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Tadulako University
Palu
LECTURE BLOCK 8
2014
FUNGAL INFECTION
IN DERMATOLOGY
Diany Nurdin
Dermato-venereology department
Faculty of Medicine
Tadulako University
Palu
FUNGAL INFECTION
A. CLASIFICATION :
- SUPERFICIAL MYCOSIS
- SUB-CUTANEOUS/DEEP MYCOSIS
- SYSTEMIC MYCOSIS
- SUPERFICIAL MYCOSIS
- Dermatophyta
- Non Dermatophyta
DERMATOPHYTOSIS
GENUS:
Trichophyton Sp.
Epidermophyton Sp.
Mycrosporum Sp.
Cont...
CLASSIFISATION
1. ANTHROPOPHILIC
2. ZOOPHILIC (M.canis dog and cat)
3. GEOPHILIC ( M. gypseum soil)
TRANSMISION:
PATHOGENESIS :
ADHERENCE PENETRATION DEVELOPMENT OF
HOST RESPONSE
CLINICAL MANIFESTATION
TINEA CORPORIS
TINEA CAPITIS
Kerion
Gray patch
Favus
Black dot
TINEA CRURIS
TINEA PEDIS
LABORATORY EXAMINATION
1. Woods Lamp:
Blue-green fluorescence
2. Microscopy: KOH 10-30%
3. Culture: Saborauds agar
4. Biopsy
5. Skin test
NON DERMATOPHYTOSIS
1.CANDIDIASIS
CUTANEUS CANDIDIASIS
EPIDEMIOLOGY
Age: Any age.
Etiology: Candida albicans
Predisposing factors:
Diabetes, obesity, hyperhidrosis,
heat, maceration,
polyendocrinopathies,
systemis and topical corticosteroid
CUTANEUS CANDIDIASIS
LABORATORY
Direct microscopy: scraping using Grams
stain
or KOH preparation (10-30%)
Fungal culture: Saboraud medium
MANAGEMENT
Prevention: Keeping intertriginous areas
dry
Therapy : Topical antifungal
MUCOSAL CANDIDIASIS
EPIDEMIOLOGY
Age : All ages
Etiology : Candida albicans
Transmission : Overgrowth associated
with local or systemic suppression of
immunity or antibiotic therapy
MUCOSAL CANDIDIASIS
RISK FACTORS:
HIV infection
debilitation
diabetes mellitus
broad spectrum antibiotic therapy
topical or parenteral
corticosteroid
Parenteral hyperalimentation
corpus alienum
MUCOSAL CANDIDIASIS
PHYSICAL EXAMINATION
MUCOSAL CANDIDIASIS
2. PITYRIASIS VERCISOLOR
EPIDEMIOLOGY
Predisposing factors:
high humidity, high rate sebum
production
PITYRIASIS VERSICOLOR
SKIN SYMPTOM
Usually none or mild
pruritus
SKIN LESIONS
Macule, white to
brown color, sharply
marginated with fine
scaling (finger nail
sign)
PITYRIASIS VERSICOLOR
LABORATORY
EXAMINATIONS
Direct microscopy
KOH 10 to30%
TREATMENT
Systemic antifungal
Griseovulfin :Dermatophytosis T. Kapitis
Azole group (ketokonazol, flukonazol,
Itrakonazol : All fungal
Terbinafin: Dermatophytosis, PVC
Topical
Azole : all fungal
Terbenafin, whitfield oint : Dermatophyta
Selenium sulfide, Na thiosulfate : PVC
EPYZOONOSIS
ECTOPARASITIC INFECTION
Epidemiology:
Parasitic infection are
endemic in many developing countries
Risk factors:
1. Social - economic
2. Health education
3. Hygiene
4. Etc.
CLASSIFICATION
1. Completed inflammation:
a. Amoebiasis of the skin
b. Insect bites
2. Incomplete inflammation:
a. scabies
b. larva migrans (creeping Eruption)
c. pediculosis
Insect bites
Caused : insect toxin
Symptoms and Signs :
erythema with central necrosis
papule and punctum
nodus/urtika with punctum
vesicula bulla
Scabies
Caused: Sarcoptes Scabiei
Predilection:
Adult: hands, wrist, elbows,
anterior axillary fold, abdomen, buttocks,
areolas of female breasts, genital.
Infant : head, neck, palm and sole
SCABIES
General Considerations :
THERAPY
CAUSATIVE THERAPY
PERMETHRIN
GAMEKSAN
BENZYL BENZOAT
2-4 OINT (SULFUR)
IVERMECTIN ORAL (NOT AVAILABLE)
SYMPTOMATIC THERAPY
ANTIHISTAMIN
A serpiginous,
linear,raised, tunnel-like
erythematous lesions
MANAGEMENT
Anti parasite :
Cryo surgery
Nitrogen liquid
REFERRENCES
THANK YOU