Superficial mycosis

Clinical Name Site Most frequent organisms

Tinea capitis scalp Trichophyton tonsuruns, Microsporum audouinii
(epidemic)
Tinea capitis scalp Microsporidium canis, Trichophyton verrucosum
(non-
epidemic)
Tinea pedis interdigital T. rubrum, T. mentagrophytes, Epidermophyton
space floccosum
Tinea barbae beard Trichophyton rubrum, T. verrucosum
Tinea corporisarms, T. rubrum, M. canis, T. mentagrophytes
legs,torso
Tinea cruris groin T. rubrum, T. mentagrophytes, Epidermophyton
floccosum
Tinea manus hands T. rubrum, T. mentagrophytes
Tinea nails T. rubrum, T. mentagrophytes, E. floccosum
unguium
 Pityriasis versicolor
• Overgrowth of the • Symptoms include
Malassezia furfur yeast
•Patches of skin
causes the Pityriasis
versicolor. Factors
discoloration
promoting the growth of •Spots that do not tan the
yeast include: way the rest of the skin
•Hot and humid weather does
•Oily skin •Mild itching
•A weakened immune system •Scaling
•Hormonal changes in the
body
Treatment

• Medication
•Topical antifungal creams
(shampoos also available):
Applied widely to affected
areas.
Econazole · Ketoconazole
Oral antifungals: Used in
some cases when topical
agents do not work.
Fluconazole
 Individuals at high risk of acquiring ringworm include those who:

• Live in crowded, humid conditions.

• Sweat excessively, as sweat can produce a humid wet
environment where the pathogenic fungi can thrive.
This is most common in the armpits, groin creases and
skin folds of the abdomen.
• Participate in close contact sports like soccer, rugby, or
wrestling.
• Wear tight, constrictive clothing with poor aeration.
• Have a weakened immune system (e.g., those infected
with HIV or taking immunosuppressive drugs).
Tinea corporis
• The symptoms of
ringworm include:
•a ring-like red or silvery
rash on your skin - your
skin will look red and
irritated around the ring,
but healthy inside
•scaly, itchy and inflamed
skin
 Tinea pedis, commonly called athlete’s foot
• Causes
• It is caused by the fungus tinea
pedis
• The fungus thrives in warm, moist
environments. It is found in the
shower, locker room floors, and in
swimming pools
• Transmission:
• Direct contact- touching the
affected area
• Indirect contact- through
contaminated items such as
clothes, shoes, towels, bed sheets
• Some of the common symptoms are:
• Itching, soreness, and burning on
the soles and between toes
• Blisters on the feet that itch
• Cracking and peeling of the skin on
the feet
• Drying and scaling
• Raw skin on the feet
• Discolored, thick, and crumbly
toenails
• White and soggy toes
• Toenails that pull away from the nail
bed
•Antifungals:
• Itraconazole ·
• Fluconazole ·
• Terbinafine

•Antibiotics: Antibiotics may be

prescribed if bacterial infection
develops due to blisters.
• Erythromycin · Clindamycin

•Topical steroids: Prescribed to prevent

inflammation.
• Hydrocortisone
Tinea cruris is a dermatophytosis that is commonly caused by Trichophyton
rubrum

• Jock itch usually stays

around the creases of the
upper thigh and does not
involve the scrotum or penis.
• Jock itch may spread to the
anus, causing anal itching
and discomfort. Symptoms
include:

• Red, raised, scaly patches

that may blister and ooze
 Tinea capitis
• The symptoms of a fungal
scalp infection include:
•small patches of scaly skin
on the scalp, which may be
sore
•patchy hair loss
•an itchy scalp
Tinea fungal infections are
caused by a dermatophytes,
which live off keratin
• •Antifungals:
• Itraconazole ·
• Fluconazole ·
• Terbinafine

• •Antibiotics: Antibiotics may be

prescribed if bacterial infection
develops due to blisters.
• Erythromycin · Clindamycin

• •Topical steroids: Prescribed to

prevent inflammation.
• Hydrocortisone
 Cutaneous mycosis
• Candidas • Candida albicans is an
• Risk factors include: opportunistic
•Antibiotics pathogenic yeast
•Pregnancy • C. albicans, C. tropicalis,
C. parapsilosis, and C.
•Diabetes
glabrat
•HIV and other conditions
that impair the immune
system, including steroids
and chemotherapy
• vaginitis or vulvovaginal
candidiasis
•Vaginal itching and a burning
sensation in the vaginal region,
including the labia and vulva
•White vaginal discharge that's
sometimes described as being
similar in consistency to cottage
cheese
•Pain during urination or sex
•Redness and swelling of the
vulva
 Systemic mycoses
• are fungal infections affecting internal organs.
• In the right circumstances the fungi enter the
body via the lungs, through the gut, paranasal
sinuses or skin.
• The fungi can then spread via the bloodstream
to multiple organs including the skin, often
causing multiple organs to fail and resulting in
the death of the patient.
 Histoplasmosis(Histoplasma capsulatum)

