Transcript Dermatophytosis

Dermatophytosis
• Cutaneous mycosis
• Dermatomycosis
– Yeast
– Saprophytes
– Systemic mycosis
– Dermatophytes
• Dermatophytosis
Dermatophytosis
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Definition
Greek
English
Persian
Dermatophytes
Dermatophytosis
• Dermatophyte
– Sexual
• Arthroderma
– Asexual
• Macroconidia
–Trichophyton
–Microsporum
–Epidermophyton
Dermatophytosis
• Trichophyton
– Cylinder
• Microsporum
– Spindle
• Epidermophyton
– Club
Dermatophytosis
• Trichophyton
– T.rubrum, T.mentagrophytes, T.violaseum,
T.schoenleinii, T.verrucosum
• Microsporum
– M.canis, M.gypseum
• Epidermophyton
– E.floccosum
Dermatophytosis
• Geophilic
– M.gypseum
• Zoophilic
– M.canis, T.verrucosum
• Anthropophilic
– T.rubrum, T.violaseum, T.schoenleinii
E.floccosum
Dermatophytosis
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Tinea capitis
Tinea barbae
Tinea cruris
Tinea pedis
Tinea mannum
Tinea corporis
Tinea unguium
Tinea capitis
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Definition
Trichophyton & Microsporum
Clinical manifestation
Crust
– Krion
– Scatulum
• Age
• Genus
• Ectothrix, Endothrix, Favus
Ectothrix
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Outside
Krion
Cuticle
Gray patch
Age
Genus
After maturation
M.canis, M.audouinii,
T.verrucosum,
T.mentagrophytes
M.canis
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Zoophilic
Dog & cat
Yellow
Microconidia Few
Macroconidia
– Thick wall
– Knob
M.gypseum
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Geophilic
Favus( may be)
Red
Don't have knob
Endothrix
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Inside
Cuticle
Black dot, bald patch
Age
Genus
After maturation
Anthropophilic
– T.violaceum,
T.sudanense,
T.tonsuranse
Favus
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Hyphae (Air canal)
scatulum
Age
Genus
After maturation
Cheesy or mouse judder
T.schoenlinii
lustreless
T.schoenleinii
• Anthropophilic
• Favic chandelier
Differential diagnosis
• Alopecia
• Trichotillomania
Laboratory diagnosis
• Sampling
– Sesser
• Culture
– Scc(2)
• Direct
– Ectothrix, Endothrix, Favus
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Dermatophytosis
• Tinea capitis
Tinea barbae
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Definition
Genus
Age
Beard & mustache
Zoophilic
T.verrucosum, T.mentagrophytes
T.Verrucosum
• Zoophilic
• Cow & cattle
• 37°
• Chlamydioconidia
Tinea barbae
• Clinical manifestation
– Circular
– Scaling
– Vesicle
– Ectothrix, Endothrix, Favus
Dermatophytosis
• Tinea barbae
Dermatophytosis
• Tinea barbae
Dermatophytosis
• Tinea barbae
Tinea barbae
• Differential diagnosis
– Alopecia
• Laboratory diagnosis
Tinea cruris
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Definition
Sever itch
With tinea pedis
Ecology
Male
Anthropophilic
E.floccosum, T.mentagrophytes, T.rubrum
E.floccosum
• Anthropophilic
• Do not have
microconidia
• Macroconidia
– 2-4 or 3-5 cells
• E.stoackdaleae
Tinea cruris
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Clinical manifestation
Maculae
Red
Vesicle
Erythematic
Itch
Don't involve pubis
Dermatophytosis
• Tinea cruris
Dermatophytosis
• Tinea cruris
Dermatophytosis
• Tinea cruris
Dermatophytosis
• Tinea cruris
Tinea pedis
• Athlet ́s foot
• Age
• Shoes, warm,
moisture
• T.M, T.R, E.F
Tinea pedis
• Clinical manifestation
–Chronic intertrigenous
–Chronic papulosquamous
hyperkeratotic
–Vesicular or sub acute
–Acute ulcerative
Tinea pedis
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Chronic intertrigenous
Common type
White scale
Between 5,4 & 4,3
Itch
Dermatophytosis
• Tinea pedis
Dermatophytosis
• Tinea pedis
Dermatophytosis
• Tinea pedis
Tinea pedis
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Chronic papulosquamous hyperkeratotic
