1. DERMATOPHYTES

2. DERMATOPHYTES

3. DERMATOPHYTES
• Dermatophytes are fungal organisms that are able to exist within the
keratinous elements of living skin and which belong to one of 3 genera,
Epidermophyton Microsporum,and Trichophyton
• Dermatophytes require keratin for growth and therefore infect hair, nails,
and superficial skin, with clinical manifestations named for the area
affected.

4. DERMATOPHYTOSIS

8. TINEA CORPORIS
•Tinea corporis
•Infections of the trunk and limbs
•Finds unilateral lesions with annular or
ring-like shapes
•Pink scaly plaques or papules
•Rashes appears in the middle of ring-like
shapes and usually itchy

9. TINEA CRURIS
• Erythematous and scaly lesions and often very itchy
• Develop symmetrically from the groin down the inner thigh
• May find pustules at the edges
• Rare before puberty and commonly finds in adolescent males and
adults
• May outbreaks in sport people or living communities with shared
bathing facilities

10. TINEA PEDIS- CAUSES
• Tinea pedis is the term used for a dermatophyte
infection of the soles of the feet and the
interdigital spaces. Tinea pedis is most commonly
caused by Trichophyton rubrum, a dermatophyte
initially endemic only to a small region of
Southeast Asia and in parts of Africa and Australia
• Athlete’s foot occurs when the tinea fungus grows
on the feet. You can catch the fungus through
direct contact with an infected person, or by
touching surfaces contaminated with the fungus.
The fungus thrives in warm, moist environments.
It’s commonly found in showers, on locker room
floors, and around swimming pools.

11. RISK FOR ATHLETE’S FOOT
• Anyone can get athlete’s foot, but certain behaviors increase your risk.
Factors that increase your risk of getting athlete’s foot include:
• visiting public places barefoot, especially locker rooms, showers, and
swimming pools
• sharing socks, shoes, or towels with an infected person
• wearing tight, closed-toe shoes
• keeping your feet wet for long periods of time
• having sweaty feet
• having a minor skin or nail injury on your foo

12. THE SYMPTOMS OF ATHLETE’S FOOT
• There are many possible symptoms of athlete’s foot, which include:
• itching, stinging, and burning between your toes or on soles of your feet
• blisters on your feet that itch
• cracking and peeling skin on your feet, most commonly between your
toes and on your soles
• dry skin on your soles or sides of your feet
• raw skin on your feet
• discolored, thick, and crumbly toenails
• toenails that pull away from the nail bed

13. ATHLETE’S FOOT DIAGNOSED?
• A doctor may diagnose athlete’s foot by the symptoms. Or, a
doctor may order a skin test if they aren’t sure a fungal infection
is causing your symptoms.
• A skin lesion potassium hydroxide exam is the most common test
for athlete’s foot. A doctor scrapes off a small area of infected
skin and places it in potassium hydroxide. The KOH destroys
normal cells and leaves the fungal cells untouched so they are
easy to see under a microscope.
•

14. Treatment
• Athlete’s foot can often be treated with over-the-counter (OTC)
topical antifungal medications.
• If OTC medications don’t treat your infection, your doctor may
prescribe topical or oral prescription-strength antifungal
medications.
• Your doctor may also recommend home treatments to help clear
up the infection.

15. OTC MEDICATIONS
• There are many OTC topical antifungal medications, including:
• miconazole (Desenex)
• terbinafine (Lamisil AT)
• clotrimazole (Lotrimin AF)
• butenafine (Lotrimin Ultra)
• tolnaftate (Tinactin

16. DANDRUFF-SEBORRHAEIC DERMATITIS
Seborrhoeic dermatitis, also known as seborrhoea, is a long-term skin disorder.
Symptoms include red, scaly, greasy, itchy, and inflamed skin. Areas of the skin rich in
oil-producing glands are often affected including the scalp, face, and chest.
 Dandruff may have several causes, including:
 Irritated, oily skin.
 Not shampooing enough.
 A yeastlike fungus (malassezia) that feeds on oils on the scalps of most adults.
 Dry skin.
 Sensitivity to hair care products (contact dermatitis)
 Other skin conditions, such as psoriasis and eczema.

