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การวินิจฉัย และรักษาโรคเชื้อราที่พบบ่อยในประเทศไทย ระดับพื้นฐาน
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.
: Superficial dermatophyte
Dermatophytosis
(Superficial fungal infection)
Obesity Acanthosis nigricans Acrochordons Adiposis dolorosa Bacterial infections Candidiasis Dermatophytosis Frictional hyperpigmentation Gout Hidradenitis Hyperhidrosis
Obesity Intertrigo Keratosis pilaris Lipodermatosclerosis Plantar hyperkeratosis Pseudoacanthosis nigricans Psoriasis Stasis dermatitis Striae distensae Venous insufficiency ulcers
The Past Medical History, Social History, and Review of Systems: Athlete
Acne mechanica Calluses Chafing Erythrasma Exercise-induced anaphylaxis Folliculitis Friction blister Frostbite Furunculosis Herpes gladiatorum
The Past Medical History, Social History, and Review of Systems: Athlete
Impetigo Joggers nipples Molluscum contagiosum Otitis externa Pitted keratolysis Subungual hematoma Sunburn Talon noir Tinea gladiatorum Tinea cruris Tinea pedis
: Woods light
Microsporum spp T. tonsurans
P. versicolor: gloden yellow fluorescence
KOH
dermatophyte : branching hyaline, septate hyphae, arthropsores
black mould : brown septate hyphae : yeasts + filaments
(pseudohyphae)
(Culture for dermatophyte)
dermatophyte 28C 1
: 32-34C 1
: 37C 24-48
()
: ? ; topical systemic Rx ( )
Tinea .?. (...) ; head, face, bead area,
body, hand ,foot, groin, nail etc. dermatophytes () 3
(genera) Microsporum Trichophyton Epidermophyton
Thailand, BKK (form infectious cluster): T. capitis:
M. canis (ectothrik) T. tonsurans (endothrik)
T. corporis: T. rubrum T. cruris: T. rubrum, E. floccosum T. pedis: T.rubrum, T. mentagrophyte, T. interdigitale T. ungium: T.rubrum, T. mentagrophyte, T. interdigitale T.versicolor: Malessia species complex (M. globosa, M.
furfur, M. sypodialis)
(Tinea capitis)
( ) ( )
Microsporum spp. Trichophyton spp. : T. tonsurans M. canis
noninflammatory, human, epidemic type
(gray patch
ringworm) (black dots).
inflammatory Type
(kerion)
(scarring alopecia)
(asymptomatic carrier state)
T. tonsurans,T. violaceum
Tinea Capitis (Inflammatory type and noninflammatory type)
Tinea Capitis
Differential Diagnosis Alopecia areata Bacterial pyoderma Demidicosis Dermatomyositis Dissecting cellulitis Folliculitis Folliculitis decalvans Impetigo
Tinea Capitis Differential Diagnosis
Lichen simplex Lupus erythematosus Pediculosis Pemphigus foliaceus Pityriasis amiantacea Psoriasis Seborrheic dermatitis Secondary syphilis Traction alopecia Triangular temporal alopecia Trichotillomania
Further reading: Seebacher C, Abeck D, Brasch J et al. (2007) Tinea capitis: ringworm of the scalp. Mycoses 50(3):218226.
:
Griseofulvin 10 mg/kg x 3 months
Itraconazole 100 mg/day x 46 weeks Itraconazole pulse therapy 5
mg/kg/day x 1 week/monthx 34 months
:
Terbinafine 250 mg/day x 4 6 wks M. canis
Fluconazole, oral suspension,
2% ketoconazole shampoo 1% selenium sulphide shampoo
(tinea capitis)
(morphology) ( ) (black dot) ....
Tinea capitis
Tinea capitis
Kerion
Tinea capitis
Tinea capitis
Griseofulvin; microcrystalline form
1g/day ultramicrosized form 0.5 g/day
ultramicrosized 10-15
mg/kg/day
6-8 .
griseofulvin 20 -25 mg/kg/day
pulse therapy, single-dose griseofulvin (2 - 3 g)
glucocorticoids
prednisone is 1 mg/kg/day 10 -15
griseofulvin
Oral ketoconazole Trichophyton spp. Oral itraconazole Microsporum
Trichophyton species 100 mg/d x 6 -10 weeks, 3-5 mg/kg/day.
