1. Fungal infections
Dr.Majdy Naim

2. Majdy Naim Fungal infections of the skin
Superficial fungal infections ( affecting the skin primarily )
Deep fungal infections ( starting in the internal organs and involve the skin secondarily )
Majdy Naim Fungal infections of the skin

3. Superficial fungal infections
Dermatophytes
Epidermophyton
Trichophyton
Microsporum
Yeasts
Candida
Malassezia furfur
Majdy Naim Fungal infections of the skin

4. Classification of dermatophytic infections
Tinea capitis
Tinea corporis ( Tinea circinata )
Tinea faceie
Tinea barbae
Tinea cruris
Tinea pedis
Onychomycosis
Majdy Naim Fungal infections of the skin

5. Majdy Naim Fungal infections of the skin
Tinea capitis
Majdy Naim Fungal infections of the skin

6. Majdy Naim Fungal infections of the skin
Tinea capitis
In general 3 types
Scaly
Kerion
Black-dot
Majdy Naim Fungal infections of the skin

7. Majdy Naim Fungal infections of the skin
Scaly ringworm
In school children
Single or multiple round patches with fine grayisch-white scales
The hairs in this area become loos and break off leaving stumps about 3 mm long
These stumps are easily pulled out
Mainly due to Trichophyton violaceum and Microsporum canis
Majdy Naim Fungal infections of the skin

8. Majdy Naim Fungal infections of the skin
Kerion
The patches form follicular pustules, or boggy swelling like an abscess
Causes fall out of the hair
May end by scaring and permanent baldness
Usually due to fungi of an animal origin ( mainly Trichophyton verrucosum and microsporum canis )
Majdy Naim Fungal infections of the skin

9. Majdy Naim Fungal infections of the skin
Kerion
Majdy Naim Fungal infections of the skin
Dr. Majdy Naim

10. Kerion ( after 4months therapy)
Dr. Majdy Naim
Majdy Naim Fungal infections of the skin

11. Kerion differs from an abscess in:
Less painfull
Absence of general symptoms
Contains no pus
Kerion should not be incised
Majdy Naim Fungal infections of the skin

12. Majdy Naim Fungal infections of the skin
Black-dot
The hairs do not form stumps but break of nesr the surface of the follicles
May show slight scaling
Caused by Trichophyton violaceum
Majdy Naim Fungal infections of the skin

13. Tinea capitis (mode of infection)
Direct
Man to Man
Animal
Indirect
Use of patient‘s fomites
Friseur
Majdy Naim Fungal infections of the skin

14. Diagnosis of tinea capitis
Clinical examination
Woods Light
Microskopic examination ( KOH)
Culture (Sabourauds agar medium)
Majdy Naim Fungal infections of the skin

15. Treatment of tinea capitis
Systemic therapy
Essential
Griseofulvin for 8 weeks
Terbenafen (Lamisil) 6 weeks
Topical therapy
Alone useless
Antifugal ceams
Antifugal shampoo
Majdy Naim Fungal infections of the skin

16. Majdy Naim Fungal infections of the skin
Tinea corporis
Majdy Naim Fungal infections of the skin

17. Majdy Naim Fungal infections of the skin
Tinea corporis
Seen in any age, but children are most susceptible
Caused by almost all species of trichophyta and microspora
Lesions are annular with central healing and active edge
They are single or multiple, and can be itchy
Majdy Naim Fungal infections of the skin

18. Majdy Naim Fungal infections of the skin
Treatment
Topical antifungul
By localized moderate cases
Systemic antifungal
By extensive or resistant cases
Majdy Naim Fungal infections of the skin

19. Majdy Naim Fungal infections of the skin
Tinea Facei
Face except moustache and beard area in adult male
Any part of the face in children
May be steroid modified
Majdy Naim Fungal infections of the skin

20. Majdy Naim Fungal infections of the skin
Tinea barbae
Deep fungus
infection
Adult men
Mostly by animal
farmers
Majdy Naim Fungal infections of the skin

