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1
Mohamed Abdullatif Abdurahman
B.Pharm, MMM
2
4
Pityriasis (Tinea versicolor) :
• Caused by Malassezia furfur;
elicits mild, chronic scaling,
mottling of skin; also
implicated in folliculitis,
psoriasis, and seborrheic
dermatitis.
• May cause an opportunistic
fungemia in infants
• Treated with daily applications
of selenium sulfide. Topical or
oral azoles are also effective.
Tinea nigra (or tinea nigra
palmaris)
• Caused by the dematiaceous
fungus Hortaea (Exophiala)
werneckii.
• The lesions appear as a dark
(brown to black)
discoloration, often on the
palm.
• Tinea nigra will respond to
treatment with keratolytic
solutions, salicylic acid, or
azole antifungal drugs. 5
Piedra
• White piedra – caused by
Trichosporon beigelii;
whitish or colored masses
develop scalp, pubic, or
axillary hair
• Black piedra – caused by
Piedraia hortae; dark-
brown to black gritty
nodules, mainly on scalp
hairs 6
Dermatophytosis
8
• Infections strictly confined to keratinized
epidermis (skin, hair, nails) are called
dermatophytosis (ringworm and tinea)
• 40 species in the genera Trichophyton,
Microsporum, Epidermophyton
• Closely related and morphologically similar
• Causative agent of ring worm varies case to
case
9
• Natural reservoirs- humans, animals, and soil
(Anthropophilic, Zoophilic and Geophilic)
respectively.
• Infection facilitated by moisture, warmth,
specific skin chemistry, composition of
sebum and perspiration, youth, heavy
exposure, and genetic predisposition.
• Long infection period followed by localized
inflammation and allergic reactions to fungal
proteins
10
11
12
Treatment of dermatophytes
• Therapy consists of thorough removal of
infected and dead epithelial structures and
application of a topical antifungal chemical or
antibiotic.
• Treatment of dermatophytes includes topical
antifungal agents – tolnaftate, miconazole
applied for several weeks.
13
14
15
Subcutaneous Mycoses
• Sporotrichosis
• Chromoblastomycosis
• Mycetoma
16
Sporotrichosis
(rose-gardener’s disease)
• Caused by Sporothrix schenckii
• Very common saprobe fungus that
decomposes plant matter in soil
• Infects appendages and lungs
• The initial lesion is usually located
on the extremities but can be found
anywhere.
• followed by secondary spread with
involvement of the draining
lymphatics and lymph nodes
• Lymphocutaneous variety
occurs when disseminated
infection spreads to nearby
lymph nodes usually in
debilitated patients.
• The treatment of choice is oral
itraconazole or another azole.
For systemic disease,
amphotericin B is given.
17
18
Chromoblastomycosis
• Caused by soil saprobes with dark-
pigmented mycelia and spores
(Fonsecaea pedrosoi, Phialophora
verrucosa, Cladosporium
carrionii)
• The fungi are introduced into the
skin by trauma.
• The primary lesion becomes
verrucous and wart-like with
extension along the draining
lymphatics.
• Surgical excision with wide margins is the
therapy of choice for small lesions.
• Chemotherapy with flucytosine or
itraconazole may be efficacious for larger
lesions.
19
20
Mycetoma
Madura foot
• Eumycetoma is a mycetoma caused by a
fungus accidentally implanted into the skin
• Caused by Pseudallescheria or Madurella
• Particularly prevalent in India, Africa, and
Latin America
• Progressive, tumorlike disease of the hand or
foot due to chronic fungal infection; may lead
to loss of body part
• The management of eumycetoma is
difficult, involving surgical debridement or
excision and chemotherapy
21www.mycetoma.edu.sd/
Thank you
22

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Superficial & cutaneous mycoses

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  • 4. 4 Pityriasis (Tinea versicolor) : • Caused by Malassezia furfur; elicits mild, chronic scaling, mottling of skin; also implicated in folliculitis, psoriasis, and seborrheic dermatitis. • May cause an opportunistic fungemia in infants • Treated with daily applications of selenium sulfide. Topical or oral azoles are also effective.
  • 5. Tinea nigra (or tinea nigra palmaris) • Caused by the dematiaceous fungus Hortaea (Exophiala) werneckii. • The lesions appear as a dark (brown to black) discoloration, often on the palm. • Tinea nigra will respond to treatment with keratolytic solutions, salicylic acid, or azole antifungal drugs. 5
  • 6. Piedra • White piedra – caused by Trichosporon beigelii; whitish or colored masses develop scalp, pubic, or axillary hair • Black piedra – caused by Piedraia hortae; dark- brown to black gritty nodules, mainly on scalp hairs 6
  • 8. 8 • Infections strictly confined to keratinized epidermis (skin, hair, nails) are called dermatophytosis (ringworm and tinea) • 40 species in the genera Trichophyton, Microsporum, Epidermophyton • Closely related and morphologically similar • Causative agent of ring worm varies case to case
  • 9. 9 • Natural reservoirs- humans, animals, and soil (Anthropophilic, Zoophilic and Geophilic) respectively. • Infection facilitated by moisture, warmth, specific skin chemistry, composition of sebum and perspiration, youth, heavy exposure, and genetic predisposition. • Long infection period followed by localized inflammation and allergic reactions to fungal proteins
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  • 13. Treatment of dermatophytes • Therapy consists of thorough removal of infected and dead epithelial structures and application of a topical antifungal chemical or antibiotic. • Treatment of dermatophytes includes topical antifungal agents – tolnaftate, miconazole applied for several weeks. 13
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  • 15. 15 Subcutaneous Mycoses • Sporotrichosis • Chromoblastomycosis • Mycetoma
  • 16. 16 Sporotrichosis (rose-gardener’s disease) • Caused by Sporothrix schenckii • Very common saprobe fungus that decomposes plant matter in soil • Infects appendages and lungs • The initial lesion is usually located on the extremities but can be found anywhere. • followed by secondary spread with involvement of the draining lymphatics and lymph nodes
  • 17. • Lymphocutaneous variety occurs when disseminated infection spreads to nearby lymph nodes usually in debilitated patients. • The treatment of choice is oral itraconazole or another azole. For systemic disease, amphotericin B is given. 17
  • 18. 18 Chromoblastomycosis • Caused by soil saprobes with dark- pigmented mycelia and spores (Fonsecaea pedrosoi, Phialophora verrucosa, Cladosporium carrionii) • The fungi are introduced into the skin by trauma. • The primary lesion becomes verrucous and wart-like with extension along the draining lymphatics.
  • 19. • Surgical excision with wide margins is the therapy of choice for small lesions. • Chemotherapy with flucytosine or itraconazole may be efficacious for larger lesions. 19
  • 20. 20 Mycetoma Madura foot • Eumycetoma is a mycetoma caused by a fungus accidentally implanted into the skin • Caused by Pseudallescheria or Madurella • Particularly prevalent in India, Africa, and Latin America • Progressive, tumorlike disease of the hand or foot due to chronic fungal infection; may lead to loss of body part
  • 21. • The management of eumycetoma is difficult, involving surgical debridement or excision and chemotherapy 21www.mycetoma.edu.sd/