycosis axillaris
Laboratory diagnosis:Laboratory diagnosis: Sampling:Sampling:
Sesser & KOH10%Sesser & KOH10% DirectDirect CultureCulture
Trichomycosis axillarisTrichomycosis axillaris
TreatmentTreatment Scraping and sulphur ointment 3%Scraping and sulphur ointment 3%
KeratomycosisKeratomycosis
INCIDENCE OF INCIDENCE OF FKFK
Developed worldDeveloped world 6 -35% of all microbial keratitis6 -35% of all microbial keratitis
Developing worldDeveloping world 22 - >50%22 - >50%
FUNGAL GROUPSFUNGAL GROUPS
FilamentousFilamentous FusariumFusarium
AspergillusAspergillusDematiaceousDematiaceous
YeastsYeasts CandidaCandida
Fungal KeratitisFungal Keratitis
Risk factors:Risk factors: Topical corticosteroids ↓corneal resistance to Topical corticosteroids ↓corneal resistance to
infectioninfection Contact lens use Contact lens use Immunocomprised states Immunocomprised states
Fungal KeratitisFungal KeratitisRisk factorsRisk factors Injury, ocular surface compromiseInjury, ocular surface compromise TemperatureTemperature WindWind HumidityHumidity Urbanisation/employmentUrbanisation/employment
Fungal KeratitisFungal Keratitis
ExogenExogenEndogen Endogen
Fungal KeratitisFungal Keratitis
Gray-white color, dry, and rough corneal Gray-white color, dry, and rough corneal surfacesurface White ring in the cornea and satellite White ring in the cornea and satellite lesions near the edge of the primary lesions near the edge of the primary Most cases remain superficial Most cases remain superficial but deep invasion may but deep invasion may occuroccur
DIAGNOSISDIAGNOSIS
Clinical features (diff.diagnosis)Clinical features (diff.diagnosis)
MicrobiologyMicrobiology
HistopathologyHistopathology
DNA amplificationDNA amplification
HISTOPATHOLGYHISTOPATHOLGY
Haematoxylin and eosin (H&E)Haematoxylin and eosin (H&E)
Periodic acid-Schiff (PAS)Periodic acid-Schiff (PAS)
GrocottGrocott
Fungal KeratitisFungal Keratitis
Treatment: Treatment: Natamycin 5% drops (filamentous)Natamycin 5% drops (filamentous)
Works particularly well Fusarium sppWorks particularly well Fusarium spp Amphotercin B 0.15-0.30% (Candida)Amphotercin B 0.15-0.30% (Candida) Most effective for yeastMost effective for yeast
Otomycosis Otomycosis
OtomycosisOtomycosis
Bacterial, viral or fungal infection of Bacterial, viral or fungal infection of external auditory canalexternal auditory canalCategorized by time courseCategorized by time course AcuteAcute ChronicChronic
Swimmer’s earSwimmer’s ear
OrganismsOrganisms
1.1. FungiFungi1.1. AspergillusAspergillus2.2. CandidaCandida species species
2.2. PseudomonasPseudomonas species species 3.3. Staphylococci Staphylococci 4.4. StreptococciStreptococci5.5. Gram negative rodsGram negative rods
Risk FactorsRisk Factors
High humidityHigh humidityWater exposureWater exposureHigh environmental temperatureHigh environmental temperatureLocal traumaLocal traumaAllergyAllergyStressStressAlkaline pH of canalAlkaline pH of canal
OtomycosisOtomycosis
Often indistinguishable from bacterial OEOften indistinguishable from bacterial OEDull painDull painHearing loss (obstructive)Hearing loss (obstructive)
OtomycosisOtomycosis
TreatmentTreatmentThorough cleaning and drying of canalThorough cleaning and drying of canalTopical antifungals Topical antifungals ClotrimazoleClotrimazole
Acidifying of the EAC with drops likeAcidifying of the EAC with drops like 2% acetic acid2% acetic acid 3% boric acid3% boric acid
درماتوفیلوزیسدرماتوفیلوزیسمترشحه، چرکمترشحه، چرکحیوانحیوانانسانانسانپوسته و دلمهپوسته و دلمهاسکار و آلوپسیاسکار و آلوپسیمسریمسری
درماتوفیلوزیسدرماتوفیلوزیسDermatophilus congolonsisDermatophilus congolonsisاکتینومایستاکتینومایستگوسفند و دامگوسفند و دامپارازیت پوستپارازیت پوستفصل بارانیفصل بارانیتماس مستقیمتماس مستقیمLumpy woolLumpy wool
عالئم بالینیعالئم بالینیاپیدرماپیدرمزخم های کم عمقزخم های کم عمقاگزودااگزوداکدر شدن موکدر شدن موریزش دلمهریزش دلمهبهبودبهبودآلوپسیآلوپسی
تشخیص آزمایشگاهیتشخیص آزمایشگاهیگیریگیری نمونهنمونه
پوسته و ترشحاتپوسته و ترشحاتمستقیممستقیم
رنگ آمیزیرنگ آمیزیمتیلن بلومتیلن بلوگیمساگیمسا ،میکرون میکرون55- - 22رشته های منشعب، رشته های منشعب
88 کوکسی کوکسی کشتکشت
بالد آگاربالد آگار3737درجه درجه
تشخیص آزمایشگاهیتشخیص آزمایشگاهیکاتاالز مثبتکاتاالز مثبتاوره آز مثبتاوره آز مثبتاسید فست منفیاسید فست منفیهیدرولیز نشاسته مثبتهیدرولیز نشاسته مثبت
درماندرمانسولفات مسسولفات مس درصد/ درصد55سولفات روی سولفات روی /پنی سیلینپنی سیلین
کراتولیز حفره ایکراتولیز حفره ایPitted keratolysisPitted keratolysisالیه شاخی کف پاالیه شاخی کف پاضایعات سطحی گردضایعات سطحی گرد
عامل بیماریعامل بیماریاکتینومایستاکتینومایستنوکاردیانوکاردیادرماتوفیلوسدرماتوفیلوسکورینه باکتریومکورینه باکتریوم
عوامل مستعد کنندهعوامل مستعد کنندهرطوبترطوبتگرماگرمارعایت نکردن بهداشترعایت نکردن بهداشتچکمهچکمهپوتینپوتین
عالئم بیماریعالئم بیماریالیه های سطحی کف پاالیه های سطحی کف پاانگشتان و پاشنه پاانگشتان و پاشنه پاتجزیه کراتینتجزیه کراتینضایعات سطحی گردضایعات سطحی گردبوی نامطبوعبوی نامطبوع
تشخیص آزمایشگاهیتشخیص آزمایشگاهینمونه گیرینمونه گیری
پوستهپوستهمستقیممستقیم
پتاس و رنگ آمیزیپتاس و رنگ آمیزیرشته و کوکسیرشته و کوکسی
کشتکشتمشکل استمشکل است
درماندرماناز بین بردن شرایط مستعد کنندهاز بین بردن شرایط مستعد کننده درصد درصد4040 تا تا 2020فرمالین فرمالین