MICROBIOLOGY LECTURE M3 – Cutaneous Mycoses

Lecture and Notes by Evelina N. Lagamayo M.D.

USTMED ’07 Sec C – AsM PATHOGENESIS

• “keratophilic fungi” – use keratin as a substrate

CUTANEOUS MYCOSES • keratinases

Schematic Diagram of Tissues Colonized by Dermatophytes

CHARACTERISTICS

• diseases of the skin, hair, and nails

• involves the keratinized layers of the skin and its
appendages
• clinical manifestation: tinea or ringworm
o Ex. Tinea pedis, tinea ungium,tinea corporis

ETIOLOGY : Dermatophytes

• Classification in anamorphic state:

1. Microsporum
2. Trichophyton
3. Epidermophyton

• Teleomorphic state of Microsporum and Trichophyton is

genus Arthroderma

ECOLOGY AND EPIDEMIOLOGY

• Classification according to ecological niche: A. Stratum corneum; B. Ectothrix hair infection; C. Entothrix hair
infection; D. favic hair infection

1. Geophilic dermatophytes- isolated from the soil LABORATORY DIAGNOSIS

2. Zoophilic dermatophytes- associtation with
domestic and wild animals and birds
3. Anthropophilic dermatophytes- associated with
humans and their habitats
Asexual State of Selected Dermatophytes
• KOH: 10%, 20%
• Except: T. schoenleinii causing favus:
o infected hair have a waxy mass of hyphal
elements(scutulum) surrounding the base of
the hair follicle at the scalp line.
o microscopic exam: degenerated hyphal
elements coursing throughout the hairshaft
• Fungal Culture : SDA w/ cylcoheximide, chloramphenicol
o conidia:
 macroconidia – large and
multicellular
 microconidia - small and unicellular
o spiral hyphae, chlamydospores, nodular
bodies, racquet hyphae and chandeliers

TREATMENT

1. Azoles – miconazole, clotrimazole, econazole (topical)

- Mechanism of action:
o interferes with cytochrome P-450-
Classification of Dermatophytes According to Ecological Niche
dependent enzyme system s at the the
demethylation step from lanosterol to
ergosterol

2. Griseofulvin
- fungistatic, affects the microtubular system of
fungi
- interferes with the mitotic spindle and cytoplasmic
microtubules
- oral route

Fungal infection of the hair, Fungal infection of the hair,

endothrix infection ectothrix infection

General Characteristics of Macroconidia and Microconidia of

Dermatophytes

KOH preparation of skin scrapings. KOH smear of skin scrapings. M.

Dermatophytes showing septate furfur showing spherical yeast cells
hyphae intertwined among (A) and short hyphal fragments(B)
epithelial cells.(Phase contrast-
500X)

KOH smear of sputum. Rhizopus
spp. Showing fragmented portions
of septate hyphae of varying size
Scotch tape preparation with
lactophenol cotton blue or aniline
blue
-fin-
audsmartinez@gmail.com
ustmedc3@yahoogroups.com

Performance of a wet mount, Microslide culture, showing

showing agar positioned under inoculation of agar plug
coverslip before using pressure to
disperse growth

Numerous small, spherical M. canis, showing several spindle-

microconidia(A) contrasted with a shaped , thick-walled, multicelled
large, elongated macroconidium(B) macroconidia

M. gypseum, showing ellipsoidal, E. floccosum, showing numerous

multicelled macroconidia smooth, multiseptate, thin-walled
macroconidia that appear club-
shaped

M. canis, macroconidia M. gypseum, macroconidia

Epidermophyton floccosum, T. mentagrophytes, macroconidia

macroconidia and microconidia

Trichophyton schoenleinii, favic

chandelier