Cutaneous Mycoses (dermatophytosis

)
 General futures

 Involves skin, nail, and hair
 Known as ringworm or tinea  Keratinized layer are infected  Fungi known as dermatophytes  Infection range form mild to sever  Depend on host state and fungal species  Resist cycloheximide

 Etiologic agents
 Over hundred species described

 Only 40 are valid
 less associated with human diseases

 Grouping of dermatophytes
 Anamorphic state (asexual phase)  Three genera  Depend on sporulation

Etiologic agents cont.
 Morphologic futures

 Nutritional requirements
 Microsporum, Trichophyton and

Epidermophyton

Natural habitat
 Anthropophilic (humans)

 Zoophilic (animal)
 Geophilic (soil)  All of them can cause diseases in human

Natural habitat Cont.
 ANTROPOPHILIC
 Trichophyton rubrum...

 GEOPHILIC

 Microsporum gypseum...

 ZOOPHILIC

 Microsporum canis: cats and dogs

 Microsporum nanum: swine Trichophyton

verrucosum: horse and swine…

DERMATOPHYTOSIS Clinical Classification
 Infection is named according to the

anatomic location involved a. Tinea barbae e. Tinea pedis (Athlete’s foot) b. Tinea corporis f. Tinea manuum c. Tinea capitis g. Tinea unguium d. Tinea cruris (Jock itch)

Images of dermatophytes infections
T. pedis

Kerion

T. manuum

Onychomycosis

Pathogenesis and Immunity
 Contact and trauma

 Moisture
 Crowded living conditions

 Cellular immunodeficiency (chronic

inf.)  Re-infection is possible (but, larger inoculum is needed, the course is shorter )

Clinical manifestation
 Tinea capitis (scalp)  Common in children  Typical lesions," kerion”, scarring,

“alopecia”  Favus (Tinea favosa)  Debris, yellow cup shaped crust  Scutula  Cicatricial alopecia
 T. schoenleinii

Clinical manifestation Cont.
 Skin

 Circular, dry, erythematous, scaly,

itchy lesions  Nail  Thickened, deformed, friable, discoloured nails, subungual debris accumulation

DERMATOPHYTOSIS Transmission
 Close human contact

 Sharing clothes, combs, brushes,

towels, bed sheets. (Indirect)  Animal-to-human contact (Zoophilic)

Human contact

Animal contact

Dermatophytes Diagnosis
I. Clinical  Appearance  Wood lamp (UV, 365 nm) II. Lab  Direct microscopic examination (10-25% KOH)  Ectothrix/endothrix/favus hair

Dermatophytes Diagnosis images

Clinical

Wood lamp

Edothrix

KOH

Ectothrix

Hair invasion by Dermatophytes

Dermatophytes Diagnosis
 Culture

 Mycobiotic agar
 Sabouraud dextrose agar

 Should contain antibiotic $ actidione
M. canis T. vilaceum

T. rub rum

Dermatophytes Identification
 Colony characteristics

 Microscopic morphology
Macroconidium Microconidium  Microsporum---fusiform---------------(+)  Epidermophyton clavate-----------------(-)  Trichophyton-- (few) cylindrical/ --- --(+) clavate/fusiform single, in clusters

genus

Microscopic morphology of dermatophytes
 Examples

Microsporum canis

T rubrum

E. floccosum

Chlamydospores

Treatment
 Topical  Miconazole, clotrimazole  econazole, terbinafine...  Oral  Griseofulvin  Ketaconazole  Itraconazole  Terbinafine

Sign up to vote on this title
UsefulNot useful