Dermatophytes .pptx

Fungal Infections

1. DERMATOPHYTES

2. DERMATOPHYTES

3. DERMATOPHYTES Dermatophytes are fungal organisms that are able to exist within the keratinous elements of living skin and which belong to one of 3 genera, Epidermophyton Microsporum,and Trichophyton Dermatophytes require keratin for growth and therefore infect hair, nails, and superficial skin, with clinical manifestations named for the area affected.

4. DERMATOPHYTOSIS

5. TINEA CORPORIS Tinea corporis Infections of the trunk and limbs Finds unilateral lesions with annular or ring-like shapes Pink scaly plaques or papules  Rashes appears in the middle of ring-like shapes and usually itchy 

6. TINEA CRURIS  Erythematous and scaly lesions and often very itchy Develop symmetrically from the groin down the inner thigh May find pustules at the edges Rare before puberty and commonly finds in adolescent males and adults May outbreaks in sport people or living communities with shared bathing facilities

7. TINEA PEDIS- CAUSES Tinea pedis is the term used for a dermatophyte infection of the soles of the feet and the interdigital spaces. Tinea pedis is most commonly caused by Trichophyton rubrum, a dermatophyte initially endemic only to a small region of Southeast Asia and in parts of Africa and Australia Athlete’s foot occurs when the tinea fungus grows on the feet. You can catch the fungus through direct contact with an infected person, or by touching surfaces contaminated with the fungus. The fungus thrives in warm, moist environments. It’s commonly found in showers, on locker room floors, and around swimming pools.

8. RISK FOR ATHLETE’S FOOT Anyone can get athlete’s foot, but certain behaviors increase your risk. Factors that increase your risk of getting athlete’s foot include: visiting public places barefoot, especially locker rooms, showers, and swimming pools sharing socks, shoes, or towels with an infected person wearing tight, closed-toe shoes keeping your feet wet for long periods of time having  sweaty feet having a minor skin or nail injury on your foo

9. THE SYMPTOMS OF ATHLETE’S FOOT There are many possible symptoms of athlete’s foot, which include: itching , stinging, and burning between your toes or on soles of your feet blisters  on your feet that itch cracking and peeling skin on your feet, most commonly between your toes and on your soles dry skin on your soles or sides of your feet raw skin on your feet discolored , thick, and crumbly toenails toenails that pull away from the nail bed

10. ATHLETE’S FOOT DIAGNOSED? A doctor may diagnose athlete’s foot by the symptoms. Or, a doctor may order a skin test if they aren’t sure a fungal infection is causing your symptoms. A  skin lesion potassium hydroxide exam  is the most common test for athlete’s foot. A doctor scrapes off a small area of infected skin and places it in potassium hydroxide. The KOH destroys normal cells and leaves the fungal cells untouched so they are easy to see under a microscope.

11. Treatment Athlete’s foot can often be treated with over-the-counter (OTC) topical antifungal medications . If OTC medications don’t treat your infection, your doctor may prescribe topical or oral prescription-strength antifungal medications . Your doctor may also recommend home treatments to help clear up the infection.

12. OTC MEDICATIONS There are many OTC topical antifungal medications, including: miconazole (Desenex) terbinafine (Lamisil AT) clotrimazole (Lotrimin AF) butenafine (Lotrimin Ultra) tolnaftate (Tinactin

13. DANDRUFF-SEBORRHAEIC DERMATITIS Seborrhoeic dermatitis , also known as  seborrhoea , is a long-term skin disorder. Symptoms include red, scaly, greasy, itchy, and inflamed skin. Areas of the skin rich in oil-producing glands are often affected including the scalp, face, and chest. Dandruff may have several causes, including: Irritated, oily skin. Not shampooing enough. A yeastlike fungus ( malassezia ) that feeds on oils on the scalps of most adults. Dry skin. Sensitivity to hair care products (contact dermatitis) Other skin conditions, such as psoriasis and eczema .

14. CAUSES & TREATMENT Dandruff has been shown to be possibly the result of three factors: Skin oil commonly referred to as sebum or sebaceous secretions The metabolic by-products of skin micro-organisms most specifically Malassezia yeasts. Individual susceptibility and allergy sensitivi ty.

