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What are the characteristics for cutaneous vs superficial mycoses?
- Superficial mycosis: skin infections involve only the stratum corneum, hair infections involve only the cuticle; no cellular response, no direct discomfort to patient. Pityriasis versicolor and Tinea nigra for skin as well as piedra for hair
- Cutaneous mycoses: infection usually restricted to keratinized layers of skin and hair, cellular immune response is generated, referred to as dermatophytoses
Classify dermatophytes based on source (3 categories)
- Anthropophilic: infect humans only
- Geophilic: inhabit the soil – infect humans and animals
- Zoophilic: inhabit animals, but may infect people
Explain the transmission of dermatophytes (3 categories)
- Anthropophilic fungi: close human contact such as sharing items
- Geophilic fungi: outbreaks originate from soil, secondary human transmission reported (rare)
- Zoophilic fungi: animal-to-human contact or indirect via fomites
Define the locations involved with the following “Tinea” – capitis, barbae, corporis, cruris, pedis, manuum, unguium
- Tinea capitis: hair and scalp
- - Exothrix - grows on outside of hair shaft
- -Endothrix - invades hair shaft
- Tinea barbae: infections of beard area
- Tinea corporis: infections on the trunk
- Tinea cruris: infections of inguinal area
- Tinea pedis: infections of the foot
- Tinea manuum: infections of the hand
- Tinea unguium: involvement of the nails
What is Phaeohyphomycosis? How is it treated?
- Infection caused by dermatiaceous, or black mold (contains melanin in cell wall)
- Associated with allergic fungal sinusitis, brain abscess, meningitis
- Treatment: surgical drainage or excision, Amphotericin B for epidural or brain abscesses, itraconazole for sinusitis, voriconazole for meningitis
What is Mycetoma?
- Type of subcutaneous Mycoses involving both cutaneous and subcutaneous tissue
- Localized, chronic, noncontageous
- If disease is caused by filamentous fungi it is known as eumycetoma
- Develops weeks/months after traumatic injury, tissue becomes indurated, abscesses, draining sinuses, and deep granulomatous lesions develop
- Best treatment is medicosurgical
- Ketoconazole, itraconazole, or amphotericin B for 10 months!
What are the organisms the create a Mycetoma?
- Acremonium, Curvularia giniculata, Exophila jeanselmei, Madurella, Pseudallescheria boydii
- also sometimes it is used to describe infections due to Actinomycetes or norcardia