superficial mycosis maculaepapulevesiclebullapustulenodulefistulascale
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Superficial mycosisSuperficial mycosis
MaculaeMaculaePapulePapuleVesicleVesicleBullaBullaPustulePustuleNodule Nodule FistulaFistulaScaleScale
Superficial mycosisSuperficial mycosis
DefinitionDefinition
FungiFungi Pityriasis versicolorPityriasis versicolor Tinea nigraTinea nigra PiedraPiedra
BacteriaBacteria ErythrasmaErythrasma Trichomycosis axillarisTrichomycosis axillaris
Superficial mycosisSuperficial mycosis
OtomycosisOtomycosis
KeratomycosisKeratomycosis
Pitted keratolysisPitted keratolysis
Dermatophylosis Dermatophylosis
Pityriasis versicolorPityriasis versicolor
Tinea versicolorTinea versicolorMaculaeMaculaeMalassezia sppMalassezia sppNormal floraNormal floraBoys & girlsBoys & girlsAfter maturationAfter maturationBeautyBeautyWarm & humidity Warm & humidity SeasonSeason
Pityriasis versicolorPityriasis versicolor
Conditions:Conditions: HealthHealth SweatSweat Greasy skinGreasy skin IC.IC. Chronic bacterial infectionsChronic bacterial infections SteroidsSteroids
Pityriasis versicolorPityriasis versicolor
Clinical manifestations:Clinical manifestations: MaculaeMaculae White, cream, pink, red, White, cream, pink, red,
brownbrown PositionPosition ScaleScale PainlessPainless Not itchingNot itching
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Superficial mycosisSuperficial mycosis
Pityriasis versicolorPityriasis versicolor
Pityriasis versicolorPityriasis versicolor
Differential diagnosis:Differential diagnosis: VitiligoVitiligo ChloasmaChloasma
Pityriasis versicolorPityriasis versicolor
Laboratory diagnosis:Laboratory diagnosis:
SamplingSampling ScalpelScalpel Scathe tapeScathe tape Wood 1s lampWood 1s lamp
DirectDirect
Culture Culture
Pityriasis versicolorPityriasis versicolor
TreatmentTreatment Selenium sulfide Selenium sulfide Clotrimazole Clotrimazole
Tinea nigraTinea nigra
Phaeoanellomyces werneckiiPhaeoanellomyces werneckii Exophiala werneckiiExophiala werneckii
EcologyEcology
PalmPalm
Tinea nigra palmarisTinea nigra palmaris
Tinea nigraTinea nigra
Clinical manifestation:Clinical manifestation:
Annular Annular CentrifugeCentrifuge
Regular or irregularRegular or irregular
PainlessPainless
No itching No itching
Tinea nigraTinea nigra
Differential diagnosis:Differential diagnosis: Malignant melanomaMalignant melanoma Silver nitrateSilver nitrate
Tinea nigraTinea nigra
Laboratory diagnosis:Laboratory diagnosis: Sampling:Sampling:
Scalpel & KOH10%Scalpel & KOH10% Direct:Direct:
HyphaeHyphae
ChlamydioconidiaChlamydioconidia Culture:Culture:
SS
Tinea nigraTinea nigra
TreatmentTreatment Keratolytic ointmentKeratolytic ointment
whitfieldwhitfield
PiedraPiedra
HairHair
Nodule Nodule
Bread, groin, axillarBread, groin, axillar
White & blackWhite & black
PiedraPiedra
Clinical manifestation:Clinical manifestation: White piedra:White piedra:
Trichosporon beigeliiTrichosporon beigelii BasidiomycetesBasidiomycetes
NoduleNodule Bread, head, pubisBread, head, pubis White, brown, yellow, White, brown, yellow, Soft Soft
PiedraPiedra
Clinical manifestation:Clinical manifestation: Black piedra:Black piedra:
Piedra hortaePiedra hortae AscomycetesAscomycetes
NoduleNodule HeadHead ThickThick Black to brown Black to brown
PiedraPiedra
Differential diagnosis:Differential diagnosis: Pediculosis Pediculosis
PiedraPiedra