15. MECHANISM The fungus Malassezia furfur (previously known as Pityrosporum ovale ) as the cause of dandruff. While this species does occur naturally on the skin surface of people both with and without dandruff, in 2007 it was discovered that the responsible agent is a scalp specific fungus, Malassezia globose. T he metabolizes triglycerides present in sebum by the expression of lipase, resulting in a lipid byproduct oleic acid. During dandruff, the levels of Malassezia increase by 1.5 to 2 times its normal level. Oleic acid penetrates the top layer of the epidermis, the stratum corneum , and evokes an inflammatory response in susceptible people which disturbs homeostasis and results in erratic cleavage of stratum corneum cells .

16. SEBORRHOEIC DERMATITIS In   seborrhoeic dermatitis , redness and itching frequently occur around the folds of the nose and eyebrow areas, not just the scalp. Dry , thick, well-defined lesions consisting of large, silvery scales may be traced to the less common condition of scalp  psoriasis . Inflammation can be characterized by redness, heat, pain, swelling and can cause sensitivity. Inflammation and extension of scaling outside the scalp exclude the diagnosis of dandruff from seborrhoeic dermatitis .  However, many reports suggest a clear link between the two clinical entities - the mildest form of the clinical presentation of seborrhoeic dermatitis as dandruff, where the inflammation is minimal and remain subclinical . Seasonal changes, stress, and immunosuppression seem to affect seborrheic dermatitis

17. TREATMENT- ANTIFUNGAL AGENTS Antifungal treatments including ketoconazole, zinc pyrithione and selenium disulfide have been found to be effective. Ketoconazole appears to have a longer duration of effect. Ketoconazole is a broad spectrum antimycotic agent that is active against Candida and M. furfur. Of all the antifungals of the imidazole class, ketoconazole has become the leading contender among treatment options because of its effectiveness in treating seborrheic dermatitis as well . Ciclopirox is widely used as an anti-dandruff agent in most preparations

18. Beard ringworm- Tinea Barbae Tinea infections are commonly called ringworm because some may form a ring-like pattern on affected areas of the body. Beard ringworm (tinea barbae ), also known as tinea sycosis or barber's itch, is a fungal infection of the skin, hair, and hair follicles of the beard and mustache area. Beard ringworm may be passed to other people by direct contact with infected people or animals, with contaminated objects, or from the soil . Tinea barbae is a type of  Dermatophytosis . It is most often caused by  Trichophyton mentagrophytes  or  Trichophyton verrucosum . Tinea barbae usually causes superficial, circular patches, but deeper infection may occur. An inflamed  kerion  (a swollen patch generally on the scalp that sometimes oozes pus) may also develop, which can result in scarring and whisker loss. Tinea barbae is rare.  Although beard ringworm is most common in men, it may also affect women who have dark, coarse hair on their faces and necks .

19. Risk Beard ringworm may occur in people of all races. However, it is seen almost exclusively in older teens and adult males. Beard ringworm is more commonly seen in warmer, more humid climates. It is most frequently passed to humans from animals, so agricultural workers are the most commonly infected people with beard ringworm.

20. SIGNS AND SYMPTOMS The most common locations for beard ringworm infection include the following: Chin Cheeks Neck Upper lip Beard ringworm may affect either the outer surface (superficial) or the deep portion of the skin that holds shafts of hair (hair follicles ). If the infection is superficial, beard ringworm appears as a pink-to-red scaly patch ranging in size from 1 to 5 cm. Alternatively, small pus-filled bumps (pustules) may be seen around hair follicles in the affected skin . In deeper forms of beard ringworm, you may see firm red nodules covered with pustules or scabs that may ooze blood and pus. Beard ringworm is usually itchy. Deeper forms of beard ringworm may be accompanied by fever and swollen lymph glands.

