SUPERFICIAL

MYCOSES
Mark Laurence A. Manzano
 MYCOSES
• Mycoses (singular, mycosis) are diseases
caused by fungi.

• Superficial, cutaneous, subcutaneous, and

systemic mycoses.

• Infections not involving the skin or deeper

tissues just under the skin are termed
systemic.
SUPERFICIAL MYCOSES

• Superficial mycoses are infections confined to the outermost

layer of skin: hair, ears and eyes

• affect only the cornified layers (stratum corneum) of the

epidermis

• the term tinea (Latin meaning worm) was applied to each disease,
along with a Latin term for the body site.
EPIDEMIOLOGY &
PATHOGENESIS
KERATITIS
• Mycotic keratitis (Keratomycosis): cornea: loss of vision: systemic mycosis

• Fusarium, Aspergillus, Curvularia, Penicilium, Candida species

• White plaque in the cornea

• Diagnosis: tissue samples: 10-20%KOH, SDA

• Treatment: Natamycin
EPIDEMIOLOGY &
PATHOGENESIS
OTOMYCOSIS
• Fungus ear

• Mycotic otitis externa

• Apergillus, Mucor, Penicillium, Rhizopus

• Minor irritation

• Pus inside ear canal

• 10-20%KOH, SDA

• Therapy: cotton swab with Burrow’s solution

EPIDEMIOLOGY &
PATHOGENESIS
PTYRIASIS VERSICOLOR
• Liver spots

• Tinea versicolor

• Dermatomycosis furfuracea

• Chromophytosis

• Horny layer of epidermis

• Trunk of the body

EPIDEMIOLOGY &
PATHOGENESIS
PTYRIASIS VERSICOLOR
• tinea versicolor (pityriasis versicolor): discoloration or depigmentation and scaling of
the skin

• seborrheic dermatitis, or dandruff

• Discrete, serpentine, hyper- or hypopigmented maculae occur on the skin. face, chest,
trunk, and abdomen
EPIDEMIOLOGY &
PATHOGENESIS
PTYRIASIS VERSICOLOR
• yeast Malassezia furfur complex. (Malassezia globosa, M. restricta)

• Lesions: fluoresce pale yellow under a Wood’s lamp

• M. furfur requires lipids for growth

• scrapings of infected skin, treated with 10– 20% KOH or stained with calcofluor white
EPIDEMIOLOGY &
PATHOGENESIS
PTYRIASIS VERSICOLOR

• Short unbranched hyphae and spherical cells are observed.

• the spaghetti and meatballs fungus (specimen: skin scrapping)

• Typical yeastlike colonies may be observed only after the culture medium is overlaid
with olive oil.

• Colonies are cream-colored, moist, and smooth

EPIDEMIOLOGY &
PATHOGENESIS
PTYRIASIS VERSICOLOR
• treatment with antidandruff shampoos, selenium sulfide Topical or oral
azoles(Ketoconazole)
EPIDEMIOLOGY &
PATHOGENESIS
PIEDRAS
• Black Piedra
• White Piedra
• Tinea nodosa
• Chignon disease
• Beigel’s disease

• Piedra: hair shaft

• nodules composed of hyphae and a

cementlike substance that attaches it to
the hair shaft
EPIDEMIOLOGY &
PATHOGENESIS
PIEDRAS
• Black piedra is caused by Piedraia hortae

• Scalp hair

• White piedra is caused by Trichosporon ovoides and Trichosporon inkin. (old books:
Trichosporon beigelii, Trichosporon cutaneum)

• Facial and genital hairs

PIEDRAS
Piedraia hortae
• hard, dark brown to black gritty nodules

• nodules consist of asci (sacklike

structures) containing eight ascospores
PIEDRAS
Piedraia hortae
Laboratory Diagnosis.

10% to 20% KOH

the nodules may be crushed open to reveal the asci

SDA
brown, restricted colonies that remain sterile
Dark brown with metallic green tinge
Compact, raised center, slightly fuzzy
PIEDRAS
Trichosporon spp.
• Examination of the genome of members of the genus has revealed that T. beigelii is
no longer a valid species but rather a complex of at least 19 distinct species.

• Trichosporon ovoides, T. asteroides, T. cutaneum, and T. inkin have been implicated

in superficial mycoses.

• T. asahaii: severe and frequently fatal disease in immunocompromised hosts

• T. mucoides: recovered frequently from the cerebrospinal fluid (CSF) as a cause of

meningitis.
PIEDRAS
White piedra
• soft mycelial mat surrounding hair of the
scalp, face, and pubic region

• immunocompromised host: hematologic

disorders or malignancies or are
undergoing chemotherapy
PIEDRAS
White piedra
• Laboratory Diagnosis.
Trichosporon spp.: arthroconidia,hyphae, and blastoconidia
The colonies are straw to cream-colored and yeastlike.

• biochemical reactions:
• absence of carbohydrate fermentation
• potassium nitrate positive
• urease positive

• Treatment: Piedra’s
• 1:2000 solution of bichloridemercury
• 3% sulfur ointment
• Benzoic acid
• Salicylic acid
EPIDEMIOLOGY &
PATHOGENESIS
TINEA NIGRA
Phaeoannellomyces werneckii

• characterized by brown or black

macular patches, primarily on the palms.
• (old books: Cladosporium werneckii)
• Keratomycosis nigrans palmaris
• Pityriasis nigra
• Microsporosis nigra
• Tinea nigra palmaris
• Treatment: Azoles: Itraconazole,
keratolytic solutions, salicylic acid
EPIDEMIOLOGY &
PATHOGENESIS
TINEA NIGRA
Hortaea werneckii

Tinea nigra: brown to black nonscaly macules that occur most often on the palms of
the hands and soles of the feet

Obsolete synonyms for H. Werneckii include Phaeoannellomyces werneckii and

Exophiala werneckii.
EPIDEMIOLOGY &
PATHOGENESIS
TINEA NIGRA
Laboratory Diagnosis.

skin scrapings: 10% to 20% KOH

septate hyphal elements and budding cells
Strongly dermatiaceous hyphae

SDA
H. werneckii produces shiny, moist, yeastlike colonies that start with
brownish coloration that eventually turns olive to greenish black.
THANK YOU!
RMT soon!