Dermatophytosis Cutaneous mycosis Dermatomycosis Yeast Saprophytes Systemic mycosis

Dermatophytosis • • • Definition Greek English Persian Dermatophytes

Dermatophytosis • Dermatophyte – Sexual • Arthroderma – Asexual • Macroconidia – Trichophyton –

Dermatophytosis • Trichophyton – Cylinder • Microsporum – Spindle • Epidermophyton – Club

Dermatophytosis • Trichophyton – T. rubrum, T. mentagrophytes, T. violaseum, T. schoenleinii, T. verrucosum

Dermatophytosis • Geophilic – M. gypseum • Zoophilic – M. canis, T. verrucosum •

Dermatophytosis • • Tinea capitis Tinea barbae Tinea cruris Tinea pedis Tinea mannum Tinea

Tinea capitis • • Definition Trichophyton & Microsporum Clinical manifestation Crust – Krion –

Ectothrix • • Outside Krion Cuticle Gray patch Age Genus After maturation M. canis,

M. canis • • • Zoophilic Dog & cat Yellow Microconidia Few Macroconidia –

M. gypseum • • Geophilic Favus( may be) Red Don't have knob

Endothrix • • Inside Cuticle Black dot, bald patch Age Genus After maturation Anthropophilic

Favus • • Hyphae (Air canal) scatulum Age Genus After maturation Cheesy or mouse

T. schoenleinii • Anthropophilic • Favic chandelier

Differential diagnosis • Alopecia • Trichotillomania

Laboratory diagnosis • Sampling – Sesser • Culture – Scc(2) • Direct – Ectothrix,

Tinea barbae • • • Definition Genus Age Beard & mustache Zoophilic T. verrucosum,

T. Verrucosum • Zoophilic • Cow & cattle • 37° • Chlamydioconidia

Tinea barbae • Clinical manifestation – Circular – Scaling – Vesicle – Ectothrix, Endothrix,

Tinea barbae • Differential diagnosis – Alopecia • Laboratory diagnosis

Tinea cruris • • Definition Sever itch With tinea pedis Ecology Male Anthropophilic E.

E. floccosum • Anthropophilic • Do not have microconidia • Macroconidia – 2 -4

Tinea cruris • • Clinical manifestation Maculae Red Vesicle Erythematic Itch Don't involve pubis

Tinea pedis • Athlet s foot • Age • Shoes, warm, moisture • T.

Tinea pedis • Clinical manifestation – Chronic intertrigenous – Chronic papulosquamous hyperkeratotic – Vesicular

Tinea pedis • • • Chronic intertrigenous Common type White scale Between 5, 4

Tinea pedis • • Chronic papulosquamous hyperkeratotic T. rubrum Moccasin foot Scaling

Tinea pedis • • Vesicular or sub acute T. M, T. R Id reaction

Tinea pedis • Acute ulcerative • Bacteria • Treatment is difficult

Tinea mannum • • Definition Position Clinical manifestation Agents

T. mentagrophytes • • 4 strain Interdigital is anthropophilic Erinaci is zoophilic (-) Hair

T. mentagrophytes • Hyphae – Spiral or coil • Macroconidia – Club

T. rubrum • Anthropopilic • • CMA Urease Hair Sorbitol + +

Tinea corporis • • • Definition Trichophyton Microsporum Body reaction Contagious Direct & indirect

Tinea corporis • Tinea imbricata – T. concentricum – Anthropophilic – Clinical manifestation –

Laboratory diagnosis • • Tinea cruris, pedis, mannum & corporis Sampling Direct Culture

Tinea unguium • Definition • Onychomycosis – Yeast – Saprophytes • scopulariopsis

Tinea unguium • Leukonychia mycotica • invasive

Dermatophytosis • Treatment – Griseofulvine – Terbinafin

Factors involved • Regional – Heat – Humidity • Individual – Local • Hyperhydrosis

Antigens • Complex structure – Cell wall Antigen – Enzymes

Cell wall Antigen • • Chitin Glucan Mannoprotein Galactomannan

Enzymes • • Keratinase Elastase Collagenase Proteinase – Metalloproteinase – Serine proteinase

