Fungal infection

1. DISEASE CONTROL AND
PREVENTION
PREPARED BY :PHILIPO RAPHAEL

2. IDENTIFICATION OF PATIENT WITH DERMATOPHYTES

3. INTRODUCTION
Dermatomycosis is a term applied to fungal
infection of the skin and its appendages i.e hair
and nails
 Different types are identified according to
causative organism, site and clinical appearance
 They are sometimes indicators of immune
suppression as occurs in AIDS, cancer, diabetes
and tuberculosis

4. TYPES OF DERMATOMYCOSIS
Types of dermatomycosis
 Tinea capitis (ringworm of the scalp)
 Tinea corporis (ringworm of the body)
 Tinea pedis (ringworm of the foot or athletes
foot)
 Tinea unguium (ringworm of the nails)
 Tinea versicolor or pityriasis

5. DIAGNOSTIC APPROACHES FOR
DERMATOPHYTES

6. MODES OF TRANSMISSION OF
DERMATOPHYTES
All fungi may be transmitted to humans by direct skin
contact from their habitat in the soil, vegetation,
animals or other individuals
Genital infection (balanitis and vulvo-vaginitis) may
spread during sexual intercourse but most candida
infections are not sexually transmitted
Local conditions on the skin such as moist and hot
environment are predisposing factors

7. SIGNS AND SYMPTOMS OF
DERMATOPHYTES
Tinea Capitis (Ringworm of the scalp)
Begins as a small papule which spreads to
involve a larger area
 Hairs in the affected skin become brittle and
break off easily
Occurs mainly in children under 10 years and
often disappears after puberty

8. IMAGE SHOWING TINEA CAPITIS
INFECTION

9. TINEA CORPORIS
Tinea Corporis (Ringworm of the body)
Characterized by flat ring shaped spreading
lesions
 The ring lesions are reddish, vesicular or
pastula, and may be dry and scaly, or moist
and crusted
 The central area often clears leaving
apparently normal skin

10. IMAGE SHOWING TINEA CORPORIS
INFECTION

11. TINEA PEDIS
Tinea Pedis (Ringworm of the foot or athletes
foot)
 Characterized by scaling and cracking of the skin
between the toes, particularly the fourth and
fifth toes
Tinea Unguium (Ringworm of the nails)
 Characterized by a thickening, discolouration and
brittleness of the nails
 There is accumulation of caseous materials
beneath the nail which becomes chalky and
disintegrates

12. IMAGE SHOWING TINEA PEDIS
INFECTION

13. TINEA VERSICOLOR
Tinea Versicolor or Pityriasis
 Skin on side of face, neck and chest show
many irregular, round and light-coloured areas
This is a very superficial infection

14. IMAGE SHOWING TINEA VERSICOLOR
INFECTION

15. TREATMENT OF DERMATOPHYTES
Tinea Capitis
 Griseofulvin is the drug of choice, although oral
therapy with Itraconazole and Terbinafine are effective
alternatives.
Oral Fluconazole seems to have similar efficacy to
Griseofulvin
 Give Griseofulvin at a dosage of 250 mg twice a day or
500mg once a day in adults and 20-25mg/kg for
children for 6-12 weeks.
 Whitefield’s ointment applied twice daily for 3 – 6
weeks has also been used in areas where the above
drugs are not available.

16. GRISEOFULVIN TABLETS

17. ALTERNATIVE TREATMENT OF
GRISEOFULVIN

18. ALTERNATIVE TREATMENT OF
GRISEOFULVIN

19. ALTERNATIVE TREATMENT OF
GRISEOFULVIN

20. TREATMENT OF DERMATOPHYTES
Tinea Corporis
This responds well with application of topical
antifungal such as Clotrimazole 1% cream,
lotion or solution (use twice daily), and
ketoconazole 2% cream (used once daily)
 Severe disease and disease in immune
compromised patients should be treated with
systemic agents

21. TREATMENT OF T.CORPORIS

22. TREATMENT OF T.CORPORIS

23. TREATMENT OF CHOICE FOR
T.CORPORIS

24. TREATMENT OF T.CRURIS
Tinea Cruris
 Topical antifungal treatment should be used
(just as in Tinea corporis)
Resistant lesions can be treated with
Griseofulvin or other systemic agents
 Patients should be advised to dry the area
completely after bath and not to wear tight
clothing

25. TREATMENT OF TINEA PEDIS
Tinea Pedis
 Topical agents applied for duration of 4 weeks
are usually effective
 Chronic or extensive disease may require
 Griseofulvin 250 – 500mg twice daily for 6 –
12 weeks, or
 Terbinafine 250 mg daily or itraconazole 200
mg daily

26. TREATMENT OF TINEA UNGUIUM
Tinea Unguium
 Systemic antifungal are indicated
 Terbinafine and itraconazole are more
effective than other agent

27. IMAGE SHOWING TINEA UNGUIUM
INFECTION

28. SYSTEMIC ANTIFUNGALS

29. SYSTEMIC ANTIFUNGALS

30. PREVENTION AND CONTROL OF
DERMATOPHYTES
Dermatomycosis Prevention and Control
 Early diagnosis and treatment of infected
person
Improve personal hygiene – regular bathing
with water and soap
 Dry skin well (especially feet)

31. KEY POINTS
Dermatomycosis is a fungal infection of the skin
 Four types of dermetomycosis are common i.e.
tinea capitis, corporis, pedis, unguim and
vesicolor
 Fungal infections are mostly transmitted through
body contact
 Signs and symptoms depends on the area
affected

32. EVALUATION
What causes of dermatophytes?
 What is the mode of transmission of
dermatophytes?
 What are major signs and symptoms of
dermatophytes?
 What is the treatment of dermatophytes?
 What are the prevention and control measures
of dermatophytes?