Cutaneous Fungi Flashcards by tcarlso 3

Where are the two places that superficial mycoses take place on the body?

Stratum corneum of skin

Cuticle of hair

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Where are the places the epidermophyton (dermatophyte) likes to infect?

Lower limbs and torso

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Is there an inflammatory reactions with superficial mycoses? What is the primary concern with superficial mycoses?

No—Cosmetic concern

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Pityriasis versicolor (tinea versicolor) is caused by what?

Malassezia furfur (pityrosporum orbiculare)

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Is Malassezia furfur dimorphic? Normal flora?

yes

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Malassezia furfur is usually found where on the body?

Its lipophilic, so sebaceous glands

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What are the causative factors of pityriasis versicolor?

More sebaceous secretions

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What are the symptoms of Malassezia furfur infection?

Scaly patches yellow-brown to dark brown in color

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How do you diagnose Malassezie furfur infx?

Direct observation of skin scrapings with KOH prep

“spaghetti and meatballs”

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Spaghetti and meatball morphology = ?

Malassezie furfur (Pityriasis versicolor)

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What is the treatment for Pityriasis versicolor?

Topical treatment of keratolytic agents

Topical azoles

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Tinea nigra is caused by what?

Exophiala Werneckii infection

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Is Exophiala Werneckii dimorphic? What form is in the body?

dimorphic, with yeast like form in the body

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Where, geographically, are Exophiala Werneckii infections found?

warm coastal regions

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How is tinea nigra transmitted?

Constant contact with the organism (wood, compost)

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What are the symptoms of tinea nigra? How does this occur?

Light brown-black, oval shaped lesions over the hands and feet

Produces melanin

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How do you diagnose Tinea nigra?

KOH treated scrapings and seeing thick walled septate hyphae containing dark pigment

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What is the treatment for tinea nigra?

topical stuffs

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What are the species that cause black and white piedra?

Black = piedra hortae
White = Trichosporin beiglii

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Where, geographicaly are white ad black pidera found?

Black = tropics
White = Temperate and semi tropical

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How are black/white piedra transmitted?

soil and compost or animals

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What is the clinical syndrome of black piedra?

Hard, gritty nodules on hair/scalp firmly attached to hair. Cause a metallic sound when combing hair

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What is the clinical syndrome of white piedra?

Fluffy/soft/white nodules on pubic/facial/axillary hair

loosely attached to hair

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How do you diagnose black/white pedira?

Microscopic examination of hair

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What is the treatment for piedra?

Shaving hair off, hygeine

Cutaneous mycoses are caused by a group of fungi collectively known as what? What do they utilize for nutrition?

Dermatophytes--utilize keratin as a nutrient source

What are the three genera of dermatophytes? What do they all have in common?

Microsporum Trichophyton Epidermophyton All are capable of degrading and utilizing keratin

How are dermatophytes transmitted?

Geophilic (soil) Zoophilic (animals) Anthropophilic (people)

What are the predisposing factors for dermatophytes?

Closed toed shoes, community showers

What is the clinical syndrome of dermatophytes?

Circular lesions--"ringworm". Itching

Clinical manifestations of dermatophyte infection are referred to as what? Are these indicative of the species?

Tinea (blank) No correlation between species names

What is tinea pedis?

Athletes foot

What is the presentation of tinea pedis?

Lesions of the foot | Scaliness of foot

What is tinea corporis?

Ring worm

How does tinea corporis present?

Red, round, scaly patch with a raised border, usually on the trunk Pustules

What is tinea capitus? Symptoms?

Scalp infections Scaly lesions Patches of hair loss

What is FAVUS?

Mass of hyphal elements surround the base of a hair shaft in tinea capitis

What is tinea cruris? Symptoms?

Jock itch | Erythematous area around the groin

What is tinea unguium-(onychomycosis)? Symptoms?

Nail infections Dry/cracked toenails Hyperkeratosis and discoloration

How do you diagnose tinea infections? (2)

KOH prep and see hyphae (to confirm fungi) Woods lamp (green fluorescence)

What is the Woods lamp helpful for?

Determining lesions on the scalp are fungi via fluorescence

How do you treat dermatophyte infections?

Application of topical azoles

What is the drug used for tinea capitis?

Griseofulvin

How do you treat tinea unguium?

oral antifungals for a long time

Candida infectious form = what form? Environmental?

Yeast in environment | Hyphal forms in tissue

Candida albicans is normal flora. What predisposes it to infection (beside immunosuppression)?

Open-ish, wet areas.

What are the cutaneous infections associated with candida?

Diaper rash | Dishwasher hands

What are the symptoms of cutaneous candidiasis?

Papules or confluent plaques that are red and TTP

Chronic mucocutaneous candidiasis is associated with what? (2)

T cell deficits | Endocrine disorders

Where on the body are chronic mucocutaneous candidiasis found?

Mouth Face Fingernails

What is the usual immune response to chronic mucocutaneous candidiasis?

Granuloma

What are the three major predisposing factors to disseminated candidiasis?

1. Increase in colonization 2. Breakdown of normal physical barriers 3. Immunosuppression

Treatment for systemic candidiasis?

Amp B

What are subcutaneous mycoses? How are subcutaneous mycoses transmitted?

Fungal infections of the dermis Acquired through trauma of the skin

What is sporotrichosis? Cause?

Infections of cutaneous, sub and lymph by Sporothrix schenckii

Sporothrix schenckii is dimorphic? What is the form it takes in tissue?

Yes--yeast in tissue

How is Sporothrix schenckii (sporotrichosis) transmitted?

traumatic inoculation of plant surfaces (thorns, splinters etc)

What are the symptoms of Sporothrix schenckii infx (sporotrichosis)?

Inflammation at site of inoculation followed by painless granulomas up the lymph tract

How do you diagnose sporotrichosis? What is specific about how it grows?

Cultivation in tissue or pus Mold converts to yeast at 37 C

What is the treatment for sporotrichosis?

Oral KI/azoles

What is the causative agent of chromoblastomycosis?

Chromomycosis

Where, geographically, is Chromomycosis found?

Tropics

What are the symptoms of Chromomycosis?

Painless, darkly pigmented **cauliflower** lesions

How do you diagnose Chromomycosis?

**Brown** pigment hyphae in skin scrapings **Medlar bodies**

Medlar bodies (copper colored pennies) = ?

Chromomycosis

What is the treatment for Chromomycosis?

Surgical removal of lesions 5-fluorocytosine

What is mycetoma?

Madura foot Chronic subcutaneous infections of the foot

What are the three common species that cause Mycetoma?

Madurella mycetomatis M. grisea Pseudallescheria boydii

What are the symptoms of mycetoma?

Slow growing papule Ulcerating lesions with pus Bone involvement

How do you diagnose Mycetoma?

Grain in pus, tissues, or discharge Culture

How do you treat Mycetoma?

Amputation

Colored grains in pus = ?

Mycetoma