Trans 1 : Superficial mycoses

Mycoses: disease caused by fungi >>> Superficial mycoses - stays on the uppermost layer of the epidermis: S. corneum - no invasion of living tissue, cellular response, pathologic changes - patients are unaware, checked only for aesthetic purposes - 4 kinds based on location = Skin: Pityriasis versicolor & Tinea nigra = Hair: Black & White Piedra -------------------------------------------------------------------------*** Pityriasis versicolor - caused by Malassezia furfur : lypophylic yeast-like cell - Pitysporum organisms cause Malassezia infections - aka "an-an" - discoloration depends on: > normal skin tone of the person > amount of exposure to sunlight > severity of the disease >Clinical Manifestations - furfuraceous scales appear on the trunk, shoulders, arms; not so much in the face and neck - not pruritic but itchiness may be felt around the sides of the lesions - common in adolescents - presence of this fungal infection may cause hypopigmentation caused by the fungi blocking off the sun - common in tropical areas than temperate countries due to sweat(?) >Lab Diagnosis - skin scrapings + 10% KOH + glycerol + Parker's Ink - fluoresce a pale greenish color under Wood's UV light >Culture - not necessary for diagnosis - SAB w/peanut oil, Dixon's agar >Morphology - spaghetti & meatballs - blastospores >Treatment - keratinolytic agents, Selenium sulfide(1 %) shampoo, Mild fungicides -------------------------------------------------------------------------*** Tinea nigra - caused by Exophiala werneckii - dark discoloration of the palms, sometimes the plantar and others - found in soil, compost, humus and wood - commmon in tropical & sub-tropical countries : C. & S. America, Africa, S.E. Asia, Australia - does not cause inflammation & scaling, only brown-black macules >Lab diagnosis - skin scrapings + KOH

>Culture - SAB >Morphology - Annelloconidia : 2-celled separated by a septate - brown to dark olivaceous >Treatment - keratinolytic agents, iodine, salycilic acid, sulfur -------------------------------------------------------------------------***Piedra - either Black or White *Black: hard and surrounds the outer shaft of the hair, scalp *White: soft, hair on usually moist areas: underarm, genitals, face -------------------------**Black - Piedraia hortae - smaller, hard, black nodules - seen in scalp hair (common), mustache (not so), axilla, groin (rare) - common in C.& S.America, Africa, Asia >Lab diagnosis - hair shaft with nodules + 25% NaOH or KOH >Culture - SAB with chloramphinecol - SAB w/ or w/out cyclohexamine - slow growth, dark brown-black with heaped center, flat periphery >Morphology - Dark, septated hyphae with ascospore in round to oval ascus >Treatment - shaving of hair - topical fungicides -------------------------***White - Trichosporon spp. (beigelii & cutaneum) - soft, white-yellow, more discrete & packed, larger - found in soil, spoiled food, stagnant water, body surfaces, horses - seen in axilla, face, genital hair, not so in scalp, eyebrow/lashes - common in S.America & Asia, sporadic in N.America & Europe >Lab Diagnosis - hair shaft with nodules + 10% KOH or 25% NaOH + 5% glycerin >Culture - SAB with chloramphinecol/ without ceclyhexamide - rapid growth, white, soft mycelium - wrinkled furrows w/irreg folding >Morphology - hyaline septate hyphae, either arthroconidia or blastoconidia >Treatment - shaving of hair - topical fungicides