dermatophytosis cutaneous mycosis dermatomycosis –yeast –saprophytes –systemic mycosis...
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Dermatophytosis
• Cutaneous mycosis
• Dermatomycosis– Yeast– Saprophytes– Systemic mycosis– Dermatophytes
•Dermatophytosis
Dermatophytosis
• Definition
• Greek
• English
• Persian
• Dermatophytes
Dermatophytosis
• Dermatophyte– Sexual
• Arthroderma
– Asexual• Macroconidia
–Trichophyton–Microsporum–Epidermophyton
Dermatophytosis
• Trichophyton– Cylinder
• Microsporum– Spindle
• Epidermophyton– Club
Dermatophytosis
• Trichophyton– T.rubrum, T.mentagrophytes, T.violaseum,
T.schoenleinii, T.verrucosum
• Microsporum– M.canis, M.gypseum
• Epidermophyton– E.floccosum
Dermatophytosis
• Geophilic – M.gypseum
• Zoophilic– M.canis, T.verrucosum
• Anthropophilic – T.rubrum, T.violaseum, T.schoenleinii
E.floccosum
Dermatophytosis
• Tinea capitis
• Tinea barbae
• Tinea cruris
• Tinea pedis
• Tinea mannum
• Tinea corporis
• Tinea unguium
Tinea capitis
• Definition• Trichophyton & Microsporum• Clinical manifestation• Crust
– Krion– Scatulum
• Age• Genus• Ectothrix, Endothrix, Favus
Ectothrix
• Outside • Krion• Cuticle• Gray patch • Age• Genus• After maturation • M.canis, M.audouinii,
T.verrucosum, T.mentagrophytes
M.canis• Zoophilic• Dog & cat• Yellow • Microconidia Few• Macroconidia
– Thick wall– Knob
M.gypseum
• Geophilic• Favus( may be) • Red • Don't have knob
Endothrix
• Inside • Cuticle• Black dot, bald patch • Age• Genus• After maturation • Anthropophilic
– T.violaceum, T.sudanense, T.tonsuranse
Favus
• Hyphae (Air canal) lustreless
• scatulum
• Age
• Genus
• After maturation
• Cheesy or mouse judder
• T.schoenlinii
T.schoenleinii
• Anthropophilic
• Favic chandelier
Differential diagnosis
• Alopecia
• Trichotillomania
Laboratory diagnosis
• Sampling– Sesser
• Culture– Scc(2)
• Direct – Ectothrix, Endothrix, Favus
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Tinea barbae
• Definition
• Genus
• Age
• Beard & mustache
• Zoophilic
• T.verrucosum, T.mentagrophytes
T.Verrucosum
• Zoophilic
• Cow & cattle
• 37°
• Chlamydioconidia
Tinea barbae
• Clinical manifestation – Circular– Scaling– Vesicle– Ectothrix, Endothrix, Favus
Dermatophytosis
• Tinea barbae
Dermatophytosis
• Tinea barbae
Dermatophytosis
• Tinea barbae
Tinea barbae
• Differential diagnosis– Alopecia
• Laboratory diagnosis
Tinea cruris
• Definition
• Sever itch
• With tinea pedis
• Ecology
• Male
• Anthropophilic
• E.floccosum, T.mentagrophytes, T.rubrum
E.floccosum
• Anthropophilic
• Do not have microconidia
• Macroconidia – 2-4 or 3-5 cells
• E.stoackdaleae
Tinea cruris
• Clinical manifestation
• Maculae
• Red
• Vesicle
• Erythematic
• Itch
• Don't involve pubis
Dermatophytosis
• Tinea cruris
Dermatophytosis
• Tinea cruris
Dermatophytosis
• Tinea cruris
Dermatophytosis
• Tinea cruris
Tinea pedis
• Athlet >s foot• Age• Shoes, warm,
moisture• T.M, T.R, E.F
Tinea pedis
• Clinical manifestation
–Chronic intertrigenous
–Chronic papulosquamous hyperkeratotic
–Vesicular or sub acute–Acute ulcerative
Tinea pedis
• Chronic intertrigenous• Common type• White scale• Between 5,4 & 4,3• Itch
Dermatophytosis
• Tinea pedis
Dermatophytosis
• Tinea pedis
Dermatophytosis
• Tinea pedis
Tinea pedis
