KEPANITERAAN KLINIK KULIT & KELAMIN RSUP FATMAWATI DERMATOPHYTA-NON-CANDIDIASIS

Miftahul Jannah 108103000060

FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN UIN SYARIF HIDAYATULLAH JAKARTA

Tinea nigra Uniformly tan macule on the plantar foot, present for several years. KOH preparation showed hyphae

Tinea pedis: interdigital dry type The interdigital space between the toes shows erythema and scaling; the toenail is thickened, indicative of associated distal subungual onychomycosis

Tinea pedis: interdigital macerated type The webspace between the fourth and fifth toes is hyperkeratotic and macerated in a black individual with plantar keratoderma and hyperhidrosis. The greenish hue is caused by Pseudomonas aeruginosa superinfection of this moist intertriginous site. Erythrasma also occurs in the setting of moist intertriginous sites and may occur concomitantly with interdigital tinea pedis and/or Pseudomonas intertrigo

Tinea pedis: moccasin type Fairly sharply marginated erythema of the plantar foot with a mild keratoderma associated with distal/lateral subungual onychomycosis, typical of T. rubrum infection.

Tinea pedis: moccasin type Hyperkeratosis and scaling of the dorsa of the feet occurring on the portion of the foot covered by a moccasin; note the associated distal/lateral subungual onychomycosis, typical of T. rubrum infection

Tinea pedis: bullous type Ruptured vesicles, bullae, erythema, and erosion on the plantar aspect of the great toe. Hyphae were detected on KOH preparation obtained from the roof of the inner aspect of the bulla. In some cases, superficial white onychomycosis may also be seen with this T. mentagrophytes infection.

Bentuk Subungual distalis: Dimulai dari tepi distal menjalar ke proksimal. Leukonikia trikofita (keputihan di permukaan kuku). Kukunya hancur(untuk membedakannya dg candidiasis )

Tinea manuum Erythema and scaling of the right hand, which was associated with bilateral tinea pedum; the "one-hand, two-feet" distribution is typical of epidermal dermatophytosis of the hands and feet. In time, distal/lateral subungual onychomycosis occurs on the fingernails

Tinea cruris Confluent, erythematous, scaling plaques on the medial thighs, inguinal folds, and pubic area. The margins are slightly raised and sharply marginated. Erythrasma should be ruled out by Wood's lamp examination

Tinea corporis Inflammatory annular plaques, becoming confluent on the medial thigh. This type of inflammatory lesion is seen with zoophilic dermatophytic infection and with topical glucocorticoid use.

Tinea corporis: acute and subacute Multiple, bright red, sharply marginated lesions with only minimal scaling of several weeks' duration on the trunk of a child. Three lesions are more inflammatory and thicker. Microsporum canis was isolated on fungal culture, which had been contracted from a pet guinea pig

Tinea corporis: chronic Sharply marginated, hyperpigmented plaques of many months' duration on the back, buttocks, and thighs. The lesions have a psoriasiform appearance. Associated tinea cruris and tinea pedis are usually present

Tinea facialis Sharply marginated, ertythematous, scaling, and crusted plaques on the face of a child. Note asymmetry

Tinea facialis Erythematous plaque with a geographic shape; scaling is minimal but adequate for KOH preparation

Tinea incognito Arcuate red plaques on the medial ankle in a patient who had applied a fluorinated glucocorticoid cream. Moccasin-type tinea pedis is apparent on the plantar foot

Tinea capitis: "black dot" variant A subtle, asymptomatic patch of alopecia due to breaking off of hairs on the frontal scalp in a 4-year-old black child. The lesion was detected because her infant sister presented with tinea corporis. Trichophyton tonsurans was isolated on culture

Tinea capitis: "gray patch" type A large, round, hyperkeratotic plaque of alopecia due to breaking off of hair shafts close to the surface, giving the appearance of a mowed wheat field on the scalp of a child. Remaining hair shafts and scales exhibit a green fluorescence when examined with a Wood's lamp. Microsporum canis was isolated on culture

Kerion An extremely painful, boggy, purulent inflammatory nodule on the scalp of this 4-year-old child. The lesion drains pus from multiple openings and there is retroauricular, tender lymphadenopathy. Infection was due to T. verrucosum contracted from an infected rabbit.

Tinea barbae Scattered, discrete follicular pustules and papules in the moustache area, easily mistaken for S. aureus folliculitis

Tinea barbae and tinea facialis Confluent, painful papules, nodules, and pustules on the upper lip. Epidermal dermatophytosis (tinea facialis) with sharply marginated erythema and scaling is present on the cheeks, eyelids, eyebrows, and forehead. Trichophyton mentagrophytes was isolated on culture. In this case, the organism caused two distinct clinical patterns (epidermal involvement, tinea facialis versus follicular inflammation, tinea barbae, kerion), depending on whether glabrous skin or hairy skin was infected. (See also Image 23-1.)

Non dermatophyta

Pityriasis versicolor Sharply marginated brown macules on the trunk. Fine scale was apparent when the lesions were abraded with the edge of a microscope slide

Pityriasis versicolor Multiple, small-to-medium-sized, well-demarcated hypopigmented macules on the back of a tanned individual with white skin

 Pitirosporm folikulitis penyakit kronis pada folikel pilosebasea

berupa papul, pustul folikular yang biasanya gatal

Tempat predileksi :dada, punggung dan

lengan bagian atas. Kadang di leher dan jarang dimuka.

Candida albicans: KOH preparation Budding yeast forms and sausage-like pseudohyphal forms

Cutaneous candidiasis: intertrigo Small peripheral "satellite" papules and pustules that have become confluent centrally, creating a large eroded area in the submammary region.

Cutaneous candidiasis: intertrigo Erythematous papules with a few pustules, becoming confluent on the medial thigh. The lesions occurred during a holiday trip to the Caribbean

Cutaneous candidiasis: intertrigo Vesicles, pustules, and papules becoming confluent on the perineum and perianal area. The patient had successfully undergone a bone marrow transplantation 4 weeks before the appearance of the cutaneous lesions. The initial impression by the oncologist was that the lesions were reactivated herpes simplex; KOH preparation and cultures confirmed the diagnosis of Candida intertrigo

Candidiasis: diaper dermatitis Confluent erosions, marginal scaling, and "satellite pustules" in the area covered by a diaper in an infant. Atopic dermatitis or psoriasis also occurs in this distribution and may be concomitant.

Oral candidiasis: thrush White curdlike material on the mucosal surface of the lower lip of a child; the material can be abraded off with gauze (pseudomembranous), revealing underlying erythema.

Oral candidasis: thrush Extensive cottage cheese-like plaques, colonies of Candida that can be removed by rubbing with gauze (pseudomembranous), on the palate and uvula of an individual with advanced HIV disease. Patches of erythema between the white plaques represent erythematous (atrophic) candidiasis. Involvement may extend into the esophagus and be associated with dysphagia.

Candidiasis: vulvitis Psoriasiform, erythematous lesions becoming confluent on the vulva with erosions and satellite pustules on the thighs

Candidiasis: balanoposthitis Multiple, discrete pustules on the glans penis and inner aspect of the foreskin (the preputial sac).

Lesi kemerahan, tidak bernanah, kuku tebal, mengeras, berlekuk, kadang kecoklatan, tidak rapuh seperti tinea