21. TREATMENT It is extremely difficult to totally get rid of beard ringworm with only topical medications; oral antifungal medications are usually required. However, if the infection has just started, you might try one of the following over-the-counter antifungal creams or lotions: Terbinafine Clotrimazole Miconazole

22. TREATMENTS KOH MOUNT: To confirm the diagnosis of beard ringworm, your physician might scrape some surface skin material (scales) or pluck an affected hair and place it onto a glass slide for examination under a microscope. If you have many pus-filled lesions or if deeper lumps are present, your physician may wish to perform a procedure to grow out the fungus (fungal culture) in order to discover the particular organism that may be causing the infection. The procedure involves: Penetrating the pus-filled lesion with a needle, scalpel, or lancet. Rubbing a sterile cotton-tipped applicator across the skin to collect the pus. Sending the specimen away to a laboratory. The fungal culture can take up to 3 weeks to produce final results. Since beard ringworm usually requires oral antifungal pills in order to get rid of the infection completely, your physician will likely recommend one of the following oral medications: Terbinafine, Itraconazole , Griseofulvin , Fluconazole, Ketoconazole Beard ringworm should go away within 4–6 weeks after using effective treatment .

23. TINEA VERSICOLOR- BODY WHITESPOT Tinea versicolor is a superficial infection resulting from a normal body yeast. It normally affects the back, shoulders, and upper chest, although it can involve the neck, upper arms, and rarely, the face. It produces a substance that leads to bleaching of the skin and pale patches that last for weeks, even after effective treatment.   Tinea versicolor  results from superficial infection by a yeast,  Malassezia furfur . Tinea versicolor  produces color variations in the skin; dark spots or red on light skin or patches of lightness on dark skin – “versicolor” means color variations . T he yeast causing tinea versicolor usually arises from the patient’s own body flora. Tinea versicolor can produce itching and a red  rash . It is predisposed to develop in areas of previous skin  trauma .

24. SYMPTOMS Discolored patches of skin are the hallmark of tinea versicolor. Versicolor means color variations, and characteristically it will appear dark or red on light skin, and light on dark skin. On the same patient, the appearance may vary over the course of the year depending upon whether the skin is winter pale or summer tanned. On the same patient, the appearance may vary with body location, being pink/brown on the mid back and pale on a tanned neck. The rash is usually confined to shoulders, mid-back, and chest, but occasionally it will extend further down the arms. Facial involvement is only occasionally seen, usually in African-Americans and other darker-skinned patients. Other skin findings such as severe itching, enlarging lumps, skin ulceration,  hair loss , and  swollen lymph nodes  are not symptoms of tinea versicolor and should prompt a search for another diagnosis

25. CAUSES Malassezia furfur , a common human yeast carried by most people, can start to act more like  tinea corporis  ( ringworm ). While most people are never bothered by this yeast, it is also is felt to be responsible for  dandruff  ( seborrhea ), which explains why some of the treatments used for  dandruff  also help tinea versicolor.

26. TREATMENT Topical econazole ( Spectazole ), ciclopirox ( Ciclodan ),  ketoconazole  ( Xolegel ,  Nizoral ),  clotrimazole  (Lotrimin), and miconazole (Monistat) are all effective in treating tinea versicolor when applied until there is no further itching, scaling, or redness. Topical terbinafine ( Lamisil ) may be effective but may not work as well for yeast-related problems as it does for other  fungal infections . Products that combine an antifungal with an exfoliating agent ( Kerasal ) or with an absorptive powder ( Zeasorb ) would be harder to use over a large area of the back and shoulders than a cream or spray.

27. ONYCHOMYCOSIS Onychomycosis , also known as tinea unguium , is a fungal infection of the nail. Symptoms may include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail bed. Toenails or fingernails may be affected, but it is more common for toenails to be affected.

28. ONYCHOMYCOSIS

29. TREATMENT

30. References https://en.wikipedia.org/wiki/Onychomycosis#:~: text=Onychomycosis%2C%20also%20known%20as%20tinea,is%20more%20common%20for%20toenails Kauffman, Carol A. (2018).  Harrison's Principles of Internal Medicine . New York, NY: McGraw-Hill https:// en.wikipedia.org/wiki/Athlete%27s_foot https://dermnetnz.org/topics/tinea-barbae