1. /2  Bacillus anthracis..  Bacillus anthracis.. Cutaneous Black Lesions..  Clostridium perfingens and other sp. : Necrotizing Fasciitis.. Myonecrosis, Cellulitis, tissues putrefaction, gas production/ Gas gangrene.. Surgical/Traumatic wound.. Skin- Subcutaneous (Mixed Infection).. Specific Enzymes & Exotoxins  Borrelia Burgdorferi : Lyme disease.. Transmitted by Tick/ Insect bites.. Incub. 1-3 weeks.. Annular Rash.. Chronic Skin Lesion.. Cardiac & Neurological Abnormality.. Arthritis.. Endemic USA, China, Japan  Bartonella species: G-ve bacilli Bartonellosis Cat Scratch Fever..followed Cat scratch or bite..Skin lesions.. Subacute regional lymphadenitis..Septicemia.

2. Tuberculosis-Leprosy-1  Cutaneous Tuberculosis (TB).. Cutaneous TB is a relatively uncommon form of extra-pulmonary TB..  Rare M. tuberculosis.. Common M. marinum- ulcerans.. Low Temperature..Water.. Skin Lesions.. Chronic cutaneous ulcer.. Small granulomas Follow skin injury..Trauma.  Leprosy: Chronic bacterial infection caused by M. leprae.. It primarily affects cold body sites skin, mucous membranes.. peripheral nerves.. nose, ears, eye lids and testes. M. leprae.. It primarily affects cold body sites skin, mucous membranes.. peripheral nerves.. nose, ears, eye lids and testes.  characterized by multiple skin lesions accompanied first by sensation loss/ anesthesia.. sensory loss in the affected areas, toes, finger tips, tissue destructions.

3. Leprosy-2

4. Leprosy-33/  Lebrosy can affect people of all races around the world. However, it is most common in warm, wet areas in the tropics and subtropics.  In most cases, it is spread through long-term contact with a person who has the disease but has not been treated.  Most people will never develop the disease even if they are exposed to the bacteria.. have a natural immunity to leprosy. a natural immunity to leprosy.  Worldwide prevalence is reported to be around 5.5 million, with 80% of these cases found in 5 countries: India, Indonesia, Myanmar, Brazil and Nigeria.

5. Clinical Leprosy-4  Infection incubation period range from 6 months - 40 years or longer. usually begins in the extremities  Leprosy forms depend on the person's immune response to the infection.  There are several forms of leprosy:  Tuberculoid form.. Mild Form.. Few AF Bacilli, Lepromin skin test +ve, Presence nerve sensation  lepromatous type Severe form.. Numerous Acid-fast bacilli, Loss nerve sensation.. Lepromin skin test -ve

6. Diagnosis & Treatment  Lab Diagnosis: A skin biopsy may show characteristic granulomas (mixed inflammatory cell infiltrate in the deeper layers of the skin, the dermis) with involvement of the nerves.  Presence Acid fast bacilli.. number of bacilli visible depending on the type of leprosy.. No Culture.. No Protected Vaccine available.. BCG may help & reduce the severity of disease  Treatment: Dapsone, Rifampin, Clofazimine. Life-long Treatment..No Cure but Less Tissue Damage and Spread of Infection.

7. Common Fungal Skin Infection-1  Superficial & Cutaneous Mycosis : Invade only dead tissues of the skin.. keratinized body tissues.. Skin, Hair, Nails. causes skin peeling, redness, itching, burning.. less blisters and sores.  Malnourishment, poor hygiene, suppressed immunity & warm moist climate may increase the incidence fungal skin infection  Dermatophytes: Trichopyhton, Microsporum, Epidermatophyton spp., Yeast forms Piytrosporum, Trichosporons..present in hair follicles & skin folding.  Transmission: Usually from person to person or animal to person.. dust particles..common more with chronic skin disorders.

8. Tinea Corporis

9. Tinea pedis -Tinea capitis kerion Tinea pedis -Tinea capitis kerion

10. Skin Fungal Infection-2  Tinea capitis: Hair follicles, scalp circular patches.. Scaling, Hair Loss..Children..Rare adults  Tinea corporis: Skin annular-erythematic lesions, Vesicles, Scaling.. Itching.. Rash.. All Ages.. Mostly caused by Dermatophytes..rarely mixed with Yeast  Tinea pedis : Red vesicles.. Interdigital spaces, web lesions, Toes, Plantar surface.. Feet, Itching.. Chronic lesions..Wearing tight shoes/socks, increased feet sweating.. More in Adults than children.. Cased by all Dermatophytes.  Tinea cruris: Pelvic area.. Groin.. Erythematic Lesions, Itching, Chronic.. more common in male young adults..mostly Epidermophyton spp

11. Skin Fungal Infection-3  Tina unguium (Onychomycosis): Mostly caused by Trichophyton,Microsporum.. less Candida..fingernails & toenails. Nails become colorless/dark colored, thicken, disfigure and brittle..Diabetes  Psoriasis is a common skin disorder produces thick red plaques covered with silvery scales..can affect the nails, scalp, skin and joints..not caused by fungus and not transmitted to others.  Eczema develops due to multiple immunological & other medical conditions.. Skin becomes inflamed or irritated..No infectious agent involved.  Aspergillus & Cryptococcus spp. Rare cause localised skin or nail.. 

12. Onychomycosis-Psoriasis

13. Skin Fungal Infection-3  Tinea Versicolor/Pityriasis: Malassezia furfur / Piytrosporum folliculitis.. Lipophilic Yeast..difficult to culture in Labs. Part skin flora.. Endogenous infection.. Skin Moist-Folded Area.. Discoloration.. Red Spots.. Mostly Face- Neck Finger Trunk..Mild..rarely Chronic, Stress conditions, UV-Light, Common in young adults.  Head dundruff, Seborrheic dermatitis.  White & Black Piedra..Trichosporon spp., Soft to hard nodules. scalp hair & hair shaft, skin face, any body part.

14. Yeat skin infection  Candidasis: C. albicans, C. glabrata, C. tropicalis.. Other spp. Endogenous infection..moist folds of skin.. Lesions, finger nails, toenails, Finger webs.. Diabetes, immuno-compromessed.. more common in Infant & women.. Candida infections can look just like other types of dermatitis /eczema or skin allergy. itching, redness..infection  Blasmycosis: Blastomyces dermatitidis & Histoplasmosis : Histoplasma capsulatum.. Dimorphic Fungi.. Soil..Spore Inhalation.. Respiratory infection.. Systemic Infection.. Complications: Skin ulcerations/lesions Granulomas..causes severe damages..common USA, Canada

15. Tinea Pityrisis / versicolor Seborrheic dermatitis

16. Lab diagnosis-4  Direct microscopic examination of skin scales dissolved in a 10 % solution potassium hydroxide (KOH).. demonstrating the fungus as small Filaments / Yeast like structures.  Culture: Sabouraud Dextrose agar, Incubation at room temperature & 37 C for 2-6 Weeks.. Slow growth for Dermatophytes..Rapid growth Candida.  ChromCandida agar.. used for rapid identification of common Candida species.  Treatment: Most skin infections respond very well to topical antifungal drugs..Less systemic drug.. interact with Ergosterol..causing Fungal Cell membrane disruption.. Imidazole drugs..miconazole, clotrimazole, econazole, ketoconazole, fluconazole