Oral terbinafine125 mg/day x 6 weeks oral fluconazole
(Tinea Barbae)
: T. mentagrophytes T.
verrucosum.
: Inflammatory or kerion-like : tinea
capitis. Superficial or sycosiform type :
bacterial folliculitis. Circinate, spreading type : tinea
circinata of glabrous skin.
Differential Diagnosis Acne vulgaris Actinomycosis Bacterial folliculitis Blastomycosis Blastomycosis-like pyoderma Dental sinus Halogenoderma Herpetic sycosis
Differential Diagnosis
Impetigo Lupus vulgaris Perioral dermatitis Pseudofolliculitis barbae Pyoderma faciale Ruptured epidermal inclusion cyst Seborrheic dermatitis Sweets syndrome Sycosis barbae Syphilis
Further reading: Maeda M, Nakashima T, Satho M et al. (2002) Tinea barbae due to Trichophyton
verrucosum. Eur J Dermatol 12(3):272274.
Griseofulvin(microsized) 1 g/day x 2 - 3
antifungals, wet compresses,
systemic glucocorticoid therapy
(Tinea faciei)
dermatophyte T. rubrum annular, often unilateral scaly plaques
Differential Diagnosis Actinic keratosis Atopic dermatitis Candidiasis Coccidioidomycosis Contact dermatitis Demodex folliculitis Granuloma annulare Lupus erythematosus Lupus vulgaris
Differential Diagnosis -Jessners lymphocytic infiltrate -Perioral dermatitis -Pityriasis alba -Polymorphous light eruption -Psoriasis -Pyoderma -Rosacea -Sarcoidosis -Seborrheic dermatitis -Syphilis
Further reading: Lin RL, Szepietowski JC, Schwartz RA (2004) Tinea faciei, an often deceptive facial
eruption. Int J Dermatol 43(6):437440.
(Tinea Corporis)
Trichophyton, Microsporum Epidermophyton.
T. rubrum, M. canis T. mentagrophytes.
:
(zoophilic species)
Subtypes/ variants Tinea corporis, classic Tinea gladiatorum Tinea imbricata Tinea profunda (Majocchis granuloma)
Differential Diagnosis Candidiasis Contact dermatitis Cutaneous T-cell lymphoma Erythema annulare centrifugum Granuloma annulare Lupus erythematosus Nummular eczema
Differential Diagnosis Parapsoriasis Pityriasia rosea (herald patch) Psoriasis Pyoderma Sarcoidosis Seborrheic dermatitis Subacute cutaneous lupus erythematosus
Differential Diagnosis Superficial pemphigus Syphilis Tinea versicolor
Further reading:Ziemer M, Seyfarth F, Elsner P, Hipler UC (2007) Atypical manifestations of tinea corporis. Mycoses 50 (Suppl 2):3135
Tinea Incognito : .
Differential Diagnosis
Discoid lupus erythematosus Impetigo Lichen planus Nummular eczema Psoriasis Purpura Rosacea Seborrheic dermatitis
Further reading: Romano C, Maritati E, Gianni C (2006) Tinea incognito in Italy: a 15-year survey. Mycoses 49(5):383387
Tinea incognito
:
azole (clotrimazole, econazole, miconazole, sulconazole), naftifine terbinafine x 24
allylamines, benzylamine, imidazoles,
ketoconazole miconazole
griseofulvin (micronized) 1 g/day
:
: Griseofulvin 10 mg/kg x 4 Itraconazole 200 mg/day x 1 Terbinafine 250 mg/day x 24 ketoconazole 200 mg/day x 10
(Tinea pedis)
: dermatophyte
erythema, chronic diffuse
desquamation, bulla formation : T. rubrum, T. mentagrophytes,
E. floccosum
Tinea Pedis ( 4 )
Subtypes/ Variants Interdigital Moccasin Ulcerative Vesiculobullous
(Tinea manuum)
: dermatophyte
1. Dyshidrotic (eczematoid)
2. Hyperkeratotic:
(Tinea manuum)
(Tinea pedis)
Pitted keratolysis
Actinomycoses
(Tinea manum) (Tinea pedis)
Differential Diagnosis Atopic dermatitis Contact dermatitis Dyshidrotic eczema Keratolysis exfoliativa Palmoplantar pustulosis Psoriasis
Differential Diagnosis Acral lentiginous melanoma Atopic dermatitis Candidiasis Contact dermatitis Dyshidrotic eczema Erythrasma Erythema multiforme Friction blister Gram-negative toe-web infection
Differential Diagnosis
Id reaction Juvenile plantar dermatosis Kaposis sarcoma Localized bullous pemphigoid Mycosis fungoides palmaris et plantaris Pagetoid reticulosis Psoriasis Pyoderma Scabies Syphilis WeberCockayne syndrome
Further reading: Ecemis T, Degerli K, Aktas E et al. (2006) The necessity of culture for the diagnosis
of tinea pedis. Am J Med Sci 331(2):8890.
