FUNGAL INFECTIONS

of SKIN
Kushal
CLASSIFICATION

Superficial
Deep
–Subcutaneous
–Systemic
Superficial
Tinea versicolor
Tinea nigra
Piedra
Dermatophytosis
Candidiasis
Subcutaneous
Sporotrichosis
Chromoblastomycosis
Mycetoma
Entomophthoromycosis
Rhinosporidiosis
Lobomycosis
SYSTEMIC
Cryptococcosis
Histoplasmosis
Blastomycosis
Coccidioidomycosis
Paracoccidioidomycosis
 Opportunistic mycosis
Candidiasis
Mucormycosis
Aspergillosis
Penicilliosis
 SOURCE OF INFECTION

Geophilic
Zoophilic
Anthropophilic
 AETIOLOGICAL AGENTS

Trychophytons – skin, hair, nails

Epidermophyton – skin, nails
Microsporum - skin, hair
COMMON SPECIES

T. rubrum
T. mentagrophytes
T. violaceum
T. schonleinii
M. canis
M. audouinii
E. floccosum
 PATHOGENESIS

HOST – PARASITE
INTERACTION
PREDISPOSING FACTORS

 LOCAL – Heat, moisture, sweating, Occlusion,

Trauma, Steroid use
 General -malnutrition, immunosuppression-
congenital/acquired,diabetes mellitus, steroid use
 Personal & Social – hygiene, overcrowding,
poor SE status
 Candidiasis - Extremes of age, antibiotic Tt,
OCP use,IUCD, Dentures
 DIAGNOSIS
KOH smear
Culture – Sabouraud’s agar
Biopsy
Wood’s lamp
TREATMENT

Attention to
predisposing factors
Pharmacological
TREATMENT - TOPICAL

Whitfield’s ointment ( TV, Derma)

Castellani’s paint (C)
Gentian violet ( C )
Sodium thiosulphate ( TV)
Selenium sulphide ( TV)
Zinc pyrithione (SB)
TREATMENT - TOPICAL

 Polyenes- Nystatin, Hamycin

 Imidazoles- Mico, Clotri, Tioco, Eco, Ketoco,
Bifo, Sulco, Oxiconazole
 Triazoles - Terco, Fluco
 Allylamines- Naftifine, Terbinafine
 Bezylamines - Butenafine
 Morpholines – Amorolfine
 Ciclopirox olamine
TREATMENT - Systemic

Polyenes – Amphotericin B, Nystatin

Azoles-
– Imidazoles- Ketoconazole
– Triazoles- Fluconazole, Itraconazole
Allylamine – Terbinafine
Miscellaneous- Griseofulvin, Potassium
iodide,5-flucytosine.
DEPENDING ON SITE

TINEA CORPORIS
TINEA FACIEI
TINEA CRURIS
TINEA MANUUM
TINEA PEDIS
TINEA CAPITIS
TINEA BARBAE
TINEA UNGUIUM
TINEA FACIEI
TINEA CRURIS
TINEA CAPITIS

PATCHY ALOPECIA
BLACK DOT
FAVUS
 KERION
KERION
TINEA UNGUIUM
Dermatophytosis -Treatment

 Whitfield’s ointment  Griseofulvin

 Imidazoles  Imidazoles
 Triazoles  Triazoles
 Allylamines  Allylamines
 Bezylamines
 Morpholines
 Ciclopirox olamine
 TOPICAL TOPICAL +
SYSTEMIC
Limited
Extensive lesions of
involvement of
– T. corporis,cruris,
– T. corporis,cruris, manuum, pedis
manuum, pedis T unguium
T.Capitis
T. Barbae
TINEA VERSICOLOR
Tinea versicolor - Treatment

TOPICAL SYSTEMIC
 Whitfield’s ointment
Imidazoles
 Imidazoles
 Allylamines
Triazoles
 Sodium thiosulphate
 Selenium sulphide
 CANDIDIASIS

ORAL
PERLECHE
VULVOVAGINITIS
BALANITIS
INTERTRIGO
PARONYCHIA
CHRONIC MUCO CUTANEOUS
 CANDIDIASIS

TOPICAL SYSTEMIC
Castellani’s paint Polyenes
Gentian violet Imidazoles
 Polyenes
Triazoles
Imidazoles
Triazoles
PIEDRA
 TINEA NIGRA

PHAEOANNELOMYCES
WERNECKI
CHROMOBLASTOMYCOSIS
SPOROTRICHOSIS
 MYCETOMA
EUMYCETOMA
ACTINOMYCETOMAS
MYCETOMA
ENTOMOPHTHOROMYCOSIS
RHINOSPORIDIOSIS
OTHERS

HISTOPLASMOSIS
CRYPTOCOCCOSIS
PENICILLIOSIS
COCCIDIODOMYCOSIS
CRYPTOCOCCOSIS
Penicilliosis