دانلود
advertisement
Superficial mycosis Maculae Papule Vesicle Bulla Pustule Nodule Fistula Scale Superficial mycosis Definition Fungi Pityriasis versicolor Tinea nigra Piedra Bacteria Erythrasma Trichomycosis axillaris Superficial mycosis Otomycosis Keratomycosis Pitted keratolysis Dermatophylosis Pityriasis versicolor Tinea versicolor Maculae Malassezia spp Normal flora Boys & girls After maturation Beauty Warm & humidity Season Pityriasis versicolor Conditions: Health Sweat Greasy skin IC. Chronic bacterial infections Steroids Pityriasis versicolor Clinical manifestations: Maculae White, cream, pink, red, brown Position Scale Painless Not itching Superficial mycosis Pityriasis versicolor Superficial mycosis Pityriasis versicolor Superficial mycosis Pityriasis versicolor Superficial mycosis Pityriasis versicolor Superficial mycosis Pityriasis versicolor Superficial mycosis Pityriasis versicolor Superficial mycosis Pityriasis versicolor Superficial mycosis Pityriasis versicolor Superficial mycosis Pityriasis versicolor Pityriasis versicolor Differential diagnosis: Vitiligo Chloasma Pityriasis versicolor Laboratory diagnosis: Sampling Scalpel Scathe tape Wood ́s lamp Direct Culture Pityriasis versicolor Treatment Selenium sulfide Clotrimazole Tinea nigra Phaeoanellomyces werneckii Exophiala werneckii Ecology Palm Tinea nigra palmaris Tinea nigra Clinical manifestation: Annular Centrifuge Regular or irregular Painless No itching Tinea nigra Differential diagnosis: Malignant melanoma Silver nitrate Tinea nigra Laboratory diagnosis: Sampling: Scalpel & KOH10% Direct: Hyphae Chlamydioconidia Culture: S Tinea nigra Treatment Keratolytic ointment whitfield Piedra Hair Nodule Bread, groin, axillar White & black Piedra Clinical manifestation: White piedra: Trichosporon beigelii Basidiomycetes Nodule Bread, head, pubis White, brown, yellow, Soft Piedra Clinical manifestation: Black piedra: Piedra hortae Ascomycetes Nodule Head Thick Black to brown Piedra Differential diagnosis: Pediculosis Piedra Laboratory diagnosis: Sampling: Sesser & KOH10% Direct: White: hyphae & arthroconidia Black: ascus & ascospore Culture: S Piedra Treatment: Scraping Clotrimazole Erythrasma Bacteria Corynebacterium minutissimum Chronic Intertrigenous Erythrasma Clinical manifestation: Maculae Red or brown Scale Itching No inflammation Superficial mycosis Erythrasma Superficial mycosis Erythrasma Superficial mycosis Erythrasma Superficial mycosis Erythrasma Erythrasma Differential diagnosis: Pityriasis versicolor Candidiasis Tinea cruris Erythrasma Laboratory diagnosis: Sampling: Scalpel & simple staining Direct: Strand Culture: BHI, Blood agar Wood ́s lamp Erythrasma Treatment Erythromycin Trichomycosis axillaris Bacteria Corynebacterium tenuis Nodule Hair Axillaries & pubis Red Yellow black Trichomycosis axillaris Differential diagnosis: Pediculosis Trichomycosis axillaris Laboratory diagnosis: Sampling: Sesser & KOH10% Direct Culture Trichomycosis axillaris Treatment Scraping and sulphur ointment 3% Keratomycosis INCIDENCE OF FK Developed world 6 -35% of all microbial keratitis Developing world 22 - >50% FUNGAL GROUPS Filamentous Fusarium Aspergillus Dematiaceous Yeasts Candida Fungal Keratitis Risk factors: Topical corticosteroids ↓corneal resistance to infection Contact lens use Immunocomprised states Fungal Keratitis Risk factors Injury, ocular surface compromise Temperature Wind Humidity Urbanisation/employment Fungal Keratitis Exogen Endogen Fungal Keratitis Gray-white color, dry, and rough corneal surface White ring in the cornea and satellite lesions near the edge of the primary Most cases remain superficial but deep invasion may occur DIAGNOSIS Clinical features (diff.diagnosis) Microbiology Histopathology DNA amplification HISTOPATHOLGY Haematoxylin and eosin (H&E) Periodic acid-Schiff (PAS) Grocott Fungal Keratitis Treatment: Natamycin 5% drops (filamentous) Works particularly well Fusarium spp Amphotercin B 0.15-0.30% (Candida) Most effective for yeast Otomycosis Otomycosis Bacterial, viral or fungal infection of external auditory canal Categorized by time course Acute Chronic Swimmer’s ear Organisms 1. Fungi 1. 2. 2. 3. 4. 5. Aspergillus Candida species Pseudomonas species Staphylococci Streptococci Gram negative rods Risk Factors High humidity Water exposure High environmental temperature Local trauma Allergy Stress Alkaline pH of canal Otomycosis Often indistinguishable from bacterial OE Dull pain Hearing loss (obstructive) Otomycosis Treatment Thorough cleaning and drying of canal Topical antifungals Clotrimazole Acidifying of the EAC with drops like 2% acetic acid 3% boric acid درماتوفیلوزیس مترشحه ،چرک حیوان انسان پوسته و دمله اسکار و آلوپس ی مسری درماتوفیلوزیس Dermatophilus congolonsis اکتینومایست گوسفند و دام پارازیت پوست فصل بارانی تماس مستقیم Lumpy wool عالئم بالینی اپیدرم زخم های کم عمق اگزودا کدر شدن مو ریزش دمله بهبود آلوپس ی تشخیص آزمایشگاهی نمونه گیری پوسته و ترشحات مستقیم رنگ آمیزی متیلن بلو گیمسا رشته های منشعب 5 -2 ،میکرون کشت بالد آگار 37درجه 8کوکس ی تشخیص آزمایشگاهی کاتاالز مثبت اوره آز مثبت اسید فست منفی هیدرولیز نشاسته مثبت درمان سولفات مس سولفات روی /5درصد پنی سیلین کراتولیز حفره ای Pitted keratolysis الیه شاخی کف پا ضایعات سطحی گرد عامل بیماری اکتینومایست نوکاردیا درماتوفیلوس کورینه باکتریوم عوامل مستعد کننده رطوبت گرما رعایت نکردن بهداشت چکمه پوتین عالئم بیماری الیه های سطحی کف پا انگشتان و پاشنه پا تجزیه کراتین ضایعات سطحی گرد بوی نامطبوع تشخیص آزمایشگاهی نمونه گیری مستقیم پوسته پتاس و رنگ آمیزی رشته و کوکس ی کشت مشکل است درمان از بین بردن شرایط مستعد کننده فرمالین 20تا 40درصد