(Tinea pedis)
(Tinea pedis)
(talcum/antifungal powders undecylenic acid tolnaftate powders)
20% - 25 % aluminum chloride hexahydrate topically
imidazole allylamine
griseofulvin
griseofulvin terbinafine, ketoconazole, itraconazole
:
Itraconazole 200400 mg/day x 1 Oral terbinafine 250 mg/day x 2-6
Hendersonula toruloidea
whitefield ointment
Id Reaction
immune-mediated skin reaction (infections or infestations).
: symmetric erythematous papules, vesicles eczematous
Id Reaction Differential Diagnosis
Seborrheic dermatitis Stasis dermatitis
Associations Bacterial infection Dermatophyte infection Molluscum contagiosum Pediculosis capitis Scabies infestation Tick bite
Further reading: Atzori L, Pau M, Aste M (2003) Erythema multiforme ID reaction in atypical
dermatophytosis: a case report. J Eur Acad Dermatol Venereol 17(6):699701
Id Reaction Differential Diagnosis
Atopic dermatitis Autoeczematization Contact dermatitis Dermatophytosis Drug eruption Dyshidrotic eczema Erysipelas Erythema multiforme Folliculitis GianottiCrosti syndrome Pityriasis lichenoides et varioliformis acuta Scabies
(Tinea Cruris)
: subacute chronic dermatophytosis genitalia, pubic area, perineal perianal skin.
The scrotum usually appear completely normal.
Anthropophilic dermatophytes: E. floccosum T. rubrum
[ E. floccosum (most common), T. rubrum T. mentagrophytes]
:
(erythematous lesions with central clearing)
KOH: branching hyphae + arthrospores.
Differential Diagnosis Acanthosis nigricans Baboon syndrome Candidiasis Contact dermatitis Erythrasma Extramammary Pagets disease HaileyHailey disease
Intertrigo Inverse pityriasis rosea Irritant dermatitis Langerhans cell histiocytosis Mycosis fungoides Pediculosis Pemphigus foliaceus Psoriasis Pyoderma Seborrheic dermatitis
haloprogin, tolnaftate imidazoles (miconazole, clotrimazole, econazole)
; griseofulvin (micronized form) 500 -1000 mg/day
:
azole (clotrimazole, econazole, miconazole, sulconazole), naftifine terbinafine - 2-4
: Itraconazole 200 mg/day x 1 Terbinafine 250 mg/day x 24 Griseofulvin 10 mg/kg x 4
:
20-25
Intertrigo
: pruritus, erythema, scale maceration
Intertrigo Differential Diagnosis Acanthosis nigricans Acrodermatitis enteropathica Baboon syndrome Biotin deficiency Bowens disease Candidiasis Contact dermatitis Dermatophytosis
Intertrigo Differential Diagnosis
Erythrasma Extramammary Pagets disease HaileyHailey disease Granuloma gluteale infantum Langerhans cell histiocytosis Inverse psoriasis Necrolytic migratory erythema Pemphigus Seborrheic dermatitis Staphylococcal infection Streptococcal infection
Intertrigo
Evaluation Gram stain bacterial culture KOH and fungal culture
Further reading: Farage MA, Miller KW, Berardesca E, Maibach HI (2007) Incontinence in the aged: contact dermatitis and other cutaneous consequences. Contact dermatitis 57(4):211217
Intertrigo
Intertrigo
(Tinea unguium and onychomycosis)
T. unguium : dermatophyte infection of the nail plate.
Onychomycosis : all infection of the nail caused by any fungus, including nondermatophytes and yeasts.
anthropophilic species T. mentagrophytes var. interdigitale and T.
rubrum. zoophilic
species.
