W1L2 Superficial Fungus Infection

Question 1

Type(3)

Answer 1

Dermatophytes:
Tinea (microsporum, trichophyton & epidermophyton)

Pityriasis versicolor: (malassezia furfur)

Candidiasis (moniliasis): cause by Candida albicans

Question 2

Clinical types Dermatophyte? (7)

Answer 2

Tinea capitis
Tinea barbae
Tinea corporis
Tinea pedis
Tinea manum
Tinea cruris
Tinea unguium (Onychomycosis)

Question 3

Mode of infection tinea capitis?(4)

Answer 3

-Direct (infected person/infected animal = cats, dogs)
-Indirect (cappings, beddings, combs)
-Contaminated air
-Mild trauma is required to inoculate fungus into scalp

Question 4

4 types of tinea capitis?

Answer 4

1. Scaly type
2. Black dot type
3. Kerion
4. Favus

Question 5

Cp Scaly type?

Answer 5

• Microsporum audouinii & M. canis.
• Well defined patch cover w fine grayish scales & some erythematous
• The hairs: lusterless, break off and appear short stumps/loose and easily epilated resulting complete loss hair from affected patch
• ± itching.
• Single/multiple lesion

Question 6

Cp Black dot type?

Answer 6

-T. tonsurans & T. violaceum
-Affected area shows loss of hair, studded w black dots
-Presence of black dots due to breaking hair shafts at skin surface

Question 7

Cp Kerion?

Answer 7

• Animal type of fungi
• Abscess like lesion:
  -boggy swelling
  -hairs loose & when removed seropus comes out
  -Sinuses & ulcerations may occur
  -Thick crusting w matting adjacent hairs
  -Lymphadenopathy(frequent)
  -Heal leave scar alopecia
  -Well def dull red plaque studded wi multi pustule

Question 8

Cp Favus?

Answer 8

• Trichophyton schoenleinii
• Affected area covered by lesions called sulphur cups or scutula which form around affected hair
• Scutulum (concave yellow crust surrounding hair follicle opening, mousy odour)
• Scarring alopecia,due destruction hair follicles

Question 9

Treatment tinea capitis?

Answer 9

1. Systemic (10-20,20-40,>40)
   - Griseofulvin (tab=125mg)
   ~125mg/10kg/d for 6w (10w in favus)
   - Terbinafine (tab=250mg)
   ~62.5mg/d/4w, x2, x2
   - Itraconazole (cap=100mg)
   ~50mg/d/2w, x2, x2
   - Erythromycin (Kerion)
   ~ 1gm/day 7day (40mg/kg/day in child)
2. Topical
   - Imidazole antifungal (clotrimazole,miconazole)
   - Whitfield’s ointment
   - Tincture iodine 2%
   - Wet compresses w antiseptic lotion (K. permenganate 1/8000 to remove crusts kerion)

Question 10

MOI Tinea Corporis (T. Circinata)?(3)

Answer 10

-infected person
-infected animals
-autoinoculation from T. cruris, T.pedis or T. unguium

Question 11

CP Tinea Corporis (T. Circinata)?

Answer 11

• Well def plaques w raise border covered w scales or minute papules, vesicles, pustules and crusts
• Center of lesion more or less clear giving the lesion circinate appearance Coalescence of lesions polycyclic lesion
• New lesions may dev in clear center form concentric rings
• ± itching.

Question 12

Dx T. Circinata?

Answer 12

• Scraping & M.E: scraping is done from the raised border of the lesion. Spores & hyphae
• Culture: on sabouraud’s agar media