common fungal & parasitic skin infections. superficial fungal infections scabies lieshmaniasis

Common Fungal & Parasitic Skin Infections

Common Fungal & Parasitic Skin Infections

• Superficial Fungal Infections

• Scabies

• Lieshmaniasis

Superficial Fungal Infections

• DERMATOPHYTES

• YEASTS

-Candida sp.

-Pityrosporum.

DERMATOPHYTE

• Dermatophytes group of fungi (ringworm)

have the ability to infect and survive only

on dead keratin on the top layer of the skin

hair and the nails.

CLASSIFICATION

• The ringworm fungi belong to three genera: Microsporum, Trichophyton, and Epidermophyton .

• There are several species of Microsporum and Trichophyton and one species of Epidermophyton .

CLINICAL CLASSIFICATION

• Tinea means fungal infection.• Clinically, dermatophyte infections are classified

by body region:– T.Corporis body– T.Cruris groin– T.Pedis foot– T.Unguium nail– T.Capitis scalp

Tinea corporis

Tinea pedis

tinea capitis

Chronic tinea of the big toe nail.

YEAST

• Candida albicans

• Pityrosporum : pityriasis versicolor

Candida albicans

It is a commensal flora of the gut which become

pathogenic when the immune status of the

person changed

physiological (old age , neonate and pregnancy)

pathological ( DM, HIV and organ transplant)

Long course of Antibiotics

MUCOSAL

1. Oral

oral thrush

angular chilitis

2. Genital candidiasis

• Oral candidiasis: thrush can be removed by rubbing with gauze

Candidiasis of the tongue

Angular cheilitis

• Candida groin infection.

Pityriasis versicolor

• Pityrosporum orbiculare

• Asypmtomatic• Well demarcated

brown patches with branny over the trunk and upper extremities

Mycetoma (Madura foot)

• Various species of fungus or actinomycetes may be involved.

• They gain access usually to the feet or legs, via a penetratng wound.

• The area becomes lumpy and distorted,aterenlarging and developing multiple sinuses.

• Pus exuding from these shows tiny diagnostic granules.

Treatment

• Surgery

• Systemic antibiotics or antifungal drugs, depending on the organism isolated

Investigation Fungal Infections

• Scraping clipping and Hair sampling

• KOH/microscoy• Skin biopsy

Histopathology with PAS stain

• Culture• Wood's lamp

• Tinea capitis with positive Wood's lamp

Treatment

Topical Antifungal– Nystatin preparation (oral thrush)– Imidazoles e.g. cotrimazole

Systemic Antifungal

– Itraconazole and fluconazole– Allylamine e.g. Terbinafine– Griseovulvin

Indication of systemic treatment:

1.Tinea Capitis

2. Paronychia and Onychomycosis

3. Failure to respond to topical treatment

4. Immunocompramized pts.

5. Atypical presentations.

Scabies

Mite sarcoptes scabei

burrows in the stratum corneum laying eggs and the eggs will maturate 2 weeks period and the cycle repeated.

Skin lesions are Secondary eczematous eruption due to immune reaction to the mite and eggs

Sarcopte’s scabiei burrow in the skin

Pruritus and skin eruption is more severe in the flexors mainly at night

Other member of the family having severe pruritus

Vesicles in the finger webs

Diffuse scabies on an infant the lesions are most numerous around the axillae, chest,

and abdomen.

Scabies vesicles and papules in the fingerwebs and on the back of the hand

TREATMENT

• Permethrin cream

• Treat all close family whether itchy or not

PEDICULOSIS

Head lice (Pediculosis Capitis)

Children

Body lice (Pediculosis Corporis)

Pubic lice (Pediculosis Pubis)

STD ( partner should be treated)

• Spread from person to person is achieved by head-to-head contact and shared combs or hats

• The main symptom is itching.

• the hair becomes smelly. Draining lymph nodes often enlarge

• Secondary bacterial infection may be severe enough to make the child feverish.

The diagnosis can be conformed by seeing the lice eggs ( NITs)

Treatment

Permethrin creame rinse

Malathion lotion

Lieshmaniasis

• Leishmaniasis a disease caused by Leishmania parasites.

• It is transmitted to humans by a sandfly

Sandfly is one third the size of a mosquito.

Lieshmaniasis

Localized Cutaneous Well-demarcated ulcerated nodule over the exposed areas.

Disseminated Cutaneous

Mucocutaneous

Visceral

Diagnosis

• Skin biopsy

• Histopathology with Gimsa stain

• Culture

• PCR for DNA

Treatment

• Skin usually resolve but leaving a scar

• Pentostam either intralesional or intramuscular to shrink the lesion.

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