(most common dermatophytes) : T. rubrum, T. mentagrophytes var. interdigitale, E. floccosum
Candida albicans chronic mucocutaneous candidiasis (CMCC).
T. rubrum
: , , ,
(T. unguium onychomycosis)
onychomycosis 4 : Distal subungual onychomycosis (DSO) Proximal subungual onychomycosis (PSO) White superficial onychomycosis (WSO) Candidal onychomycosis
Associations AIDS Diabetes mellitus Elderly Peripheral vascular disease Smokers Tinea pedis Trauma
Further reading: Scher RK, Tavakkol A, Sigurgeirsson B (2007) Onychomycosis: diagnosis and definition of cure. J Am Acad Dermatol 56(6):939944.
:
:
White yellow irregular lesion
SWO T. mentagrophytes var. interdigitale.
KOH 28C / cycloheximide
dermatophyte non-dermatophyte mould infections
subungual material
(Tinea unguium and onychomycosis)
Differential Diagnosis Bacterial paronychia Chronic mucocutaneous candidiasis Contact dermatitis Dariers disease Lichen planus Melanoma Nailpatella syndrome Nondermatophyte onychomycosis Norwegian scabies
Green-nail syndrome : P. aeruginosa : onycholysis greenish discoloration of the nail
Differential Diagnosis
Aspergillus infection Dermatosis neglecta Foreign body Melanocytic nevus Melanoma Subungual hematoma
Further reading: Sakata S, Howard A (2007) Pseudomonas chloronychia in a patient with nail psoriasis. Med J Aust
186(8):424
Differential Diagnosis
Old age Onychogryposis Onycholysis Pachyonychia congenita Peripheral vascular disease Pincer nail deformity Pityriasis rubra pilaris Pseudomonal infection Psoriasis Traumatic nail dystrophy Twenty-nail dystrophy Yellow-nail syndrome
Ingrown Toenail (Onychocryptosis, Unguis Incarnatus)
: pain, erythema, swelling exuberant granulation tissue
Differential Diagnosis
Amelanotic melanoma Metastatic lesion Paronychia Pyogenic granuloma
Association
Congenital malalignment of the great toenails
Further reading: Daniel CR III, Iorizzo M, Tosti A, Piraccini BM (2006) Ingrown toenails. Cutis 78(6):407408.
(In-growing nails)
(SWO) distall nail involvement
: amorolfine, weekly intervals tioconazole x2/d x 6 () 912 ()
griseofulvin x 4-6-8 10 -18
: itraconazole 2 - 3 pulses treatment 400 mg/day x 1 4 200 mg/day 3
terbinafine 250 mg/day x 612 (), >12 ()
fluconazole 150450 mg x 69 (), 3 months ()
Terbinafine 250 mg/d 3 - 6
12 6
40% urea griseofulvin
nondermatophytic fungi (surgical avulsion chemical destruction)
Yeast Infections
Candida spp. Pityrosporum spp.
(Candidiasis)
oral candidiasis
: genus Candida
oral candidiasis
Candida albicans ( 6080 ) 8
humoral or cell-mediated
immunological impairment, debilitation
oral candidiasis
Acute pseudomembranous candidosis (thrush): white raised lesions on buccal mucosa, gums or tongue (infants, the elderly, HIV-infected, diabetics, cancer patients and steroid users).
Erythematous candidiasis: erythema, oedema Acute atrophic candidiasis: antibiotic
stomatitis.
oral candidiasis
Chronic atrophic candidiasis: denture stomatitis and glossitis.
