Fungal infection

Tinea capilti
Trychphytia superficialis capiliti

It is caused by Tr.tonsurans. It is ussualy seen in childern before puberty and it is transmited for
child to child.Changes are seen on scalp as round small palques which form beachs of irregular
shape.On the lesion there is white desquamation and the hair is broken on the folicles.On the
lesions there can be also the healty hair. By using the Woods lamp there is not flouresence. It
dispears in puberty spontausly

Trychphytia profunda capiliti (Kerion Celsi)

is the deep form of trichophitie of the hair which is caused by zoophil species of trychophiton. It
is seen before puberty and it is transmited from animal to human. In the beginig the changes are
plaques with pityriasis squam and hair of normal appereance. After teh 1-3 weeks there is
inflammation as folicular puritis. Those changes are as round, demarcated and elevated plaques
which are inflamated and painfull.Hair is normal appreanece. There can be lymphodenopahaty. It
spontaeously regreses after 2-3 months.

Microsporia capiliti

Causative agent is Microsporum audouinii.Infection is seen before puberty, and in puberty

spontaeously regresses. Changes are round non inflammatory plaques up to few centimeters.On
the lesions there is pityriasis desquamtion.Changes caused by microsporium have green
flouresence under the woods lamp.

Favus capiliti

Causative agent Tr.schonleinii. Changes are seen in central part of the scalp and they spread
centrifungaly. Characteristic change is plate like change of yellow color. Trough the central part
there is normal hair. There can be alopecia. Disease can last for years and it can retrive
spontaenously.

Differentilal diagnosis :

Supraficial : pityriasis capiliti, seborrhoic drmatitis, alopecia areata, ruber lichen planus,
psoriasis vulgaris,

Deep : bacterial folicultis

Treatment

T. capiliti - M.canis-grizeofluvin

Trichophiti-terbinafin,intrakonazol, flukokonazol.

Deep- corticosterid,

Tinea pedis
It is the most common fungal infection.

Interdigital form : Caustive agents are antropophil dermatophites. Changes are in III ans IV
interdigital space and on the skin benith the toes, but they don't cross the dorsum of the
foot.There is dequamation and puritis and there is no inflammation. Changes can retrive or last
for years.

Vesicular-bullous form : It is caused by zoofill species . Changes are localized on the foot and
sole. Changes are inflammated and there are vesicles and bullaes, but there are in demarated
plaques and they don't have tendency to spead.

Hyperkeratotic : the changes are localised on the foot, sole and lateral sides. Clinical picture is
charcterized inflammation, eythema, dry tick white squamos.

Differntial diagnosis :

Interdigital : bacterial intertrigo, non specific dermatitis,

Vesiculo-bullous eczema, contact dermatitis

Hyperkeratotic : psoriais, plantar ruber lichen planus.

Treatment :

Interdigital and Vesiculo-bullous : imidasole, cikopriroksoalmin

hyperkeratotic : terbinafine, intrakonazole.

Tinea corporis

is seen on the skin of the trunk and extermeties

Tinea corporis superficialis is mildly inflammated and it is caused by antrophil species of

dermatophites
Changes are seen on the trunk as round sharply demarcated plaques. On the edges there can be
crusts, pustules and vesicels .

Tinea corporis profunda-inflammatory form of infection with zoophil species.

Differntial diagnosis : non inflammatory -psoriasis, sebborhoic dermatits,

inflammatory -piodermia

Treatment- Local- imidasole, cikopriroksoalmin

General- terbinafine, intrakonazole

Tinea unguium

Distal subungual onichomychosis is charcterized by tickness and hyperkeratosis of hypoonium

and lateral sides of nail plate while the nail is perserved.Proximal white subungual onichomicosis
which is in the part of ..... where the nail plate is white and smooth and non-damaged.Superfical
white -nail plate is uneven, and it becomes easlily broken. If it lasts longer it covers matrix, nail
bed and plate. Than there is total distrofic onychomycosis with easily broken and uneven nails

Laboratory diagnosis : micological exam, culture of material

Differential diagnosis : psoriais, lichen ruber planus ,

Treatment :

for the treatment it is necessery:

laboratory analysis, clinical diagnosis

Local -amorolfin, ciklopiroksolamin

General-itrakonazol, grizeofulin

Tinea barbae

It represents deep form trichofits. It is seen in men in region of the chin.Changes are seen as
plaques with inflammatory foliculitis. It can last for few months and they retrive sponteously.

Differntial diagnosis : staphylococcus foliculitis, furncul, curbuncul

Tinea cruris

It is seen more common in men than women.It transmietd indirectly trough towels and sports
equipment

Changes are localized on ingvino-crural and intraglueal regions as large, sharply demarcated
erytematous plaques.Edge is elevated and vesicoulous and in the middle is papules.

Differential diagnosis : candida , contact dermatits

Candida
Candidiasis oralis

Most commonly seen in babys, but also adults. Changes are seen in on mucosa of the oral cavity.
They are charcterized by irregular,demarcated white adherent... in which mucosa is eytematous
and eroded. If it lasts longer the submucosa is atrophic. Hyperpalastic and andhernt changes are
seen on tounge and cheeks in people who smoke. If it spreads to esophagus that is
immunodeficiency (AIDS).

Vulvo-vaginitis

is seen in adults . the mucosa of vagina is covered . Changes are eyrtematous.

Balanoposthitis candidomycetica-changes are seen on glans of penis.

Perionyxis- is seen in persons whose hands are exposed to water.

Intertrigorous -is seen in babies and genitoanal region and in adults in intartrigorius
region.changes are seen as small subcorneal pustules which form eyteamatous plaques.

Differential diagnosis -tinea crurum,contact dermatitis

Angulus infectiosus-changes are seen on the angles of the lips. On the angles there is erythrema.

Differntial diagnosis : streptococcal angulus infectosus.

Chronic mucocuteous -is persistant supreficial infection of skin, mucosa and nail. It can be
genetic. Differential diagnosis zink deficiency.

Treatment

Local(oral,cuteous,chronic paronychie,vaginal,balatopostthetic), nistatin, imidasole

general : ketokoanzole, itrakonazole

Pityriasis veriscolor

is mild reticular infflamtion of the skin.causative agent in malesecia furur.

Clinical picture: Changes are seen on the trunk, and muscles, and rarely on face and neck. They
are comoposed from small shaply demarcated macules.

Laboratory diagnosis: direct micorscopy (spagethi and meat balls), wood lamp

Diferential diagnosis : pytirasis roescea and vitiligo

treatment : local imidasole and ciklopiroksolamin

general -itrakonazole, ketokonazole