18. CAUSES & TREATMENT
Dandruff has been shown to be possibly the result of
three factors:
 Skin oil commonly referred to as sebum or
sebaceous secretions
 The metabolic by-products of skin micro-organisms
most specifically Malassezia yeasts.
 Individual susceptibility and allergy sensitivity.

19. MECHANISM
 The fungus Malassezia furfur (previously known as Pityrosporum ovale) as the cause of
dandruff.
While this species does occur naturally on the skin surface of people both with and without
dandruff, in 2007 it was discovered that the responsible agent is a scalp specific fungus,
Malassezia globose.
The metabolizes triglycerides present in sebum by the expression of lipase, resulting in a lipid
byproduct oleic acid.
During dandruff, the levels of Malassezia increase by 1.5 to 2 times its normal level.
Oleic acid penetrates the top layer of the epidermis, the stratum corneum, and evokes an
inflammatory response in susceptible people which disturbs homeostasis and results in erratic
cleavage of stratum corneum cells.

20. SEBORRHOEIC DERMATITIS
 In seborrhoeic dermatitis, redness and itching frequently occur around the folds of the nose and
eyebrow areas, not just the scalp.
 Dry, thick, well-defined lesions consisting of large, silvery scales may be traced to the less
common condition of scalp psoriasis.
 Inflammation can be characterized by redness, heat, pain, swelling and can cause sensitivity.
 Inflammation and extension of scaling outside the scalp exclude the diagnosis of dandruff from
seborrhoeic dermatitis.
 However, many reports suggest a clear link between the two clinical entities - the mildest form
of the clinical presentation of seborrhoeic dermatitis as dandruff, where the inflammation is
minimal and remain subclinical.
 Seasonal changes, stress, and immunosuppression seem to affect seborrheic dermatitis

21. TREATMENT- ANTIFUNGAL AGENTS
 Antifungal treatments including ketoconazole, zinc
pyrithione and selenium disulfide have been found to be
effective.
 Ketoconazole appears to have a longer duration of
effect.
 Ketoconazole is a broad spectrum antimycotic agent that
is active against Candida and M. furfur. Of all the
antifungals of the imidazole class, ketoconazole has
become the leading contender among treatment options
because of its effectiveness in treating seborrheic
dermatitis as well.
 Ciclopirox is widely used as an anti-dandruff agent in
most preparations

22. Beard ringworm- Tinea Barbae
 Tinea infections are commonly called ringworm because some may form a ring-like pattern on affected areas of the
body. Beard ringworm (tinea barbae), also known as tinea sycosis or barber's itch, is a fungal infection of the skin,
hair, and hair follicles of the beard and mustache area. Beard ringworm may be passed to other people by direct
contact with infected people or animals, with contaminated objects, or from the soil.
 Tinea barbae is a type of Dermatophytosis. It is most often caused by Trichophyton mentagrophytes or Trichophyton
verrucosum.
 Tinea barbae usually causes superficial, circular patches, but deeper infection may occur. An inflamed kerion (a
swollen patch generally on the scalp that sometimes oozes pus) may also develop, which can result in scarring and
whisker loss. Tinea barbae is rare.

23. Risk
Beard ringworm may occur in people of all races. However, it is
seen almost exclusively in older teens and adult males.
Beard ringworm is more commonly seen in warmer, more humid
climates. It is most frequently passed to humans from animals, so
agricultural workers are the most commonly infected people with
beard ringworm.

24. SIGNS AND SYMPTOMS
 The most common locations for beard ringworm infection include the following:
 Chin
 Cheeks
 Neck
 Upper lip
 Beard ringworm may affect either the outer surface (superficial) or the deep portion of the skin that holds shafts of hair
(hair follicles).
 If the infection is superficial, beard ringworm appears as a pink-to-red scaly patch ranging in size from 1 to 5 cm.
Alternatively, small pus-filled bumps (pustules) may be seen around hair follicles in the affected skin.
 In deeper forms of beard ringworm, you may see firm red nodules covered with pustules or scabs that may ooze blood
and pus.

