SUPERFICIAL MYCOSES

By

Dr. Emad AbdElhameed Morad

Lecturer of Medical Microbiology and Immunology

Superficial mycoses
1- Pityriasis versicolor 2- Tinea nigra Skin Skin

3- Black piedra
4- White piedra

Hair
Hair

Pityriasis versicolor
Causative agent:
o Malassezia furfur is the causative agent. o Malasseszia furfur is a lipophilic fungus living on the skin as part of the normal flora. o So, it is cultivated on media containing fatty substances like olive oil.

 Diseases caused by Malassezia furfur:

o Pityriasis versicolor is associated with hyperpigmented or hypopigmented macules usually on the chest and upper back of the patients. o Pityriasis folliculitis. o Catheter acquired fungemia in patients receiving total parenteral nutrition containing lipid emulsion.

Pityriasis versicolor

 Laboratory diagnosis:
Woods lamp:
o o Woods light is ultraviolet light at wave length 365 nm. The lamp is held four or five inches from the affected skin. If pityriasis versicolor is present on the skin, the affected skin will appear yellowish green in color. Skin scrapings from the lesions. The skin scrapings are mounted in 10-20% KOH. It will show spherical budding cells and short unbranched angular septate hyphae (spaghetti and meat balls). These microscopic features are diagnostic for Malassezia furfur and culture is not necessary.

Specimen:
o o o o

Direct Microscopy:

 Treatment:
Daily application of selenium sulfide. Topical or oral azoles are very effective.

Tinea nigra
Causative agent:
o Exophiala (Hortae) werneckii is the causative agent. o It is a saprophytic fungus which occurs in the soil. o It is a dematicaeous fungus (contains melanin in its cell wall and appear dark in color under the microscope).

 Clinical picture:
o Brown to black discoloration of the palm of the hand. o So, Tinea nigra is also called Tinea palmaris. o But, it may affect the sole of the foot.

Tinea nigra

 Laboratory diagnosis:
Specimen:
o Skin scrapings from the lesions.

Direct Microscopy:
o o The skin scrapings are mounted in 10-20% KOH. It will show brown to black two celled yeast cells + branched septate hyphae.

 Treatment:
Keratolytic solutions like salicylic acid. Azoles are also effective.

Black piedra
o Piedraia hortai is the causative agent. o It is a dematicaeous mold. o It affects the hair like beard, moustache and scalp & pubic hair. o It causes brown to black hard nodules around the hair shaft. o It is treated by removal of infected hairs + topical antifungal drugs.

White piedra
o Trichosporon beigelii is the causative agent. o It is a mold. o It affects the hair. o It causes large, white to yellow soft nodules around the hair shafts. o It is treated similar to black piedra.

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