Immune system • Skin • Unsaturated transferin • α 2 macroglobulin

Skin • • • Physical & chemical barrier Innate immunity Low humidity UV Flora

skin • Keratinization & Epidermal Proliferation – Increase turn over – Shedding • Antifungal

Immune system • Unsaturated transferin – Free iron • e chain transport • Krebs

The inflammatory response • Reverse relationship • Inflammatory & chronic – Anthropophilic • Inflammation

The inflammatory response • Dermatophyte → complement → chemo tactic Hydrogen peroxide alternative C

Humeral immunity • Types of Ab – Ig. G, Ig. M, Ig. A &

Cell mediated immunity • Deficiency in CMI – Permanent infection – Recurrent infection

Regulation Of Immune Response • Mannan – Immune inhibitor – Blocking of monocyte receptors

Immunization • T. verrucosum • LFT-130 • Drug therapy

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Dermatophytosis • Cutaneous mycosis • Dermatomycosis – Yeast – Saprophytes – Systemic mycosis – Dermatophytes • Dermatophytosis

Dermatophytosis • • • 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 • • Tinea capitis Tinea barbae Tinea cruris Tinea pedis Tinea mannum Tinea corporis Tinea unguium

Tinea capitis • • Definition Trichophyton & Microsporum Clinical manifestation Crust – Krion – Scatulum • Age • Genus • Ectothrix, Endothrix, Favus

Ectothrix • • Outside Krion Cuticle Gray patch Age Genus After maturation M. canis, M. audouinii, T. verrucosum, T. mentagrophytes

M. canis • • • Zoophilic Dog & cat Yellow Microconidia Few Macroconidia – Thick wall – Knob

M. gypseum • • Geophilic Favus( may be) Red Don't have knob

Endothrix • • Inside Cuticle Black dot, bald patch Age Genus After maturation Anthropophilic – T. violaceum, T. sudanense, T. tonsuranse

Favus • • 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

Tinea barbae • • • 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

Tinea barbae • Differential diagnosis – Alopecia • Laboratory diagnosis

Tinea cruris • • 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 • • Clinical manifestation Maculae Red Vesicle Erythematic Itch Don't involve pubis

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 • • • Chronic intertrigenous Common type White scale Between 5, 4 & 4, 3 Itch

Dermatophytosis • Tinea pedis

Tinea pedis • • Chronic papulosquamous hyperkeratotic T. rubrum Moccasin foot Scaling

Dermatophytosis • Tinea pedis

Tinea pedis • • Vesicular or sub acute T. M, T. R Id reaction Dermatophytid

Dermatophytosis • Tinea pedis

Tinea pedis • Acute ulcerative • Bacteria • Treatment is difficult

Tinea mannum • • Definition Position Clinical manifestation Agents

T. mentagrophytes • • 4 strain Interdigital is anthropophilic Erinaci is zoophilic (-) Hair penetration – – DW 10% yeast extract Horse hair 25° to 4 week 20 ml 5 D

T. mentagrophytes • Hyphae – Spiral or coil • Macroconidia – Club

T. rubrum • Anthropopilic • • CMA Urease Hair Sorbitol + +

Tinea corporis • • • Definition Trichophyton Microsporum Body reaction Contagious Direct & indirect Annular Center & margin Vesicle – T. M, T. V

Dermatophytosis • Tinea corporis

Tinea corporis • Tinea imbricata – T. concentricum – Anthropophilic – Clinical manifestation – Genetic – Ecology

Tinea imbricata

Laboratory diagnosis • • Tinea cruris, pedis, mannum & corporis Sampling Direct Culture

Tinea unguium • Definition • Onychomycosis – Yeast – Saprophytes • scopulariopsis

Tinea unguium • Leukonychia mycotica • invasive

Dermatophytosis • Tinea unguium

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 • • Chitin Glucan Mannoprotein Galactomannan

Enzymes • • Keratinase Elastase Collagenase Proteinase – Metalloproteinase – Serine proteinase

Immune system • Skin • Unsaturated transferin • α 2 macroglobulin

Skin • • • 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 • α 2 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 C 5 a Myeloproxidase Oxidative Super oxide Neutrophile Activation Defensin Nonoxidative Lactoferin Catepsin

Humeral immunity • Types of Ab – Ig. G, Ig. M, Ig. A & Ig. E – 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