Laboratory diagnosis:Laboratory diagnosis: Sampling:Sampling:
Sesser & KOH10%Sesser & KOH10% Direct:Direct:
White:White: hyphae & arthroconidia hyphae & arthroconidia
Black:Black: ascus & ascospore ascus & ascospore Culture:Culture:
SS
PiedraPiedra
Treatment:Treatment: ScrapingScraping Clotrimazole Clotrimazole
ErythrasmaErythrasma
BacteriaBacteria
Corynebacterium minutissimumCorynebacterium minutissimum
ChronicChronic
IntertrigenousIntertrigenous
ErythrasmaErythrasma
Clinical manifestation:Clinical manifestation: MaculaeMaculae
Red or brownRed or brown
ScaleScale
ItchingItching
No inflammationNo inflammation
Superficial mycosisSuperficial mycosis
ErythrasmaErythrasma
Superficial mycosisSuperficial mycosis
ErythrasmaErythrasma
Superficial mycosisSuperficial mycosis
ErythrasmaErythrasma
Superficial mycosisSuperficial mycosis
ErythrasmaErythrasma
ErythrasmaErythrasma
Differential diagnosis:Differential diagnosis: Pityriasis versicolorPityriasis versicolor CandidiasisCandidiasis Tinea crurisTinea cruris
ErythrasmaErythrasma
Laboratory diagnosis:Laboratory diagnosis: Sampling:Sampling:
Scalpel & simple stainingScalpel & simple staining Direct:Direct:
StrandStrand Culture:Culture:
BHI, Blood agarBHI, Blood agar Wood 1s lampWood 1s lamp
ErythrasmaErythrasma
TreatmentTreatment Erythromycin Erythromycin
Trichomycosis axillarisTrichomycosis axillaris
BacteriaBacteria
Corynebacterium tenuisCorynebacterium tenuis
Nodule Nodule
HairHair Axillaries & pubisAxillaries & pubis RedRed YellowYellow blackblack
Trichomycosis axillarisTrichomycosis axillaris
Differential diagnosis:Differential diagnosis: PediculosisPediculosis
Trichomycosis axillarisTrichomycosis axillaris
Laboratory diagnosis:Laboratory diagnosis: Sampling:Sampling:
Sesser & KOH10%Sesser & KOH10% DirectDirect CultureCulture
Trichomycosis axillarisTrichomycosis axillaris
TreatmentTreatment Scraping and sulphur ointment 3%Scraping and sulphur ointment 3%
KeratomycosisKeratomycosis
INCIDENCE OF INCIDENCE OF FKFK
Developed worldDeveloped world
6 -35% of all microbial keratitis6 -35% of all microbial keratitis
Developing worldDeveloping world
22 - >50%22 - >50%
FUNGAL GROUPSFUNGAL GROUPS
FilamentousFilamentous
FusariumFusarium
AspergillusAspergillus
DematiaceousDematiaceous
YeastsYeasts
CandidaCandida
Fungal KeratitisFungal Keratitis
Risk factors:Risk factors: Topical corticosteroids ↓corneal resistance to Topical corticosteroids ↓corneal resistance to
infectioninfection Contact lens use Contact lens use Immunocomprised states Immunocomprised states
Fungal KeratitisFungal KeratitisRisk factorsRisk factors Injury, ocular surface compromiseInjury, ocular surface compromise TemperatureTemperature WindWind HumidityHumidity Urbanisation/employmentUrbanisation/employment
Fungal KeratitisFungal Keratitis
ExogenExogen
Endogen Endogen
Fungal KeratitisFungal Keratitis
Gray-white color, dry, and rough corneal Gray-white color, dry, and rough corneal surfacesurface
White ring in the cornea and satellite White ring in the cornea and satellite lesions near the edge of the primary lesions near the edge of the primary Most cases remain superficial Most cases remain superficial but deep invasion may but deep invasion may occuroccur
DIAGNOSISDIAGNOSIS
Clinical features (diff.diagnosis)Clinical features (diff.diagnosis)
MicrobiologyMicrobiology
HistopathologyHistopathology
DNA amplificationDNA amplification
HISTOPATHOLGYHISTOPATHOLGY
