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Common Fungal & Parasitic Skin Infections
Common Fungal & Parasitic Skin Infections
• Superficial Fungal Infections
• Scabies
• Lieshmaniasis
Superficial Fungal Infections
• DERMATOPHYTES
• YEASTS
-Candida sp.
-Pityrosporum.
DERMATOPHYTE
• Dermatophytes group of fungi (ringworm)
have the ability to infect and survive only
on dead keratin on the top layer of the skin
hair and the nails.
CLASSIFICATION
• The ringworm fungi belong to three genera: Microsporum, Trichophyton, and Epidermophyton .
• There are several species of Microsporum and Trichophyton and one species of Epidermophyton .
CLINICAL CLASSIFICATION
• Tinea means fungal infection.• Clinically, dermatophyte infections are classified
by body region:– T.Corporis body– T.Cruris groin– T.Pedis foot– T.Unguium nail– T.Capitis scalp
Tinea corporis
Tinea pedis
tinea capitis
Chronic tinea of the big toe nail.
YEAST
• Candida albicans
• Pityrosporum : pityriasis versicolor
Candida albicans
It is a commensal flora of the gut which become
pathogenic when the immune status of the
person changed
physiological (old age , neonate and pregnancy)
pathological ( DM, HIV and organ transplant)
Long course of Antibiotics
MUCOSAL
1. Oral
oral thrush
angular chilitis
2. Genital candidiasis
• Oral candidiasis: thrush can be removed by rubbing with gauze
Candidiasis of the tongue
Angular cheilitis
• Candida groin infection.
Pityriasis versicolor
• Pityrosporum orbiculare
• Asypmtomatic• Well demarcated
brown patches with branny over the trunk and upper extremities
Mycetoma (Madura foot)
• Various species of fungus or actinomycetes may be involved.
• They gain access usually to the feet or legs, via a penetratng wound.
• The area becomes lumpy and distorted,aterenlarging and developing multiple sinuses.
• Pus exuding from these shows tiny diagnostic granules.
Treatment
• Surgery
• Systemic antibiotics or antifungal drugs, depending on the organism isolated
Investigation Fungal Infections
• Scraping clipping and Hair sampling
• KOH/microscoy• Skin biopsy
Histopathology with PAS stain
• Culture• Wood's lamp
• Tinea capitis with positive Wood's lamp
Treatment
Topical Antifungal– Nystatin preparation (oral thrush)– Imidazoles e.g. cotrimazole
Systemic Antifungal
– Itraconazole and fluconazole– Allylamine e.g. Terbinafine– Griseovulvin
Indication of systemic treatment:
1.Tinea Capitis
2. Paronychia and Onychomycosis
3. Failure to respond to topical treatment
4. Immunocompramized pts.
5. Atypical presentations.
Scabies
Mite sarcoptes scabei
burrows in the stratum corneum laying eggs and the eggs will maturate 2 weeks period and the cycle repeated.
Skin lesions are Secondary eczematous eruption due to immune reaction to the mite and eggs
Sarcopte’s scabiei burrow in the skin
Pruritus and skin eruption is more severe in the flexors mainly at night
Other member of the family having severe pruritus
Vesicles in the finger webs
Diffuse scabies on an infant the lesions are most numerous around the axillae, chest,
and abdomen.
Scabies vesicles and papules in the fingerwebs and on the back of the hand
TREATMENT
• Permethrin cream
• Treat all close family whether itchy or not
PEDICULOSIS
Head lice (Pediculosis Capitis)
Children
Body lice (Pediculosis Corporis)
Pubic lice (Pediculosis Pubis)
STD ( partner should be treated)
• Spread from person to person is achieved by head-to-head contact and shared combs or hats
• The main symptom is itching.
• the hair becomes smelly. Draining lymph nodes often enlarge
• Secondary bacterial infection may be severe enough to make the child feverish.
The diagnosis can be conformed by seeing the lice eggs ( NITs)
Treatment
Permethrin creame rinse
Malathion lotion
Lieshmaniasis
• Leishmaniasis a disease caused by Leishmania parasites.
• It is transmitted to humans by a sandfly
Sandfly is one third the size of a mosquito.
Lieshmaniasis
Localized Cutaneous Well-demarcated ulcerated nodule over the exposed areas.
Disseminated Cutaneous
Mucocutaneous
Visceral
Diagnosis
• Skin biopsy
• Histopathology with Gimsa stain
• Culture
• PCR for DNA
Treatment
• Skin usually resolve but leaving a scar
• Pentostam either intralesional or intramuscular to shrink the lesion.
Thank you