21. Majdy Naim Fungal infections of the skin
Tinea cruris
More frequently during the summer months
most cases caused by Epidermophyton floccosum and Trichphyton rubrum
Affect the upper and inner surface of the thighs
Often extend into the gluteal folds and onto the buttocks
Itching occurs especially in acute types
Majdy Naim Fungal infections of the skin

22. Majdy Naim Fungal infections of the skin
Tinea Cruris
Acute
Subacute
Chronic
Majdy Naim Fungal infections of the skin

23. Majdy Naim Fungal infections of the skin
Tinea Cruris
Majdy Naim Fungal infections of the skin

24. Tinea cruris Differential diagnosis
Simple intertrigo
Seborrheic dermatitis
Candidiasis
Erythrasma
Flexural psoriasis
Contact dermatitis
Majdy Naim Fungal infections of the skin

25. Majdy Naim Fungal infections of the skin
Treatment
Topical antifungul
By mild to moderate cases
Systemic antifungal
By extensive or resistant cases
Majdy Naim Fungal infections of the skin

26. Majdy Naim Fungal infections of the skin
Tinea pedis
Most common fungus infection
In general a disease of adult life
Often in summer months
The mode of infection is usually by using infected socks, shoes or other towels, also from wet floor-boards
Caused mainly Trichophyton interdigitale, T. rubrum Epidermophyton floccosum
Majdy Naim Fungal infections of the skin

27. Tinea pedis (Athletes foot)
Majdy Naim Fungal infections of the skin

28. Majdy Naim Fungal infections of the skin
Tinea pedis
Majdy Naim Fungal infections of the skin

29. Dermatophyte infections
Keratinised epithelium:
Tinea corporis
Tinea faciale
Tinea cruris
Tinea manus
Tinea pedis
Nails:
Tinea unguium (Onychomycosis )
Hairs:
Tinea capitis
Tinea barbae
Majdy Naim Fungal infections of the skin

30. Majdy Naim Fungal infections of the skin
Onychomycosis
Majdy Naim Fungal infections of the skin

31. Majdy Naim Fungal infections of the skin
Onychomycosis
Nail may show discoloration, thickining, cracking, subungular hyperkeratosis or onycholysis
One or more nails are involved
May be associated with tinea pedis
Majdy Naim Fungal infections of the skin

32. Majdy Naim Fungal infections of the skin
Tinea manuum
Majdy Naim Fungal infections of the skin

33. Majdy Naim Fungal infections of the skin
Yeasts infection
Candidiasis
Tinea versicolor
Majdy Naim Fungal infections of the skin

34. Majdy Naim Fungal infections of the skin
Candidiasis
80 % Candida albicans
Majdy Naim Fungal infections of the skin

35. Majdy Naim Fungal infections of the skin
Oral candidiasis
Thrush
Angular cheilitis
Majdy Naim Fungal infections of the skin

36. Majdy Naim Fungal infections of the skin
Candidiasis
Majdy Naim Fungal infections of the skin

37. Majdy Naim Fungal infections of the skin
Candidiasis
Oral candidiasis
Thush,Angular stomatitis,Candidal glossitis,Black hairy tongue
Intertriginous candidiasis
Genital candidiasis
Vulvovaginal candidiasis, Candidial balanoposthitis
Candidal paronychia
Napkin candidiasis
Majdy Naim Fungal infections of the skin

38. Majdy Naim Fungal infections of the skin
Predisposing factors
Trauma
Friction
Moisture and sweating
Drugs
Conditions associated with low resistance
Majdy Naim Fungal infections of the skin

39. Pityriasis versicolor
Majdy Naim Fungal infections of the skin

40. Pityriasis versicolor
Very common superfacial mycotic infection
Caused by malassezia furfur
Commonly affects young adults
Climatic factors and familial predisposition appear to be important
Majdy Naim Fungal infections of the skin

41. Majdy Naim Fungal infections of the skin
Treatment
Short application of selenium sulfate (10-15 min) for 2 weeks
Topical antifungals as shampoo or cream
Systemic antifungals
Majdy Naim Fungal infections of the skin