Haematoxylin and eosin (H&E)Haematoxylin and eosin (H&E)
Periodic acid-Schiff (PAS)Periodic acid-Schiff (PAS)
GrocottGrocott
Fungal KeratitisFungal Keratitis
Treatment: Treatment: Natamycin 5% drops (filamentous)Natamycin 5% drops (filamentous)
Works particularly well Fusarium sppWorks particularly well Fusarium spp Amphotercin B 0.15-0.30% (Candida)Amphotercin B 0.15-0.30% (Candida) Most effective for yeastMost effective for yeast
Otomycosis Otomycosis
OtomycosisOtomycosis
Bacterial, viral or fungal infection of Bacterial, viral or fungal infection of external auditory canalexternal auditory canal
Categorized by time courseCategorized by time course AcuteAcute ChronicChronic
Swimmer’s earSwimmer’s ear
OrganismsOrganisms
1.1. FungiFungi1.1. AspergillusAspergillus
2.2. CandidaCandida species species
2.2. PseudomonasPseudomonas species species
3.3. Staphylococci Staphylococci
4.4. StreptococciStreptococci
5.5. Gram negative rodsGram negative rods
Risk FactorsRisk Factors
High humidityHigh humidity
Water exposureWater exposure
High environmental temperatureHigh environmental temperature
Local traumaLocal trauma
AllergyAllergy
StressStress
Alkaline pH of canalAlkaline pH of canal
OtomycosisOtomycosis
Often indistinguishable from bacterial OEOften indistinguishable from bacterial OE
Dull painDull pain
Hearing loss (obstructive)Hearing loss (obstructive)
OtomycosisOtomycosis
TreatmentTreatment
Thorough cleaning and drying of canalThorough cleaning and drying of canal
Topical antifungals Topical antifungals ClotrimazoleClotrimazole
Acidifying of the EAC with drops likeAcidifying of the EAC with drops like 2% acetic acid2% acetic acid 3% boric acid3% boric acid
درماتوفیلوزیسدرماتوفیلوزیس
مترشحه، چرکمترشحه، چرکحیوانحیوانانسانانسانپوسته و دلمهپوسته و دلمهاسکار و آلوپسیاسکار و آلوپسیمسریمسری
درماتوفیلوزیسدرماتوفیلوزیس
Dermatophilus congolonsisDermatophilus congolonsisاکتینومایستاکتینومایستگوسفند و دامگوسفند و دامپارازیت پوستپارازیت پوستفصل بارانیفصل بارانیتماس مستقیمتماس مستقیمLumpy woolLumpy wool
عالئم بالینیعالئم بالینی
اپیدرماپیدرمزخم های کم عمقزخم های کم عمقاگزودااگزوداکدر شدن موکدر شدن موریزش دلمهریزش دلمهبهبودبهبودآلوپسیآلوپسی
تشخیص آزمایشگاهیتشخیص آزمایشگاهی
گیریگیری نمونهنمونهپوسته و ترشحاتپوسته و ترشحات
مستقیممستقیمرنگ آمیزیرنگ آمیزی
متیلن بلومتیلن بلوگیمساگیمسا ،میکرون میکرون55- - 22رشته های منشعب، رشته های منشعب
88 کوکسی کوکسی
کشتکشتبالد آگاربالد آگار3737درجه درجه
تشخیص آزمایشگاهیتشخیص آزمایشگاهی
کاتاالز مثبتکاتاالز مثبتاوره آز مثبتاوره آز مثبتاسید فست منفیاسید فست منفیهیدرولیز نشاسته مثبتهیدرولیز نشاسته مثبت
درماندرمان
سولفات مسسولفات مس درصد/ درصد55سولفات روی سولفات روی /پنی سیلینپنی سیلین
کراتولیز حفره ایکراتولیز حفره ای
Pitted keratolysisPitted keratolysisالیه شاخی کف پاالیه شاخی کف پاضایعات سطحی گردضایعات سطحی گرد
عامل بیماریعامل بیماری
اکتینومایستاکتینومایستنوکاردیانوکاردیادرماتوفیلوسدرماتوفیلوسکورینه باکتریومکورینه باکتریوم
عوامل مستعد کنندهعوامل مستعد کننده
رطوبترطوبتگرماگرمارعایت نکردن بهداشترعایت نکردن بهداشتچکمهچکمهپوتینپوتین
عالئم بیماریعالئم بیماری
الیه های سطحی کف پاالیه های سطحی کف پاانگشتان و پاشنه پاانگشتان و پاشنه پاتجزیه کراتینتجزیه کراتینضایعات سطحی گردضایعات سطحی گردبوی نامطبوعبوی نامطبوع
تشخیص آزمایشگاهیتشخیص آزمایشگاهی
نمونه گیرینمونه گیریپوستهپوسته
مستقیممستقیمپتاس و رنگ آمیزیپتاس و رنگ آمیزیرشته و کوکسیرشته و کوکسی
کشتکشتمشکل استمشکل است
درماندرمان
از بین بردن شرایط مستعد کنندهاز بین بردن شرایط مستعد کننده درصد درصد4040 تا تا 2020فرمالین فرمالین