SUPERICIAL FUNGI Flashcards by Arriane Cyrel (MTI)

among the most prevalent infectious disease

SUPERFICIAL FUNGI

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mode of transmission :

person to person contact (garments, blankets, clothing)

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hair infection with nodular masses of fungal elements surrounding the shaft

PIEDRA

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infections of the skin

TINEA

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macular pathches that are non-scaly

TINEA

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Yeast

Malassezia furfur

Trichosporon beigelii

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Mold

Piedra hortae

Exophiala werneckii

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Exophiala werneckii other name

Phaeoannellomyces werneckii

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Tinea versicolor/Pityriasis versicolor, Seborrhoeic dermatitis

Malassezia furfur

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causes dandruff

Seborrhoeic dermatitis

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Discoloration on the upper chest, back arms and neck

Malassezia furfur

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Hypo/hyper pigmentation

Malassezia furfur

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Lesions are well-demarcated

Malassezia furfur

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brownish , scaly areas on light skin individuals
lightish , on dark skin individuals

Malassezia furfur

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Fawn-colored macules

Malassezia furfur

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most common presentation; trunk and upper arms

Fawn-colored macules

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Wood’s Lamp Positive (light green flourescence)

Malassezia furfur

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skin scrapings, indwelling catheter tips, blood

Malassezia furfur

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– common in infants

indwelling catheter tips

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Sabouraud’s Dextrose Agar or Sheep Blood Agar containing Acti-Dione

Malassezia furfur

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Dixon’s Agar containing glycerol mono-oleate

Malassezia furfur

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stimulates growth by natural oil or fatty substances

Malassezia furfur

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culture media ; need an addition of oil

Malassezia furfur

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1-2 weeks: bacteria-like

Malassezia furfur

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Pasty white

Malassezia furfur

the collarettes of the phialides appear as distinct dark rings separation the mother and daughter cells

Malassezia furfur

10% KOH (glycerol w/ Parker ink or Calcofluor white)

Malassezia furfur

PAS/LCPB

Malassezia furfur

Electron Micrograph

Malassezia furfur

Under KOH – cluster of thick walled round budding yeast

Malassezia furfur

Short angular hyphal forms

Malassezia furfur

Topical Agent (imidazole, ketoconazole)

Malassezia furfur

Oral Tx

Malassezia furfur

Tinea nigra

Exophiala werneckii

- chronic superficial fungal on palms

Tinea nigra

Predisposing factor:

excessive sweating

Age:

less than 20 yrs old female

Brown to black macules

Exophiala werneckii

(palmar and plantar and other surfaces of the skin)

Exophiala werneckii

skin scrapings

Exophiala werneckii

SDA – serves as primary isolation media.

Exophiala werneckii

: mucoid like colonies, yeast like , and shiny black appearance

young yeast

: velvety

mature, mold

Dematiaceous: pigment brown to dark

Exophiala werneckii

initially colonies are mucoid, yeastlike and shiny black

Exophiala werneckii

Abundant aerial mycelia and become velvety, dark olivaceous in colour

Exophiala werneckii

2-celled

Exophiala werneckii

– spores

Annelloconidia

– conidiophore

Annellophores

after 7 days growth of colony; color: off-white

Exophiala werneckii

after 2 -3 weeks o color: olive black

Exophiala werneckii

 10% KOH and Parker ink  Calcofluor White Mounts

Exophiala werneckii

Sulfur Soap, SSA (sulfosalicylic), Azoles, Tropical Treatment

Exophiala werneckii

- ascomycetous fungus: produces pores

Piedra hortae

- Common in central and south america and south east asia

Piedra hortae

: produces pores

ascomycetous fungus

o chronic fungal infection of the hair shaft

Black Piedra

o mostly affects young adults o epidemics in families

Black Piedra

does not penetrate the hair follicle

Piedra hortae

: rough or sandy

Scalp hair

: black, hard, nodules on the shaft

Infected hairs

Nodules : hard fusiform

Piedra hortae

: fungal cells cemented together

Thick part

: hyphal elements

Thin part

hairs with hard black nodules

Piedra hortae

o colonies are dark, brown- black

Piedra hortae

o take about 2-3 weeks to appear

Piedra hortae

spore: barrel shape arthroconidia

Piedra hortae

hyphae: thick walled septate

Piedra hortae

- 10 days

Piedra hortae

- Glabrous/ cerebriform

Piedra hortae

: greenish to black with black reverse

Mature colonies

10% KOH w/ Parker ink; Calcofluor white

Piedra hortae

Nodules: pigmented center containing asci

Piedra hortae

- Spore/condia

Piedra hortae

- Hypahe

Piedra hortae

shave or cut the hairs short, terbinafine

Piedra hortae

: 250 mg/per day for 6 weeks

Terbinafine

- Grows at 370C

Trichosporon beigelii

- Sensitive to cycloheximide

Trichosporon beigelii

o superficial cosmetic fungal infection of the hair shaft

White Piedra

o affects scalp, axilla, facial and genital hair

White Piedra

- common in young adults

Trichosporon beigelii

- irregular, soft, white or light brown nodules firmly adhering to the hairs

Trichosporon beigelii

- soft white nodules

Trichosporon beigelii

o white or yellowish to deep cream colored

Trichosporon beigelii

o smooth, wrinkled, velvety, dull colonies with a mycelial fringe

Trichosporon beigelii

- Spore : sympodial blastoconidia – an arthroconidia with pseudohyphae

Trichosporon beigelii

- Hyphae : Hyaline septate

Trichosporon beigelii

- 5 days

Trichosporon beigelii

- Cream and waxy

Trichosporon beigelii

- Spore

- Hyphae

Trichosporon beigelii

shave the hairs, tropical

Trichosporon beigelii

Tinea Versicolor

Malassezia furfur

Yeast

Malassezia furfur Trichosporon beigelii

Mould

Exophiala werneckii (Phaeoannellomyces werneckii) Piedra horta

Skin (chest, arms, back)

Malassezia furfur

Temperate

Malassezia furfur Trichosporon beigelii

Hypopigmented

Malassezia furfur

Requires Fatty Acids

Malassezia furfur

Spaghetti and meatballs (PAS), bowling pins (electromicrograph), medicine capsule

Malassezia furfur

Tinea Nigra