T.rubrum
Moccasin foot
Scaling
Dermatophytosis
• Tinea pedis
Dermatophytosis
• Tinea pedis
Tinea pedis
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Vesicular or sub acute
T.M, T.R
Id reaction
Dermatophytid
Dermatophytosis
• Tinea pedis
Dermatophytosis
• Tinea pedis
Dermatophytosis
• Tinea pedis
Dermatophytosis
• Tinea pedis
Dermatophytosis
• Tinea pedis
Tinea pedis
• Acute ulcerative
• Bacteria
• Treatment is difficult
Tinea mannum
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Definition
Position
Clinical manifestation
Agents
T.mentagrophytes
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4 strain
Interdigital is anthropophilic
Erinaci is zoophilic (-)
Hair penetration
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DW
10% yeast extract
Horse hair
25° to 4 week
20 ml
5D
T.mentagrophytes
• Hyphae
– Spiral or coil
• Macroconidia
– Club
T.rubrum
• Anthropopilic
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CMA
Urease
Hair
Sorbitol
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Tinea corporis
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Definition
Trichophyton
Microsporum
Body reaction
Contagious
Direct & indirect
Annular
Center & margin
Vesicle
– T.M, T.V
Dermatophytosis
• Tinea corporis
Dermatophytosis
• Tinea corporis
Dermatophytosis
• Tinea corporis
Tinea corporis
• Tinea imbricata
– T.concentricum
– Anthropophilic
– Clinical manifestation
– Genetic
– Ecology
Tinea imbricata
Tinea imbricata
Laboratory diagnosis
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Tinea cruris, pedis, mannum & corporis
Sampling
Direct
Culture
Tinea unguium
• Definition
• Onychomycosis
– Yeast
– Saprophytes
• scopulariopsis
Tinea unguium
• Leukonychia mycotica
• invasive
Dermatophytosis
• Tinea unguium
Dermatophytosis
• Tinea unguium
Dermatophytosis
• Tinea unguium
Dermatophytosis
• Tinea unguium
Dermatophytosis
• Tinea unguium
Dermatophytosis
• Tinea unguium
Dermatophytosis
• Tinea unguium
Dermatophytosis
• Onychomycosis
Dermatophytosis
• Onychomycosis
Dermatophytosis
• Treatment
– Griseofulvine
– Terbinafin
Factors involved
• Regional
– Heat
– Humidity
• Individual
– Local
• Hyperhydrosis
• Local steroid
– Systemic
• Immunosuppression
• Corticosteroid
Antigens
• Complex structure
– Cell wall Antigen
– Enzymes
Cell wall Antigen
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Chitin
Glucan
Mannoprotein
Galactomannan
Enzymes
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Keratinase
Elastase
Collagenase
Proteinase
– Metalloproteinase
– Serine proteinase
Immune system
• Skin
• Unsaturated transferin
• α2 macroglobulin
Skin
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Physical & chemical barrier
Innate immunity
Low humidity
UV
Flora
skin
• Keratinization & Epidermal Proliferation
– Increase turn over
– Shedding
• Antifungal agent
– Saturated fatty acid
Immune system
• Unsaturated transferin
– Free iron
• e chain transport
• Krebs cycle
• α2 macroglobulin
– Keratinase inhibition
The inflammatory response
• Reverse relationship
• Inflammatory & chronic
– Anthropophilic
• Inflammation
• Infection
low
permanent
– Zoophilic & geophilic
• Inflammation
• Infection
sever
self limitation
The inflammatory response
• Dermatophyte → complement → chemo tactic
Hydrogen peroxide
alternative
C5a
Myeloproxidase
Oxidative
Super oxide
Neutrophile Activation
Defensin
Nonoxidative
Lactoferin
Catepsin
Humeral immunity
• Types of Ab
– IgG, IgM, IgA & IgE
– Nonprotective
Cell mediated immunity
• Deficiency in CMI
– Permanent infection
– Recurrent infection
Regulation Of
Immune Response
• Mannan
– Immune inhibitor
– Blocking of monocyte receptors
– In vitro
• Inhibition of lymphoblast production
• Inhibition of lymphocyte proliferation
Immunization
• T.verrucosum
• LFT-130
• Drug therapy