Dermatomycoses dermatophytoses Dermatophyte Infection hair cutaneoushorny layer nail

真菌性皮肤病 Dermatomycoses

一 皮肤癣菌病 dermatophytoses

Dermatophyte Infection hair cutaneoushorny layer nail plate dermatophytosis

According to different parts：tinea capitis tinea corporis tinea cruris tinea manum tinea pedis onychomycosis tinea barbae

According to different parts：tinea capitis tinea corporis tinea cruris tinea manum tinea pedis onychomycosis tinea barbae

According to different parts：tinea capitis tinea corporis tinea cruris tinea manum tinea pedis onychomycosis tinea barbae

According to different parts：tinea capitis tinea corporis tinea cruris tinea manum tinea pedis onychomycosis tinea barbae

dermatophytids metabolite of trichophyton blood circulation; dermato-allergic reaction out of focus

etiology Trichophyton human Microsporum infection Epidermophyton animal dermatophytosis

1 Leading country dermatophytes in our

dermatophytes invasion hair root 、hair strunk 、 nail plate 、 cutaneous corneum stratum tinea barbae onychomycosis tinea corporis tinea of feet and hands

the relationship between characters of dermatophytes and clinic Character: because of keratinophilic Clinic: prone to invade stratum coreum. Character: Growing in 25 -28 o. C Clinic: happening at summer or autumn. .

the relationship between characters of dermatophytes and clinic Character: Needing moderate humidity Clinic: infections exist at the moist and sweaty places Character: develop from center to peripheral Clinic: lesions looks like the ring.

the relationship between characters of dermatophytes and clinic Character: growing rapidly Clinic: lesions happening after one week commonly Character: having nothing to do with sun light Clinic: able exist in UV , but fearing dry and high temperature Character: carbon and nitrogen are neccessary Clinic: DM、 using long-term corticosteroids and thick lamina corticalis are easy to infect.

the relationship between characters of dermatophytes and clinic Character: human 、soil and animal are susceptibe. Clinic: different infected sources , different clinical appearance

tinea corporis of cruris Primary lesions ： papule、blister 、 papulovesicle

tinea cruris

differential diagnosis：circumduction erythema 、pityriasis rosea、neurodermatitis 、eczema

treatment ： topical treatment : Compound Benzoic Acid liniment（tinea corporis） Bid�× 2 -4 weeks Compound Resorcinol Liniment (tinea cruris) Bid�× 2 -4 weeks 3％miconazole cream 、terbinafine cream 、 ketoconazole cream etc (tinea corporis and cruris) Bid�× 2 -4 weeks. Generalized corporis tinea Sporanox 200 mg/d/ adult× 1 Terbinafine 0. 25 g qd× 1 -2 weeks Fluconazol 0. 15 g qw × 1 -2 weeks

Tinea of hands and feet EEfinition: finger and toe web and palma, metatarsus infect dermatophyte are called tinea of hands and feet. 1>. thick horny layer in hands and feet 2>. easily scrape 3>. sweaty, damp stuffy in feet. inducing dermatophytosis of hands and feet.

Clinical grouping scale- blister type 、 maceration -erosion mode 、hyperkeratotic pattern scale- blister type

hyperkeratotic pattern maceration -erosion mode 角化过度型

differential diagnosis ：extremity eczema 、 pompholyx 、exfoliative keratolysis

Tinea of hands and feet treatment 1、scale- blister type soaking with 10％glacial acetic acid Compound Benzoic Acid liniment miconazole cream pulvis pro pedibus ext 2、maceration -erosion mode Compound Resorcinol Liniment miconazole cream and pulvis pro pedibus ext slight effusion: radiomycin anthraco paste miconazole cream and pulvis pro pedibus considerable effusion: 0. 5 ％fradiomycin FL、 miconazole cream and pulvis pro pedibus second infection ：using the antibiotic 3、hyperkeratotic pattern Whitfield ointment 、miconazole cream companion with rhagades : carbamide lip etc. note to ringworm of hand: avoidance miscellaneous physical o chemical stimulus.

tinea capitis ：both dandruff and hair are infected dermatophytes. clinical manifestation: papule ; blister; scale; pustule.

clinical appearance susceptible population : favus child or adult. tinea alba child. black dot tinea child or adult. cutaneous lesion: favus papule , pustule , scutulum, atrophic scar. tinea alba seborrheic dermatitis’ scale child and mother patch black dot tinea seborrheic dermatitis’ scale ; macula sick hair ： favus dry and no luster, easy brisement, different leng. tinea alba brisement part from 2 -4 mm patient’scalp. 。 black dot tinea fracture part from patient’scalp. Wood light ： favus dark green fluorescence tinea alba bright green fluorescence black dot tinea no fluorescence

direct microscope ： Microsporum lanosum 、Microsporum corrosion fungus culture Trichophyton violaceum Trichophyton tonsurans.

course of disease favus slow proceeding ; inability autotherapy ; scar tinea alba rapid proceeding ; adolescent age autotherapy; no scar black dot tinea slow proceeding inability autotherapy minority scar

Kerion Definition: a deep, pustular type of tinea resembling a carbuncle or kerion is observed on the glabrous skin , which is a topical allergic response. Clinical manifestation: one or several manifest inflammation abscesses with overt edge feel fluctuant, hair become loosening and broken off easily. Common lingering effects are scar and nonvolatile alopecia. Differential diagnosis: dandruff eczema seborrheic dermatitis amianth pityriasis psoriasis alopecia areata.

prevention and cure of tinea capitis 1. overdose terbinafine : <20 kg 62. 5 mg qd 2 w at least 20 kg∽ 40 kg 125 mg qd 2 w at least >40 kg 250 mg qd 2 w at least fluconazol: 3∽ 6 mg/kg/d, 2 w at least itraconazole: 3∽ 6 mg/kg/d, 2 w at least.

prevention and cure of tinea capitis 2. drug for external: miconazole cream ext , bid× 2 m 3. shampoo: sulfur soap/d , × 2 m 4. shaving head: cutting all hairs, qw× 2 m. 5. megatemperature disinfection: towel, sheeting, pillowcase, comb etc. Kerion: forbidding incision and drainage.

Onychomycosis Definition: it is difined as the infection of the nail by fungus and represents up to 30％ of diagnosed superficial fungal infections. Clinical appearance: thick nail plate nail segregation colouration alteration and breakage, etc.

prevention and cure of onychomycosis 1. removing morbid nails: wafering mornid nails after painting 40％carbamide cream, then getting rid of them. 2. drug for external: 30％glacial acetic acid or 2％ miconazole tincture, ext bid × 3∽ 6 m 3. overdose : terbinafine : 0. 25 g qd × 3∽ 4 m fluconazol: 0. 15 g qw × 3∽ 4 m itraconazole: 0. 2 g qd 1 w/m × 3∽ 4 m