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DERMATO MEANS
SKIN
MYCOSES MEANS
FUNGUS
It comprises about
practitioner
Superficial Dermatomycoses
(tinea)
Deep Dermatomycoses
Superficial mycoses invade skin surface i.e epidermis and epidermal appendages especially hairs and nails
Classification
Regional:
T.CAPITIS:
RINGWORM:
-PUSTULAR FOLLICULITIS
-KERION CELZI
INFLAMMATORY
NON-INFLAMMATORY
1-GRAY PATCH.
T.CORPORIS:
-T.CIRCINATA. -T.CRURIS. -T.VERSICOLOUR
Tinea Capitis
Ring Worm
Gray Patch
spreads in epidemics
especially in family
and school children
Grey Patch
Symptoms
Apart from hair affection, the patient complains of hair fall
Unaccompanied
Hairs are shortly cut. Covering scales are small, dry, slate colored
Slightly adherent to the surface of the scalp but easily detached on scraping
Grey Patch
we get multiple patches dispersed on the scalp of the same clinical picture
Multiple Patches
Mode of infection
Direct
By contact with infected person.
Indirect
By contact with material soiled with the organisms e.g. head caps, bed sheets
Diagnosis
Scales and hairs are of fungal elements
by
KOH or
Lactophenol
preparation
Differential Diagnosis
Prognosis
Self-limited at puberty
Microscopic Examination
of Hair in Ring Worm
3- In kerion Celzi:
hair is surrounded
by regularly arranged
4-In Favus:
Fungal elements are arranged parallel to long axis of the hair
scaly macular lesion on the scalp of children with well defined border.
Black-Dot Type
Black-Dot R.W.
On close examination we find the hair follicle ostia are blocked with black dots black dots
which are the remains of the broken hair at the surface of the scalp
Black-Dot R.W.
Inflammatory
types of R.W
Usually affect
children but may
affect adults
Pustular folliculitis
Severe
marked edema, redness and tumefaction of the affected hair
leading to the
Each hair is
surrounded by a pool of pus and is easily detached
Kerion
Kerion
Kerion Celzi
Kerion
Celzi
Kerion
Kerion
Kerion Celzi
It usually heals by scar formation
Microsporon Canis
Favus
caused by Trichophyton
Schoenleini
common in children ,
but
it does not
alopecia
cicatrical
Favus
Contagiosity
Post Favic
Alopecia
Clinical Picture
development of
characterized by the
Scotulum
Favus
Scotulum
with its convexity at the scalp making for itself an erosion or depression in the epidermis.
scalp,
on detachement
sero-sanginous
discharge appears
The
scotulum is
deeper
The hair in the affected area in the scalp is but show changes in picture and color.
Favic Hair
Hair becomes thin, dry, friable, grayish in appearance , lusterless and dull gray in color
Microscopic Examination
The
scotulum is
under the microscope fungal elements are invading the hair with no elements outside.
Tinea Corporis
T T T T
. . . .
Tinea Circinata
Circinata
Tenia
T.Circinata
T.Circinata
Multiple Patches
of
T.C.
T.circinata
Differential Diagnosis
Superficial:
Pityriasis Rosea . Psoriasis . Lichen planus . Seborrhoeic dermatitis Erythema multiforme. Impetigo .
Deep:
Syphilis. Leprosy.
T.B. Leishmaniasis.
Sarcoidosis.
Tenia Cruris
A circinate macular lesion occupying the inner surface of the upper parts of both thighs
The lesion is brownish red in color with well defined border and circinate configuration
Surface shows minute scaliness and tendency for healing with spreading margin
T.cruris
Tenia Cruris
Differential Diagnosis
intertrigo
Tinea Versicolour
It is caused by
Microsporoon FurFur
Sites Of T.V.C
varying from
The lesions are well defined and covered by fine branny adherent scales.
.T.V.C
T.V.C.
Contrast between
Hygiene of the patient as frequent baths removes the scaly layer on the lesion
3-Hyperkeratotic type:
Hyperkeratotic Type
Hyperkeratotic T.pedis
4-Commonest
type is the interdigital type
Clinical picture of
The skin becomes whitish, sodden, macerated and the depth of the cleft is fissured
Interdigital Type
the
underlying skin
Onychomycosis
fungus infection
of the nails
The affected nail is dry, brittle, lusterless and the surface is pitted and grooved.
Onychomycosis
Differential Diagnosis
Moniliasis
Fungal
Monilial
Chronic
Treatment of Mycoses
General Treatment
Griseofulvine
An oral antibiotic fungicidal agent derived from penicillin species.
It is given in a tablet form each tablet contains 250 mgm of ordinary griseofulvine
The
same therapeutic effect is obtained by 125 mgm of fine particle F.P. Griseofulvin
Dose :
From 10-25 mg/kg body wt. in divided doses.
1/3 of body weight in tablets/ week not exceeding 20 tablets per week
effective against
except
.V . C. Erythrasma. Moniliasis.
Contraindications
Side effects :
- Nausea - Vomiting
- Headache
Duration of Treatment:
onychomycosis
Nails 3-4 months Toes 5-6 months
They should be used with caution as some of them have serious side effects as:
Ketoconazole
Terbenafine
and
Itraconazole
are used safely
in indicated cases
For Tinea Versi Color Fluconazole capsules 150 mgm once weekly for 4 weeks may be given in resistent cases
Local Treatment
local fungicidals
Tr.Iodine,Tolnaftate Clotrimazole, Undecylinic acid derivatives
Whitfield ointment
we use modified forms of Whitfield ointment because the original formula is very irritant but very effective.
eczematised
In cases of
Preparations containing
fungicidal agent
plus
hydrocortisone or
another steroid
Castellani
paint which must be prepared fresh
GOOD LUCK