Dermatomycoses

dermatophytoses

Dermatophyte
Infection
hair cutaneoushorny layer nail plate
dermatophytosis

According to different parts tinea capitis tinea corporis

tinea cruris tinea manum tinea pedis onychomycosis tinea barbae

According to different parts tinea capitis tinea corporis

tinea cruris tinea manum tinea pedis onychomycosis tinea barbae

According to different parts tinea capitis tinea corporis

tinea cruris tinea manum tinea pedis onychomycosis tinea barbae

According to different parts tinea capitis tinea corporis

tinea cruris tinea manum tinea pedis onychomycosis tinea barbae

dermatophytids
metabolite of trichophyton
blood circulation;
dermato-allergic reaction out of
focus

etiology
Trichophyton
Microsporum
Epidermophyton

human
infection
animal

dermatophytosis

1Leading
country

dermatophytes in our

dermatophytes
invasion
hair root hair strunk nail plate cutaneous corneum
stratum
tinea barbae
onychomycosis
tinea corporis
tinea of feet and hands

the relationship between characters of

dermatophytes and clinic
Character: because of keratinophilic
Clinic: prone to invade stratum coreum.

Character: Growing in 25-28 oC

Clinic: happening at summer or autumn..

the relationship between characters of

dermatophytes and clinic

Character: Needing moderate

humidity
Clinic: infections exist at the moist and
sweaty places

Character: develop from center to

peripheral
Clinic: lesions looks like the ring.

the relationship between characters of

dermatophytes and clinic
Character: growing rapidly
Clinic: lesions happening after one week commonly

Character: having nothing to do with

sun light
Clinic: able exist in UV ,but fearing dry and high
temperature
Character: carbon and nitrogen are neccessary
Clinic:DM using long-term corticosteroids
and thick lamina corticalis are easy to infect.

e relationship between characters of

dermatophytes and clinic

Character: human soil and

animal are susceptibe.

Clinic: different infected sources ,
different clinical appearance

tinea corporis of cruris

Primary lesions
papule blister
papulovesicle

tinea cruris

differential diagnosis circumduction erythema

pityriasis rosea neurodermatitis eczema

treatment
topical treatment :Compound Benzoic Acid liniment tinea corporis
Bid2-4weeks
Compound Resorcinol Liniment (tinea cruris)
Bid2-4weeks
3 miconazole cream

terbinafine cream

ketoconazole cream etc (tinea corporis and cruris)

Bid2-4weeks.
Generalized corporis tinea
Sporanox 200mg/d/ adult1
Terbinafine 0.25g qd1-2weeks
Fluconazol 0.15g qw 1-2weeks

Tinea of hands and feet

EEfinition: finger and toe web and palma,
metatarsus infect dermatophyte are called tinea
of hands and feet.
1>.thick horny layer in hands and feet
2>.easily scrape
3>. sweaty, damp stuffy in feet.
inducing dermatophytosis of hands and feet.

Clinical grouping
scale- blister type maceration -erosion
mode hyperkeratotic pattern

scale- blister type

hyperkeratotic pattern
maceration -erosion mode

differential diagnosis extremity

eczema pompholyx exfoliative
keratolysis

Tinea of hands and feet treatment

1 scale- blister type
soaking with 10 glacial acetic acid
Compound Benzoic Acid liniment miconazole cream
pulvis pro pedibus ext
2 maceration -erosion mode
Compound Resorcinol Liniment
miconazole cream and pulvis pro pedibus ext
slight effusion:radiomycin anthraco paste
miconazole cream and pulvis pro pedibus
considerable effusion: 0.5 fradiomycin FL
miconazole cream and pulvis pro pedibus
second infection using the antibiotic
3 hyperkeratotic pattern
Whitfield ointment miconazole cream
companion with rhagades : carbamide lip etc.
note to ringworm of hand:
avoidance miscellaneous physical o chemical stimulus.

tinea capitis both dandruff and hair are infected dermatophytes.

clinical manifestation: papule ;blister; scale; pustule .

clinical appearance
susceptible population : favus

child or adult.
tinea alba
child.
black dot tinea child or adult.

cutaneous lesion:

sick hair

favus

papule ,pustule ,
scutulum, atrophic scar.
tinea alba
seborrheic dermatitis scale
child and mother patch
black dot tinea seborrheic dermatitis scale
;macula

favus
tinea alba
black dot tinea

Wood light

dry and no luster, easy brisement,

different leng.
brisement part
from 2-4mm
patientscalp.
fracture part from patientscalp.

favus
tinea alba
black dot tinea

dark green fluorescence

bright green fluorescence
no fluorescence

direct microscope

Microsporum lanosum

Microsporum

corrosion

fungus culture

Trichophyton violaceum Trichophyton tonsurans .

course of disease
favus
tinea alba

black dot tinea

slow proceeding ;
inability autotherapy ; scar
rapid proceeding ;
adolescent age autotherapy; no scar
slow proceeding
inability autotherapy minority scar

Kerion
Definition: a deep, pustular type of tinea resembling a carbuncle
or kerion is observed on the glabrous skin ,
which is a topical allergic response.
Clinical manifestation: one or several
manifest inflammation abscesses
with overt edge feel fluctuant,
hair become loosening and broken off easily.
Common lingering effects are scar
and nonvolatile alopecia.
Differential diagnosis: dandruff eczema
seborrheic dermatitis
amianth pityriasis
psoriasis alopecia areata.

prevention and
cure of tinea capitis
1.overdose
terbinafine : <20kg 62.5mg qd 2w at
least
20kg 40kg 125mg qd 2w at least
> 40kg 250mg qd 2w at least
fluconazol: 36mg/kg/d, 2w at least
itraconazole: 36mg/kg/d, 2w at least.

prevention and cure of tinea

capitis
2.drug for external: miconazole cream ext ,bid2m
3. shampoo: sulfur soap/d , 2m
4. shaving head: cutting all
hairs,qw2m.
5.megatemperature disinfection:
towel, sheeting,pillowcase, comb
etc.
Kerion: forbidding incision and drainage.

Onychomycosis
Definition: it is difined as the infection of the nail
by fungus and represents up to 30 of diagnosed
superficial fungal infections.

Clinical appearance: thick nail plate nail

segregation colouration alteration and breakage,etc.

prevention and cure of

onychomycosis
1. removing morbid nails:

wafering
mornid nails after painting 40 carbamide
cream, then getting rid of them.

2. drug for external: 30 glacial acetic acid or 2

miconazole tincture, ext bid 36m

3. overdose : terbinafine :0.25g qd 34m

fluconazol: 0.15g qw 34m
itraconazole: 0.2g qd 1w/m 34m