• Chronic papulosquamous hyperkeratotic• T.rubrum• Moccasin foot• Scaling
Dermatophytosis
• Tinea pedis
Dermatophytosis
• Tinea pedis
Tinea pedis
• Vesicular or sub acute
• T.M, T.R
• Id reaction • Dermatophytid
Dermatophytosis
• Tinea pedis
Dermatophytosis
• Tinea pedis
Dermatophytosis
• Tinea pedis
Dermatophytosis
• Tinea pedis
Dermatophytosis
• Tinea pedis
Tinea pedis
• Acute ulcerative
• Bacteria
• Treatment is difficult
Tinea mannum
• Definition
• Position
• Clinical manifestation
• Agents
T.mentagrophytes• 4 strain • Interdigital is anthropophilic• Erinaci is zoophilic (-)• Hair penetration
– DW 20 ml– 10% yeast extract 5D– Horse hair– 25° to 4 week
T.mentagrophytes
• Hyphae
– Spiral or coil
• Macroconidia
– Club
T.rubrum
• Anthropopilic
• CMA +• Urease -• Hair -• Sorbitol +
Tinea corporis
• Definition• Trichophyton• Microsporum• Body reaction• Contagious• Direct & indirect• Annular• Center & margin• Vesicle
– T.M, T.V
Dermatophytosis
• Tinea corporis
Dermatophytosis
• Tinea corporis
Dermatophytosis
• Tinea corporis
Tinea corporis
• Tinea imbricata– T.concentricum– Anthropophilic– Clinical manifestation – Genetic– Ecology
Tinea imbricata
Tinea imbricata
Laboratory diagnosis
• Tinea cruris, pedis, mannum & corporis• Sampling• Direct• Culture
Tinea unguium
• Definition• Onychomycosis
– Yeast– Saprophytes
• scopulariopsis
Tinea unguium
• Leukonychia mycotica
• invasive
Dermatophytosis
• Tinea unguium
Dermatophytosis
• Tinea unguium
Dermatophytosis
• Tinea unguium
Dermatophytosis
• Tinea unguium
Dermatophytosis
• Tinea unguium
Dermatophytosis
• Tinea unguium
Dermatophytosis
• Tinea unguium
Dermatophytosis
• Onychomycosis
Dermatophytosis
• Onychomycosis
Dermatophytosis
• Treatment– Griseofulvine– Terbinafin
Factors involved
• Regional – Heat – Humidity
• Individual – Local
• Hyperhydrosis• Local steroid
– Systemic• Immunosuppression • Corticosteroid
Antigens
• Complex structure – Cell wall Antigen– Enzymes
Cell wall Antigen
• Chitin
• Glucan
• Mannoprotein
• Galactomannan
Enzymes
• Keratinase• Elastase • Collagenase• Proteinase
– Metalloproteinase– Serine proteinase
Immune system
• Skin
• Unsaturated transferin
• α2 macroglobulin
Skin
• Physical & chemical barrier
• Innate immunity
• Low humidity
• UV
• Flora
skin
• Keratinization & Epidermal Proliferation– Increase turn over– Shedding
• Antifungal agent– Saturated fatty acid
Immune system
• Unsaturated transferin– Free iron
• e chain transport• Krebs cycle
• α2 macroglobulin– Keratinase inhibition
The inflammatory response
• Reverse relationship
• Inflammatory & chronic – Anthropophilic
• Inflammation low• Infection permanent
– Zoophilic & geophilic• Inflammation sever• Infection self limitation
The inflammatory response
• Dermatophyte → complement → chemo tactic
alternative C5a
Neutrophile Activation Oxidative
Nonoxidative
Myeloproxidase
Super oxide Hyd
roge
n pe
roxi
de
Catepsin
Lactoferin
Defensin
Humeral immunity
• Types of Ab– IgG, IgM, IgA & IgE– Nonprotective
Cell mediated immunity
• Deficiency in CMI– Permanent infection– Recurrent infection
Regulation OfImmune Response
• Mannan– Immune inhibitor– Blocking of monocyte receptors– In vitro
• Inhibition of lymphoblast production• Inhibition of lymphocyte proliferation
Immunization
• T.verrucosum
• LFT-130
• Drug therapy