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Cutaneous Mycoses (dermatophytosis)

 General futures
 Involves skin, nail, and hair
 Known as ringworm or tinea
 Keratinized layer are infected
 Fungi known as dermatophytes
 Infection range form mild to sever
 Depend on host state and fungal species
 Resist cycloheximide
 Etiologic agents
 Over hundred species described
 Only 40 are valid
 less associated with human diseases
 Grouping of dermatophytes
 Anamorphic state (asexual phase)
 Three genera
 Depend on sporulation
Etiologic agents cont.
 Morphologic futures
 Nutritional requirements
 Microsporum, Trichophyton and
Natural habitat
 Anthropophilic (humans)
 Zoophilic (animal)
 Geophilic (soil)
 All of them can cause diseases in human
Natural habitat Cont.
 Trichophyton rubrum...
 Microsporum gypseum...
 Microsporum canis: cats and dogs
 Microsporum nanum: swine Trichophyton
verrucosum: horse and swine…
Clinical Classification
 Infection is named according to the
anatomic location involved
a. Tinea barbae e. Tinea pedis
(Athlete’s foot)
b. Tinea corporis f. Tinea manuum
c. Tinea capitis g. Tinea unguium
d. Tinea cruris
(Jock itch)
Images of dermatophytes infections

T. pedis


T. manuum
Pathogenesis and Immunity
 Contact and trauma
 Moisture
 Crowded living conditions
 Cellular immunodeficiency (chronic
 Re-infection is possible (but, larger
inoculum is needed, the course is
shorter )
Clinical manifestation
 Tinea capitis (scalp)
 Common in children
 Typical lesions," kerion”, scarring,
 Favus (Tinea favosa)
 Debris, yellow cup shaped crust
 Scutula
 Cicatricial alopecia
 T. schoenleinii
Clinical manifestation Cont.
 Skin
 Circular, dry, erythematous, scaly,
itchy lesions
 Nail
 Thickened, deformed, friable,
discoloured nails, subungual debris
 Close human contact
 Sharing clothes, combs, brushes,
towels, bed sheets. (Indirect)
 Animal-to-human contact (Zoophilic)

Human contact Animal contact

Dermatophytes Diagnosis
I. Clinical
 Appearance
 Wood lamp (UV, 365 nm)
II. Lab
 Direct microscopic examination
(10-25% KOH)
 Ectothrix/endothrix/favus hair
Dermatophytes Diagnosis images

Clinical Wood lamp

Edothrix KOH Ectothrix

Hair invasion by Dermatophytes
Dermatophytes Diagnosis
 Culture
 Mycobiotic agar
 Sabouraud dextrose agar
 Should contain antibiotic $ actidione

M. canis T. vilaceum

T. rub rum
Dermatophytes Identification

 Colony characteristics
 Microscopic morphology
 genus Macroconidium Microconidium
 Microsporum---- fusiform---------------(+)
 Epidermophyton clavate-----------------(-)
 Trichophyton-- - (few) cylindrical/ --- --(+)
clavate/fusiform single,
in clusters
Microscopic morphology of
 Examples

Microsporum canis T rubrum

E. floccosum Chlamydospores
 Topical
 Miconazole, clotrimazole
 econazole, terbinafine...
 Oral
 Griseofulvin
 Ketaconazole
 Itraconazole
 Terbinafine