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Superficial Mycoses (Dermatophytes)
(Skin Plants)
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SUPERFICIAL MYCOSES The superficial mycoses are usually confined to the outermost layer of skin, hair and do not invade living tissues.
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SUPERFICIAL MYCOSES Pityriasis versicolor Tinea nigra Black piedra
White piedra Keratomycosis
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PITYRIASIS VERSICOLOR (Tinea versicolor)
Superficial chronic infection of Stratum corneum Etio: Malassezia furfur (Pityrosporum orbiculare) (Lipophilic yeast) Clinical findings: Hyperpigmented or depigmented maculae on chest, back, arms, abdomen
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Characterized by a blotchy discoloration of skin which may itch.
- Up to 25% of the general population may have this lesion at any one time. - Diagnosis is usually possible by direct microscopic examination of KOH-treated skin scrapings which show a typical aspect of mycelia and spores described as "spaghetti and meatballs.“
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Malassezia furfur
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PITYRIASIS VERSICOLOR
Treatm.: Topical selenium sulfide Oral ketaconazole Oral itraconazole
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TINEA NIGRA Superficial chronic infection of Stratum corneum
Etio: Hortae (Exophiala) werneckii (pigmented) Frequent in tropical areas Clinical findings: Brownish maculae on palms, fingers, face
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TINEA NIGRA Micr.: Septate hyphae and yeast cells (brown in color)
Culture: Black colonies Treatm.: Topical salicylic acid, tincture of iodine
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Exophiala werneckii
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BLACK PIEDRA Fungal infection of the scalp hair Etio: Piedraia hortae
Frequent in tropical areas Clinical findings: Discrete, hard, dark brown to black nodules on the hair
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BLACK PIEDRA Micr. Septate pigmented hyphae, and asci; unicellular and fusiform ascospores with polar filament(s) Culture: Brown to black colonies Treatm.: Topical salicylic acid, azol cremes
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Piedraia hortae
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WHITE PIEDRA Fungal infection of facial, axillary or genital hair
Etio: Trichosporon (yeast) Frequent in tropical and temperate zones
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WHITE PIEDRA Clinical findings: Soft, white to yellowish nodules loosely attached to the hair Micr.: Intertwined septate hyphae, blasto- and arthroconidia Culture: Soft, creamy colonies Treatm.: Shaving, azoles
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Trichosporon
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KERATOMYCOSIS (=Mycotic keratitis)
Posttraumatic / postsurgical corneal inf. Etio: Saprophytic fungi (Aspergillus, Fusarium, Alternaria, Candida), Histoplasma capsulatum Clinical findings: Corneal ulcer
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KERATOMYCOSIS Micr.: Hyphae in corneal scrapings
Treatm.: Surgery (keratoplasty) Topical pimaricin Nystatin Amphotericin B
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