CUTANEOUS MYCOSES OVERVIEW OF THE DISEASE

ETIOLOGIC AGENTS(Characteristics) The most common etiologic agents are the

The skin is the most common sites of infection, primarily because microorganisms can resist high osmotic pressure and low temperature. Fungi that colonize the superficial layer of the skin are referred to as DERMATOPHYTES DERMATOMYCOSES- fungal infection of skin, ringworm in laymans term. TINEA- general term pertaining to dermatomycoses CUTANEOUS MYCOSESinfection of the deeper layers of epidermis; localized to the keratinized layers

Trichophyton rubrum Trichophyton interdigitale and Epidermophyton floccosum.

TRANSMISSION AND PATHOGENESIS The dermatophytes may have different natural sources and modes of transmission: 1. ANTHROPOPHILIC 2.ZOOPHILIC 3. GEOPHILIC

PATHOGENESIS Cutaneous mycosis Infections of hair, skin, or nails Spp: Microsporum (hair and skin), Trichophyton (hair, skin and nails), Epidermophyton (skin and nail) Keratinophilic, keratinolytic Invade uppermost layer of skin (stratum corneum) Tinea or "ringworm

DIAGNOSIS: Tinea cruris EPIDEMIOLOGY Fungi that cause ringworm are widespread, geographically, and usually not of major concern,other than as cosmetic problems. However, cases in which these diseases cause extreme disfigurements and infections are known to occur, but are rare outside of the tropics, and are believed to be due to poor diet and unsanitary condition (Christensen, 1965).

DIAGNOSTIC TESTS KOH test

Fluconazole 150-300 mg/week for 4 weeks. Griseofulvin-interferes with the mitotic spindle and cytoplasmic microtubules Azole derivatives- interfere with the cyP450 dependent enzyme systems at the demethylation step from lanosterol to ergosterol defective cell membrane with altered permeability characteristics

-The test involves gently scrapping the top of the lesion and examining the flakes of skin under a microscope. -The best areas to sample are areas over the outside border of the lesion. Skin Lesion biopsy

-removal of a piece of skin to diagnose or rule out an illness. Types of skin biopsies include: Shave biopsy-the least invasive of all three techniques Punch biopsy most often used for deeper skin spots or sores Excisional biopsy- done to remove the entire lesion Incisional biopsy- takes a piece of a larger growth for examination

PREVENTION Keep your body clean and dry. Bathe after physical exertion and sweating. Change clothes and underwear frequently in hot weather. Wear loose fitting, clean cotton underwear. Dry yourself well after showers and baths. Shower immediately after athletic activities.

TREATMENT AND PROGNOSIS RECOMMENDED:

Griseofulvin 500 mg/day until cure [4-6 weeks] ALTERNATIVE: Terbinafine 250 mg/day for 2-4 weeks. Itraconazole 100 mg/day for 15 days or 200 mg/day for 1week.

Wear loose clothing whenever possible. Do not share clothing or towels with others; wash towels frequently.

Clean exercise equipment before use. Wear sandals in the shower area at the gym and swimming pool Good personal hygiene Wash personal items regularly: Bedding Clothes Linens

Do not share personal care items: Towels Razors

Wash your hands frequently. Clean showers with strong disinfectants. Treat all active areas of tinea cruris infection simultaneously to prevent reinfection of the groin from other body sites. Advise patients with tinea pedis to put on their socks before their undershorts to reduce the possibility of direct contamination. Advise patients with tinea cruris to dry the crural folds completely after bathing and to use separate towels for drying the groin and other parts of the body.