25. TREATMENT
It is extremely difficult to totally get rid of beard ringworm with only
topical medications; oral antifungal medications are usually required.
However, if the infection has just started, you might try one of the
following over-the-counter antifungal creams or lotions:
• Terbinafine
• Clotrimazole
• Miconazole

26. TREATMENTS
KOH MOUNT: To confirm the diagnosis of beard ringworm, your physician might scrape some surface skin material (scales) or
pluck an affected hair and place it onto a glass slide for examination under a microscope.
If you have many pus-filled lesions or if deeper lumps are present, your physician may wish to perform a procedure to grow out the
fungus (fungal culture) in order to discover the particular organism that may be causing the infection. The procedure involves:
• Penetrating the pus-filled lesion with a needle, scalpel, or lancet.
• Rubbing a sterile cotton-tipped applicator across the skin to collect the pus.
• Sending the specimen away to a laboratory.
• The fungal culture can take up to 3 weeks to produce final results.
Since beard ringworm usually requires oral antifungal pills in order to get rid of the infection completely, your physician will
likely recommend one of the following oral medications:
Terbinafine, Itraconazole, Griseofulvin, Fluconazole, Ketoconazole
• Beard ringworm should go away within 4–6 weeks after using effective treatment

27. TINEA VERSICOLOR- BODY WHITESPOT
Tinea versicolor is a superficial infection resulting from a normal body yeast. It normally
affects the back, shoulders, and upper chest, although it can involve the neck, upper
arms, and rarely, the face. It produces a substance that leads to bleaching of the skin
and pale patches that last for weeks, even after effective treatment.
 Tinea versicolor results from superficial infection by a yeast, Malassezia furfur.
Tinea versicolor produces color variations in the skin; dark spots or red on light skin or
patches of lightness on dark skin – “versicolor” means color variations.
The yeast causing tinea versicolor usually arises from the patient’s own body flora.
Tinea versicolor can produce itching and a red rash. It is predisposed to develop in areas
of previous skin trauma.

28. SYMPTOMS
• Discolored patches of skin are the hallmark of tinea versicolor. Versicolor means
color variations, and characteristically it will appear dark or red on light skin,
and light on dark skin. On the same patient, the appearance may vary over the
course of the year depending upon whether the skin is winter pale or summer
tanned.
• On the same patient, the appearance may vary with body location, being
pink/brown on the mid back and pale on a tanned neck.
• The rash is usually confined to shoulders, mid-back, and chest, but occasionally
it will extend further down the arms.
• Facial involvement is only occasionally seen, usually in African-Americans and
other darker-skinned patients.
• Other skin findings such as severe itching, enlarging lumps, skin ulceration, hair
loss, and swollen lymph nodes are not symptoms of tinea versicolor and should
prompt a search for another diagnosis

29. CAUSES
Malassezia furfur, a common human yeast carried by most people, can
start to act more like tinea corporis (ringworm).
While most people are never bothered by this yeast, it is also is felt to
be responsible for dandruff (seborrhea), which explains why some of
the treatments used for dandruff also help tinea versicolor.

30. TREATMENT
• Topical econazole (Spectazole), ciclopirox
(Ciclodan), ketoconazole (Xolegel, Nizoral), clotrimazole (Lotrimin), and
miconazole (Monistat) are all effective in treating tinea versicolor when
applied until there is no further itching, scaling, or redness.
• Topical terbinafine (Lamisil) may be effective but may not work as well
for yeast-related problems as it does for other fungal infections.
• Products that combine an antifungal with an exfoliating agent (Kerasal)
or with an absorptive powder (Zeasorb) would be harder to use over a
large area of the back and shoulders than a cream or spray.

31. ONYCHOMYCOSIS
• Onychomycosis, also known
as tinea unguium, is a fungal
infection of the nail.
Symptoms may include white
or yellow nail discoloration,
thickening of the nail, and
separation of the nail from the
nail bed. Toenails or
fingernails may be affected,
but it is more common for
toenails to be affected.

32. ONYCHOMYCOSIS

33. TREATMENT

34. References
 https://en.wikipedia.org/wiki/Onychomycosis#:~:text=Onychomycosis%2C%20also%20known%2
0as%20tinea,is%20more%20common%20for%20toenails
 Kauffman, Carol A. (2018). Harrison's Principles of Internal Medicine. New York, NY: McGraw-
Hill
 https://en.wikipedia.org/wiki/Athlete%27s_foot
 https://dermnetnz.org/topics/tinea-barbae