Histoplasmosis is linked to exposure to bird and bat droppings

It usually occurs as an atypical pneumonia, with prostration, fever and
respiratory symptoms.
•Progressive disseminated histoplasmosis - fever, dyspnea, cough, loss
of weight and prostration with hepatosplenomegaly. Usually fatal within
six weeks.
•Chronic progressive pulmonary histoplasmosis is usually seen in older
patients with chronic obstructive pulmonary disease (COPD).
•Disseminated disease when seen in the immunocompromised is
usually due to reactivation of prior infection often seen in HIV infection.
Treatment: Amphotericin B · Itraconazole · Ketoconazole
 Coccidioidomycosis

• Coccidioidomycosis is caused by a mould that grows in the soil in

Southwestern USA, Mexico and Central and South America.
• of immunocompetent affected people (HIV) suffer dissemination
but in these cases mortality is high.
• usually presenting with respiratory tract symptoms plus fever, with
pleuritic pain.
• There may be arthralgia with swelling (often knees and ankles).
• Management: intravenous (IV) amphotericin for severe infections;
fluconazole or itraconazole continued for six months or longer.
• Surgery may be needed to drain cavities or abscesses or to resolve
diagnostic dilemmas in nodular disease.
 Pneumocystosis(Pneumocystis Jirovecii)

• In immunocompromised patients (especially

HIV), there can be abrupt onset of fever,
tachypnea, shortness of breath and non-
productive cough. If untreated, there is rapid
deterioration to death.
 Opportunistic infections(Immunodeficient patients)

• Aspergillosis.[This is usually caused by Aspergillus fumigatus; patients with very advanced HIV infection are particularly at risk, mostly with pulmonary disease leading
to severe necrotising pneumonia.

• Mucormycosis.It is found in patients with predisposing conditions such as diabetic ketoacidosis, chronic kidney disease and immunosuppressant drugs. Treatment is
surgical debridement under cover of amphotericin.

• Mycetoma. It may start as a papule, nodule or abscess and it progresses over months or years to form multiple abscesses and sinus tracts reaching deep into the
tissue.

• Blastomycosis.This usually occurs in men working outdoors in certain areas of South, Central and Midwestern USA and Canada; it usually affects the lung but can
disseminate to the skin, bones and urogenital tract. Symptoms include cough, fever, dyspnoea and chest pain. It may resolve or progress with bloody, purulent sputum,
pleurisy, fever, chills, loss of weight and prostration. In disseminated form, there are raised verrucous skin lesions with an abrupt, downward-sloping border often seen.

• Paracoccidioidomycosis.Also known as South American blastomycosis, it is only found in patients who have lived in South or Central Africa or Mexico and initially
affects the upper respiratory tract. It usually appears with ulceration of the upper respiratory tract. Ulcers can coalesce to destroy the epiglottis, vocal cords and uvula.
Eating and drinking are very painful. There may be skin lesions on the face.

• Sporotrichosis.This occurs when the organism is inoculated into the skin during gardening. It usually causes a skin infection - a hard, non-tender, subcutaneous nodule
which later ulcerates. Similar nodules then appear along the lymphatics draining the area.

• Chromoblastomycosis.This is a mainly tropical skin infection, usually affecting agricultural workers and causing skin infections. It begins as a papule or ulcer, usually on
a lower extremity, and enlarges over months or years to become a papillomatous, verrucous nodule.

• Cryptococcus neoformans.This is a yeast found in soil and dried pigeon droppings. Infection is usually transmitted by inhalation. Immunodeficient patients develop
progressive lung disease and dissemination. It can involve any organ but mainly the central nervous system. It often presents with meningitis.

• Candidiasis. This is normally associated with predisposing factors - eg, neutropenia, antibiotic use, indwelling lines and abdominal surgery. It can cause candidaemia
and disseminated candidiasis; also, deep focal candidiasis, in which it infects the peritoneum or meninges, is often implanted following dialysis or surgery.