Chronic hyperplastic candidiasis (oral leukoplakia): , translucent or dense, opaque white plaques on cheeks, commissures and tongue.
oral candidiasis
Angular cheilitis: soreness, erythema and fissuring at corners of mouth 20
Chronic mucocutaneous candidosis (CMCC): oral manifestation of candidiasis congenital immunological endocrinological disorders.
oral candidiasis
topical nystatin, amphotericin B or azole x 2
oral candidiasis
: Fluconazole 100200 mg/day x 2
400800 mg/day Itraconazole 200400 mg/day x 12 Parenteral Amphotericin B 0.50.7 mg/kg/day
x 1
oral candidiasis
Prophylaxis fluconazole itraconazole
(Vaginal candidiasis, vaginal thrush)
: genus Candida
80 Candida albicans C. glabrata Candida spp.
C. albicans perianal
intertrigo
:
high vaginal swab yeasts + filaments 40
37C yeast colonies 90
Acute vaginal candidosis
Topical nystatin tablets x 14 azole clotrimazole, miconazole,
econazole, ketoconazole creams and pessaries x 6 fluconazole, single dose 150 mg Itraconazole 200 mg x 2 8
Recurrent vaginal candidosis clotrimazole 500 mg 2-4 fluconazole 150 mg 1 36
: Candida
spp. confluent, bright-red erythematous plaques
white exudate satellite lesions Subtypes/ Variants Cutaneous
Balanitis Diaper dermatitis Disseminated/systemic Erosio interdigitalis blastomycetica Intertrigo Paronychia Vulvovaginitis
interdigital candidosis C. albicans candida granuloma angular
cheilitis chronic mucocutaneous candidosis ( congenital defects in cell-mediated immunity)
mucosal cutaneous infections C. albicans C. tropicalis
epidermal barrier function
:
intertriginous areas groin, axillae submammary folds
, ,
:
Candida paronychia proximal nail fold cuticle
erythema, oedema purulent discharge
Chronic mucocutaneous candidosis (CMC) erythematous granulomatous infection cell mediated immunity
:
1: Familial CMC: AR inheritance iron deficiency
2: Diffuse CMC: sporadic disorder oral cavity especially
3 : Candidiasisendocrinopathy syndrome hypoparathyroidism, hypoadrenocorticism, hypothyroidism,
4: Late onset CMC
:
KOH: skin scrapings/swabs filaments
37C 2448
Oral candidiasis
Cutaneous Candidiasis
Candidiasis
Candidiasis
Candidiasis
Candidiasis
:
(folliculitis) : itraconazole 200 mg/day fluconazole 100
mg/day. azole agents, nystatin naftifine
12
Oral: Acute atrophic Acute pseudomembranous Angular cheilitis (perleche) Chronic atrophic Chronic hyperplastic Median rhomboid glossitis
Differential Diagnosis Cutaneous: Contact dermatitis Dermatophyte infection HaileyHailey disease Intertrigo Lichen planus Psoriasis Pseudomonal infection Seborrheic dermatitis Subcorneal pustular dermatosis
Oral: Aphthous stomatitis Fordyce spots Hairy leukoplakia Herpes simplex virus infection Leukoplakia Lichen planus Pemphigus vulgaris White sponge nevus
Associations Acrodermatitis enteropathica ChediakHigashi syndrome Chronic granulomatous disease Chronic mucocutaneous candidiasis Corticosteroids Cushing syndrome Diabetes mellitus DiGeorge syndrome Down syndrome Endocrinopathies HIV infection Hyper IgE syndrome Nezelof syndrome Nutritional deficiency Severe combined immunodeficiency Thymoma
Geographic tongue
Geographic Tongue (Benign Migratory Glossitis)
benign inflammatory disorder of the dorsal tongue
serpiginous erythematous plaques devoid of filiform papillae with a yellow hyperkeratotic border
Differential Diagnosis Burns Candidiasis Contact stomatitis Eruptive lingual papillitis Lichen planus Lingua plicata Median rhomboid glossitis Syphilis
Geographic Tongue (Benign Migratory Glossitis)
Associations AIDS Atopic dermatitis Fissured tongue Lithium therapy Psoriasis
Further reading: Zargari O (2006) The prevalence and significance of fissured tongue
and geographical tongue in psoriatic patients. Clin Exp Dermatol 31(2):192195.
