Fungal infections Dr.Majdy Naim. Majdy Naim Fungal infections of the skin2 Fungal infections...

Fungal infections

Dr.Majdy Naim

Majdy Naim Fungal infections of the skin

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Fungal infections

Superficial fungal infections ( affecting the skin primarily )

Deep fungal infections ( starting in the internal organs and involve the skin secondarily )


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Superficial fungal infections

Dermatophytes Epidermophyton Trichophyton Microsporum

Yeasts Candida Malassezia furfur


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Classification of dermatophytic infections Tinea capitis Tinea corporis ( Tinea circinata ) Tinea faceie Tinea barbae Tinea cruris Tinea pedis Onychomycosis


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Tinea capitis


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Tinea capitis

In general 3 types1. Scaly

2. Kerion

3. Black-dot


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Scaly ringworm

In school children Single or multiple round patches with fine grayisch-white scales The hairs in this area become loos and break off leaving stumps about 3 mm long These stumps are easily pulled out Mainly due to Trichophyton violaceum and Microsporum canis


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Kerion

The patches form follicular pustules, or boggy swelling like an abscess

Causes fall out of the hair May end by scaring and permanent baldness Usually due to fungi of an animal origin

( mainly Trichophyton verrucosum and microsporum canis )


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Kerion

Dr. Majdy Naim


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Kerion ( after 4months therapy)

Dr. Majdy Naim


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Kerion differs from an abscess in:

Less painfull Absence of general symptoms Contains no pus Kerion should not be incised


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Black-dot

The hairs do not form stumps but break of nesr the surface of the follicles

May show slight scaling Caused by Trichophyton violaceum


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Tinea capitis (mode of infection)

Direct Man to Man Animal

Indirect Use of patient‘s fomites Friseur


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Diagnosis of tinea capitis

Clinical examination Woods Light Microskopic examination ( KOH) Culture (Sabourauds agar medium)


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Treatment of tinea capitis

Systemic therapy Essential Griseofulvin for 8 weeks Terbenafen (Lamisil) 6 weeks

Topical therapy Alone useless Antifugal ceams Antifugal shampoo


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Tinea corporis


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Tinea corporis

Seen in any age, but children are most susceptible

Caused by almost all species of trichophyta and microspora

Lesions are annular with central healing and active edge

They are single or multiple, and can be itchy


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Treatment

Topical antifungul By localized moderate cases

Systemic antifungal By extensive or resistant cases


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Tinea Facei

Face except moustache and beard area in adult male

Any part of the face in children

May be steroid modified


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Tinea barbae Deep fungus

infection Adult men Mostly by animal

farmers


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Tinea cruris

More frequently during the summer months most cases caused by Epidermophyton

floccosum and Trichphyton rubrum Affect the upper and inner surface of the

thighs Often extend into the gluteal folds and onto

the buttocks Itching occurs especially in acute types


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Tinea Cruris

AcuteSubacuteChronic


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Tinea Cruris


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Tinea crurisDifferential diagnosis Simple intertrigo Seborrheic dermatitis Candidiasis Erythrasma Flexural psoriasis Contact dermatitis


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Treatment

Topical antifungul By mild to moderate cases

Systemic antifungal By extensive or resistant cases


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Tinea pedis

Most common fungus infection In general a disease of adult life Often in summer months The mode of infection is usually by using

infected socks, shoes or other towels, also from wet floor-boards

Caused mainly Trichophyton interdigitale, T. rubrum Epidermophyton floccosum


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Tinea pedis (Athletes foot)


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Tinea pedis


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Dermatophyte infections

Keratinised epithelium: Tinea corporis Tinea faciale Tinea cruris Tinea manus Tinea pedis

Nails: Tinea unguium (Onychomycosis )

Hairs: Tinea capitis Tinea barbae


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Onychomycosis


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Onychomycosis

Nail may show discoloration, thickining, cracking, subungular hyperkeratosis or onycholysis

One or more nails are involved

May be associated with tinea pedis


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Tinea manuum


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Yeasts infection

Candidiasis Tinea versicolor


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Candidiasis

80 % Candida albicans


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Oral candidiasis

•Thrush

•Angular cheilitis


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Candidiasis


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Candidiasis

Oral candidiasis Thush,Angular stomatitis,Candidal glossitis,Black hairy

tongue Intertriginous candidiasis Genital candidiasis

Vulvovaginal candidiasis, Candidial balanoposthitis Candidal paronychia Napkin candidiasis


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Predisposing factors

Trauma Friction Moisture and sweating Drugs Conditions associated with low resistance


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Pityriasis versicolor


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Pityriasis versicolor

Very common superfacial mycotic infection Caused by malassezia furfur Commonly affects young adults Climatic factors and familial predisposition

appear to be important


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Treatment

Short application of selenium sulfate (10-15 min) for 2 weeks

Topical antifungals as shampoo or cream Systemic antifungals

Fungal infections Dr.Majdy Naim. Majdy Naim Fungal infections of the skin2 Fungal infections...

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