clinical dermatology Lange medical book 1st edition . Wikipedia fungal skin infections are commonly affect the outer layer of the skin, nails and hair. Most of the fungi causing infections are usually dermatophytes (tinea), yeast (candida) and molds

1. Fungal skin
infection
Submitted by –RUPAM CHATURVEDI

2. FUNGAL INFECTION

3. Pityriasis versicolor
• Etiological organism -Malassezia are part of the normal
skin microbiota.
• Affected Area –seborrheic .
• Hypopigmented –due to azelaic acid, which diffuses down and impairs
the function of the melanocytes
• Hyperpigmented –due to increase in size of melanosome .
• Scaling –fine powdery .
• Macules combine to form patches .
IOC-
10%koh mount shows –spaghetti and ball appearance
• Wood lamp examination –apple green florescence .
T/t
-ketoconazole
• Selenium hydroxide
• Systemic treatment –fluconazole

4. candidiasis
• C. albicans is often present as part of the normal flora in the mouth,
gastrointestinal tract, and vagina.
• Oral candidiasis /acute and chronic atrophic candidiasis/hyperplastic
candidiasis /perlach candidiasis
• Vaginal candidiasis –white creamy /curdy discharge
• Candidial paronychia –chronic infection of nail bed
• Candidial intertrigo –satellite lesions found.
• IOC-10%KOH
• DOC-fluconazole

6. Dermatophytes
• Dermatophytes can penetrate and digest keratin
present in the stratum corneum of the epidermis, hair,
and nails.
• Infections can occur by direct contact with infected
hosts or fomites.
• Tinea capitis - infection of the hair shaft and scalp.
• most common in children 3 to 7 years old and it is
uncommon after puberty.
• T. tonsurans fungal spores are confined within the hair
shaft (endothrix) and their presence can lead to hair
breakage, creating “black dots” on the scalp
fig -Kerion

7. Clinical feature –diagnosis –treatment
Diagnosis –KOH
examination or cultures of
the proximal hair fiber and
scalp scales should be
performed to confirm the
diagnosis.
DOC –Griseofulvin with
ice-cream /milk / with
food.

8. Tinea corporis
• infection primarily of the skin of the trunk and limbs.
• It can occur at any age.
• Outbreaks are more frequent in day care facilities and
schools.
• CAUSED BY-Trichophyton mentagrophtes , or the zoophilic
fungus, M. canis , which is spread by contact with cats and
dogs and other mammals.
• Tinea corporis presents initially as a red, scaly papule that
spreads outward, eventually developing into an annular
plaque with a scaly, slightly raised, well-demarcated border
1) Tinea faciei
2) Majocchi granuloma
3) Tinea incognito

9. TINEA MANUM
• Predisposing factors include manual labor, preexisting
inflammatory conditions of the hands, hyperhidrosis,
heat, and humidity.
• These can lead to a breakdown in the protective stratum
corneum barrier of the epidermis allowing the
dermatophytes to penetrate.
• Tinea manuum can present with 2 patterns
• Tinea on the palms presents with diffuse, fine scale
• On the dorsal surface, it usually presents in a ringworm
pattern with an annular plaque with a red, scaly border

10. TINEA CRURIS
• infection of the inguinal and perianal areas. Tinea
cruris is usually caused by T. rubrum , T.
mentagrophytes , and E. floccosum .
• Sweating and tight or damp clothing produces
maceration of the skin allowing the dermatophytes
to easily penetrate into the epidermis.
• C/F-
Patients present with pruritic, semicircular plaques
with sharply defined scaly borders in the inguinal folds
and the upper inner thigh.

11. TINEA PEDIS
• he skin of the soles has a thick keratinized layer and
numerous eccrine sweat glands.
• The combination of abundant keratin, sweat, and occlusion
with shoes creates a perfect environment for dermatophyte
infections.
• Patients may present with 3 patterns of tinea pedis:
1) Interdigital pattern with scales, fissures, or maceration or
malodor usually in the fourth and fifth web space.
2) Moccasin pattern with diffuse, dry, silvery white scale on
the soles extending up to the sides of the foot
3) Vesiculobullous pattern with vesicles and/or bullae on the
plantar surface, especially instep areas

12. ONYCHOMYCOSIS
• Onychomycosis is a very common nail disorder and accounts for about 50% of
nail diseases.
• Dermatophytes: T. rubrum , T. mentagrophytes , and E. floccosum
• findings-white/yellow or orange/brown streaks or patches under the nail plate
• subungual hyperkeratosis
• onycholysis
• thickened nail plate may develop
• There are 4 major patterns of infection:
1) Distal subungual
2) Proximal subungual
3) White superficial
4) Candida