Scrotal Tongue (Lingua Plicata, Fissured Tongue)
idiopathic textural change of the dorsal tongue
: furrows or grooves giving the tongue a cerebriform or rugous appearance
Differential Diagnosis Amyloid infiltration Geographic tongue Lymphedema Lymphangioma Macroglossia Mucosal neuroma syndrome Syphilitic glossitis
Scrotal Tongue (Lingua Plicata, Fissured Tongue)
Associations Acrodermatitis continua BazexDupreChristol syndrome Cowden syndrome Down syndrome MelkersonRosenthal syndrome Pachyonychia congenita Pemphigus vegetans
Further reading: Zargari O (2006) The prevalence and significance of fissured tongue and geographical tongue in psoriatic patients. Clin Exp Dermatol 31(2):192195.
topical antifungals Nystatin suspension;400,000-600,000 U
4 Clotrimazole troches;10 mg
1 - 2% gentian violet Chlorhexidine
Ketoconazole;200 mg/d x 1 to 2 weeks 400
mg/d x 1 - 2 weeks in AIDS. Fluconazole;50 to 100 mg/d x 1 week. Itraconazole;100 mg/d x 3 weeks 200 mg/d x 3
weeks prophylactic therapy:
ketoconazole fluconazole
Clotrimazole suppository 500-mg
(single-dose therapy ) 150-mg fluconazole tablet ( 5 )
candidal vaginitis single-dose therapy prophylactic regimens
Intertrigo (candidiasis); Nystatin cream powder form midazole cream
Terconazole intravaginal dose clotrimazole cream
Fluconazole 150-mg (prophylactic regimens) HIV-positive
Fluconazole 200 mg/week candidal balanitis: clotrimazole topical
cream fluconazole 150-mg
(Candidal paronychia) Redness, swelling, and tenderness of the
paronychial area with prominent retraction of the cuticle toward the proximal nail fold.
: onycholysis,
transverse ridging of the nail plate
Chronic paronychia
proximal nail fold Candida paronychia
chronic candidiasis paronychia
proximal nail fold
topical imidazole 4 % thymol absolute alcohol
anticandidal activity ketoconazole surgical
marsupialization proximal nail fold area
Pityrosporum infections of the Skin
(Pityriasis versicolor, Eichstedts Disease)
: Malassezia yeasts Malassezia globosa
:
Malassezia spp. : M. furfur ( Pityrosporum ovale P.
orbiculare) M. obtuse M. restricta M. slooffiae
M. sypodialis () M. dermatis (
atopic dermatitis) KOH: budding yeast cells + numerous filaments. (sebaceous areas) 2040
Pityrosporum infections of the Skin
: Papulosquamous lesions Folliculitis Inverse tinea versicolor
Inverse form of pityriasis versicolor
* Located predominantly in flexural areas.
: asymptomatic, patchy scaly areas of hyperpigmentation hypopigmentation upper chest, back, neck, abdomen proximal extremities
P. versicolor atrophic macules (pityriasis versicolor atrophicans)
:
Woods light pale yellow
fluorescence
Pityriasis versicolor
(Pityriasis versicolor)
:
KOH: oval, budding yeasts + short filaments. : 3234C
1 small, yellow-cream colonies
Differential Diagnosis Anetoderma Confluent and reticulated papillomatosis Epidermodysplasia verruciformis Erythema dyschromicum perstans Erythrasma
Differential diagnosis Florid cutaneous papillomatosis Idiopathic eruptive macular pigmentation Lupus erythematosus Melasma Multiple tumors of the follicular infundibulum Mycosis fungoides Parapsoriasis Pinta
Differential diagnosis
Pityriasis alba Pityriasis rosea Pityriasis rubra pilaris Progressive macular hypomelanosis Postinflammatory hypopigmentation Seborrheic dermatitis Secondary syphilis (including syphilitic anetoderma) Tinea corporis Vitiligo
Further reading:
Crowson AN, Magro CM (2003) Atrophying tinea versicolor: a clinical and histological study of 12 patients. Int J Dermatol 42(12):928932
Gupta AK, Batra R, Bluhm R et al. (2004) Skin diseases associated with Malassezia species. J Am Acad Dermatol 2004 51(5):785798
40% PG 2.5 % selenium sulfide shampoo
10 ( 2 1-2 )
1 2 KOH
()
selenium sulphide (2-2.5%) shampoo ketoconazole shampoo terbinafine
azole antifungals ketoconazole, itraconazole
()
: ketoconazole 200 mg/day x 1 ketoconazole 400 mg, x 2 ketoconazole 400 mg, 3 12 itraconazole 200 mg/day x 1 prophylaxis
200 mg x 2/day fluconazole 300 mg, once per week for 2 fluconazole 300 mg, single dose repeated 2 fluconazole 150 mg, once per for 4
Pityrosporum follculitis
subtropical tropical climates : pruritic, monomorphic eruption
of follicular papules pustules
Perifollicular, erythematous papule pustule 2 3 .
