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Superfical and Cutaneous
Superfical and Cutaneous
Outline of presentation
Objective General information about mycoses Superficial mycoses
Black piedra White piedra Tinea nigra Pityriasis
Cutaneous mycoses
Objective
At the end of this chapter, the student will be able to: List commonly known superficial and cutaneous mycoses
List the etiological agents, epidemiology, pathogenesis and clinical picture, and laboratory diagnostic techniques applied for these fungal infections.
Describe the laboratory diagnostic features to differentiate the etiological agent which causes superficial and cutaneous mycoses.
Mycoses
Dermatomycoses
Superficial mycoses Cutaneous mycoses Subcutaneous mycoses
Systemic mycoses
Primer systemic mycoses
Opportunistic mycoses
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Superficial mycoses
Development of fungal infection on epithelial tissue skin, hair nail without noticeable invasion of living tissue
Superficial infection
Black piedra White piedra Tinea nigra Pityriasis
Black piedra
Affecting hair primarily scalp
Etiology Piedraia hortae Dematiaceous filamentous fungus found in soil Particularly at humid tropical areas Classified in Ascomycetes
Characterized by formation of brown to black nodules that are very firmly attached to the hair shaft
Nodules can not be pulled out of the hair shaft
Colonies slow growing, small, folded, velvety and dark brown to black in color
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Relapses may occur even after appropriate management of the infection with antifungal agents
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White piedra
Localized to the hair of groin and axillae or scalp
But may also be seen on facial hairs and sometimes
pubic hair Fungus surround the hair shaft and form a white to brown swelling along the hair Etiology Trichosporon spp (T. inkin, T. ashii, T.beigelii, T.mucoides)
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Etiology contd
Have multilamelar dolopores cell wall; develop
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Frequent in tropical and temperate zone Common in young adults Clinical presentation
Asymptomatic fungal growth on the outside of the hair shaft
Soft, white to yellow nodules, loosely attached to the hair
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Microscopic Features
Abundant and well-developed pseudohyphae and hyphae Blastoconidia are unicellular and variable in shape Typical microscopic feature production of arthroconidia
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Tinea nigra
A superficial chronic infection of Stratum corneum
Usually occur on the palmar aspects of hands and occasionally the plantar and other surfaces of the skin
Etiology
Hortaea (Exophiala, phaeoannellomyces) werneckii Ascomycetes
A common saprophytic fungus believed to occur : In soil, compost, Humus and on wood in humid tropical and sub-tropical regions Dematiaceous fungi frequently branched septate .
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Clinical manifestations
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Azole creams
Terbinafine
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Malassezia infections
Malassezia furfur
A dimorphic, lipophilic yeast Normally resident on human skin in the sebum-rich areas of the upper trunk and head
Pityriasis versicolor
A chronic, superficial fungal disease of the skin characterized by well-demarcated white, pink, fawn, or brownish Discrete serpentine hyper or hypo pigmented maculae
occur on the skin usually on chest, upper back, arm or abdomen
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Lesions occur on the trunk, shoulders and arms, rarely on the neck and face
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showing
hyperpigmented
and
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Clinical manifestations
Erythema and scaling in areas with a rich supply of sebaceous glands, the scalp, face, eyebrows
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predispose
to
endocrine
or
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Cutaneous mycoses
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Cutaneous mycoses
Affect superficial keratinized tissue (skin hair and nail) Dermatophytes important etiologic agent The disease referred deramatophytosis
A complex of disease caused by any of several species of taxonomically related filamentous fungus
Trichophyton,
Epidemophyton
Microsporum
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Geophilic
Zoophilic
Anthrophilic
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Metabolic products usually induces an allergic and inflammatory eczematous response in the host Various forms of dermatophytes referred as tinea or ringworm
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Trichophyton interdigitale
Trichophyton tonsurans Trichophyton violaceum Trichophyton concentricum Trichophyton schoenleinii Trichophyton soudanense Microsporum audouinii Microsporum ferrugineum Trichophyton mentagrophytes Trichophyton equinum Trichophyton erinacei Trichophyton verrucosum Microsporum canis Microsporum gypseum Microsporum nanum Microsporum cookei
Humans
Humans Humans Humans Humans Humans Humans Humans Mice, rodents Horses Hedgehogs Cattle Cats Soil Soil/Pigs Soil
Very Common
Common Less Common Rare* Rare* Rare* Less Common* Less Common* Common Rare Rare* Rare Common Common Rare Rare
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Factors
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Caused by the shedding of skin scales containing viable infectious hyphal elements [arthroconidia] Transmission may take place by indirect contact
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Dermatophytosis of
The proximal medial thighs, preum and buttocks Occurs more commonly in males
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T. rubrum
T. tonsurans
T. verrucosum
Geophilic M. gypseum zoophilic species M. canis
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