cutaneous mycoses
DESCRIPTION
Fungi causing human skin infectionsTRANSCRIPT
CUTANEOUS MYCOSES
CUTANEOUS MYCOSESMycoses - Fungal InfectionsSuperficial MycosesSurface Mycoses Dead layers of skin & its appendagesPityriasis versicolor, Tinea nigra, PiedraCutaneous Mycoses Full thickness of skinDermatophytosisMuco-cutaneous Candidiasis
Subcutaneous MycosesSystemic MycosesOpportunistic Mycoses
DERMATOPHYTOSESDERMATOPHYTESFilamentous fungi infecting superficial keratinised tissues - Skin, Hair and NailDermatomycosis v/s DermatophytosisDermatophytoses = Tinea,Ringworm
GENUSSKINNAILHAIRTRICHOPHYTON+++EPIDERMOPHYTON++_MICROSPORUM+_+
Dermatophytes - morphologyIn Tissues Hypahe & Arthrospores
In Culture Thin, septate, branching hyphaeMicroconidia Small asexual sporesMacroconidia Large asexual spores
Dermatophytes morphology.GENUSCOLONYMICROCONIDIAMACROCONIDIATRICHOPHYTONPowdery/ velvety / waxy
PigmentationAbundantRelatively lessElongated, blunt ends
MICROSPORUMCottony / velvety/ powderyWhite / brown ScantyNumerousSpindle shapedEPIDERMOPHYTON
Powdery,
Greenish yellowAbsentManyPear-shaped in clustersDematophyte speciesTrichophytonT. rubrumT. violaceumT. mentagrophytesT. verrucosum
MicrosporumM. gypseumM. canisM. nanum
Epidermophyton floccosumTrichophyton mentagrophytes
Microsporum canis
Epidermophyton floccosum
Microsporum gypseum
Trichophyton rubrum
PATHOGENESISSOURCE Patient - AnthropophilicAnimal - ZoophilicSoil Geophilic
Grow only in keratinised tissuesDo not penetrate living tissuesFungal products Local inflammationHypersensitivity Distant lesionsCLINICAL PRESENTATIONSRingworm Scaly erythematous lesion with central clearing
CLINICAL PRESENTATIONSTinea capitis
Tinea corporis
CLINICAL PRESENTATIONSTinea barbae(Barbers itch)
Tinea cruris(Jock itch)
CLINICAL PRESENTATIONSTinea pedis(Athletes foot)
Moccasin type of Tinea pedis
Tinea unguium
Tinea imbricata
KerionFavus
Dermatophyte Hair InfectionEctothrixEndothrix
ID Reaction (Dermatophytid)Dermatophyte infection Hypersensitivity ID reaction at a distant site
ID lesions sterile
Disappear after treating the primary lesion
LAB DIAGNOSISSPECIMENS: in sterile paper packetsSkin scrapingsNail clippingsPlucked Hair
WOODs Lamp
MICROSCOPYKOH 10% - Digest keratinCalcofluor white Fluorescent technique
CULTUREOn Sabouraud Dextrose AgarMicroscopic study of growth
TREATMENTLimited infection Topical antifungalsExtensive /widespread lesions Oral antifungals
AZOLES Itraconazole, Clotrimazole, Ketoconazole, FluconazoleGriseofulvin Oral drug of choiceTerbinafineMUCOCUTANEOUS CANDIDIASISCANDIDACandida albicansNon-albicans Candida sppYeast-like fungusPseudohyphaeInfection of skin & mucosa; rarely of internal organs
PathogenesisCandidiasis/ Candidosis/ MoniliasisNormal inhabitant of skin and mucosaDiabetes mellitus MC risk factorOther risk factors AIDS, Steroids, Immunosuppression
Cutaneous CandidiasisMucosal CandidiasisSystemic Candidiasis - rare
CUTANEOUSINTERTRIGINOUSSkin macerated by perspirationGroin, perineum, axillae, inframammary fold
PARONYCHIAFrequent immersion of hands in water
Mucosal candidiasisOral ThrushBottlefed, elderly, etcVaginal candidiasisBalanoposthitisIntestinal candidiasisBronchopulmonary
Lab DiagnosisSPECIMENS:Scrapings, swabs, sputum, blood, etc
Microscopy budding yeast cells, pseudohyphaeCultureGerm tube testCornmeal agar ChlamydosporeSugar assimilation & Fermentation testsAntifungal susceptibility testCULTURESabouraud Dextrose Agar Creamy white, yeasty odour
Germ tube test in plasma
Chlamydospores on Cornmeal agar
Reynold Braude phenomenon
TREATMENTRemoval of predisposing factor
TOPICALNystatinAzoles
SYSTEMICAmphotericin B5 FluorocytocineAzole
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