Pityrosporum folliculitis
Malassezia (Pityrosporum) folliculitis
3 Folliculitis : scattered, itching
follicular papules pustules seborrhoeic dermatitis: numerous small
follicular papules
In AIDS: multiple pustules severe seborrhoeic dermatitis
Pityrosporum Folliculitis : pruritic follicular-based papules and pustules
on the trunk and proximal upper extremites with absence of comedones and absence of response to acne treatments
Differential Diagnosis Acne mechanica Acne vulgaris Candidiasis Drug-induced acne Eosinophilic folliculitis Steroid acne Gram-negative folliculitis Pseudomonas folliculitis
Pityrosporum Folliculitis Associations
Antibiotics Cushings syndrome Diabetes mellitus Down syndrome HIV infection Immunosuppression Seborrheic dermatitis
Further reading: Gupta AK, Batra R, Bluhm R et al. (2004) Skin diseases associated
with Malassezia species. J Am Acad Dermatol 51(5):785798
Pityrosporum folliculitis
: Ketoconazole 200 mg/day x 12
itraconazole.
topical imidazoles selenium sulphide
Dermatophytosis(Superficial fungal infection) ObesityObesityThe Past Medical History, Social History, and Review of Systems: AthleteThe Past Medical History, Social History, and Review of Systems: Athlete: Woods lightKOH (Culture for dermatophyte)Slide Number 16Tinea .?. (...) (Tinea capitis) noninflammatory, human, epidemic type inflammatory Type (asymptomatic carrier state)Tinea Capitis (Inflammatory type and noninflammatory type)Tinea CapitisTinea Capitis : : Tinea capitisTinea capitisKerionTinea capitisTinea capitis (Tinea Barbae) (Tinea faciei) (Tinea Corporis): Tinea IncognitoTinea incognito: : (Tinea pedis)Tinea Pedis( 4 ) (Tinea manuum) (Tinea manuum) (Tinea pedis)Pitted keratolysisActinomycoses (Tinea manum) (Tinea pedis) (Tinea pedis) (Tinea pedis): Hendersonula toruloideaId ReactionId ReactionId Reaction (Tinea Cruris): : : IntertrigoIntertrigoIntertrigoIntertrigoIntertrigoIntertrigo(Tinea unguium and onychomycosis) (T. unguium onychomycosis) : : (Tinea unguium and onychomycosis)Green-nail syndromeIngrown Toenail (Onychocryptosis, Unguis Incarnatus) (In-growing nails)Yeast Infections(Candidiasis) oral candidiasis oral candidiasis oral candidiasis oral candidiasis oral candidiasis oral candidiasis oral candidiasis oral candidiasis (Vaginal candidiasis, vaginal thrush) : : : : : Oral candidiasisCutaneous CandidiasisCandidiasisCandidiasisCandidiasisCandidiasis: Geographic tongueGeographic Tongue (Benign Migratory Glossitis)Geographic Tongue (Benign Migratory Glossitis)Scrotal Tongue (Lingua Plicata, Fissured Tongue)Scrotal Tongue (Lingua Plicata, Fissured Tongue)(Candidal paronychia)Chronic paronychia chronic candidiasis paronychiaPityrosporum infectionsof the Skin (Pityriasis versicolor, Eichstedts Disease)Pityrosporum infections of the Skin Inverse form of pityriasis versicolor : Pityriasis versicolor (Pityriasis versicolor) : ()()Pityrosporum follculitisPityrosporum folliculitisMalassezia (Pityrosporum) folliculitisPityrosporum FolliculitisPityrosporum FolliculitisPityrosporum folliculitis