1. Common Fungal & Parasitic Skin Infections

2. Common Fungal & Parasitic Skin Infections
Superficial Fungal Infections
Scabies
Lieshmaniasis

3. Superficial Fungal Infections
DERMATOPHYTES
YEASTS
-Candida sp.
-Pityrosporum.

4. DERMATOPHYTE
Dermatophytes group of fungi (ringworm) have the ability to infect and survive only on dead keratin on the top layer of the skin hair and the nails.

5. CLASSIFICATION
The ringworm fungi belong to three genera: Microsporum, Trichophyton, and Epidermophyton .
There are several species of Microsporum and Trichophyton and one species of Epidermophyton .

7. CLINICAL CLASSIFICATION
Tinea means fungal infection.
Clinically, dermatophyte infections are classified by body region:
T.Corporis body
T.Cruris groin
T.Pedis foot
T.Unguium nail
T.Capitis scalp

8. Tinea corporis

9. Tinea pedis

10. tinea capitis

11. Chronic tinea of the big toe nail.

12. YEAST
Candida albicans
Pityrosporum : pityriasis versicolor

13. Candida albicans
It is a commensal flora of the gut which become pathogenic when the immune status of the person changed
physiological (old age , neonate and pregnancy)
pathological ( DM, HIV and organ transplant)
Long course of Antibiotics

14. MUCOSAL
1. Oral
oral thrush
angular chilitis
2. Genital candidiasis

15. Oral candidiasis: thrush can be removed by rubbing with gauze

16. Candidiasis of the tongue

17. Angular cheilitis

18. Candida groin infection.

19. Pityriasis versicolor
Pityrosporum orbiculare
Asypmtomatic
Well demarcated brown patches with branny over the trunk and upper extremities

20. Mycetoma (Madura foot)
Various species of fungus or actinomycetes may be involved.
They gain access usually to the feet or legs, via a penetratng wound.
The area becomes lumpy and distorted,aterenlarging and developing multiple sinuses.

22. Pus exuding from these shows tiny diagnostic granules.
Treatment
Surgery
Systemic antibiotics or antifungal drugs, depending on the organism isolated

23. Investigation Fungal Infections
Scraping clipping and Hair sampling
KOH/microscoy
Skin biopsy Histopathology with PAS stain
Culture
Wood's lamp

24. Tinea capitis with positive Wood's lamp

25. Treatment Topical Antifungal Systemic Antifungal
Nystatin preparation (oral thrush)
Imidazoles e.g. cotrimazole
Systemic Antifungal
Itraconazole and fluconazole
Allylamine e.g. Terbinafine
Griseovulvin

26. Indication of systemic treatment:
1.Tinea Capitis
2. Paronychia and Onychomycosis
3. Failure to respond to topical treatment
4. Immunocompramized pts.
5. Atypical presentations.

27. Scabies Mite sarcoptes scabei
burrows in the stratum corneum laying eggs and the eggs will maturate 2 weeks period and the cycle repeated.
Skin lesions are Secondary eczematous eruption due to immune reaction to the mite and eggs

28. Sarcopte’s scabiei burrow in the skin

29. Other member of the family having severe pruritus
Pruritus and skin eruption is more severe in the flexors mainly at night
Other member of the family having severe pruritus
Vesicles in the finger webs
Diffuse scabies on an infant the lesions are most numerous around the axillae, chest, and abdomen.

31. Scabies vesicles and papules in the finger webs and on the back of the hand

32. TREATMENT
Permethrin cream
Treat all close family whether itchy or not

33. PEDICULOSIS Head lice (Pediculosis Capitis) Children
Body lice (Pediculosis Corporis)
Pubic lice (Pediculosis Pubis)
STD ( partner should be treated)

34. Spread from person to person is achieved by head-to-head contact and shared combs or hats
The main symptom is itching.
the hair becomes smelly. Draining lymph nodes often enlarge
Secondary bacterial infection may be severe enough to make the child feverish.

36. The diagnosis can be conformed by seeing the lice eggs ( NITs)
Treatment
Permethrin creame rinse
Malathion lotion

37. Lieshmaniasis Leishmaniasis a disease caused by Leishmania parasites.
It is transmitted to humans by a sandfly
Sandfly is one third the size of a mosquito.

38. Lieshmaniasis
Localized Cutaneous Well-demarcated ulcerated nodule over the exposed areas.
Disseminated Cutaneous
Mucocutaneous
Visceral

39. Diagnosis Skin biopsy Histopathology with Gimsa stain Culture
PCR for DNA

40. Treatment Skin usually resolve but leaving a scar
Pentostam either intralesional or intramuscular to shrink the lesion.

41. Thank you