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Dermatophytosis (tinea or ringworm) of the scalp, glabrous skin, and nails is caused by a closely related group of fungi known as dermatophytes which have the ability to utilise keratin as a nutrient source, i.e.
The disease process in dermatophytosis is unique for two reasons: Firstly, no living tissue is invaded the keratinised stratum corneum is simply colonised. The type and severity of the host response is often related to the species and strain of dermatophyte causing the infection. Zoophilic infections usually elicit a strong host response and on the skin where contact with the infective animal has occurred ie arms, legs, body or face. Infections by anthropophilic dermatophytes are usually caused by the shedding of skin scales containing viable infectious hyphal elements [arthroconidia] of the fungus.
It is important to recognise that the toe web spaces are the major reservoir on the human body for these fungi and therefore it is not practical to treat infections at other sites without concomitant treatment of the toe web spaces.
As the name suggests, lateral subungual onychomycosis begins at the lateral edge of the nail and often spreads to involve the entire nail bed and nail plate. Tinea corporis refers to dermatophytosis of the glabrous skin and may be caused by anthrophophilic species such as T. In patients with suspected dermatophytosis of skin [tinea or ringworm] any ointments or other local applications present should first be removed with an alcowipe.
In patients with suspected dermatophytosis of nails [onychomycosis] the nail should be pared and scraped using a blunt scalpel until the crumbling white degenerating portion is reached. Skin and nail specimens may be scraped directly onto special black cards which make it easier to see how much material has been collected and provide ideal conditions for transportation to the laboratory. It must be stressed that up to 30% of suspicious material collected from nail specimens may be negative by either direct microscopy or culture.
Skin Scrapings, nail scrapings and epilated hairs should be examined using 10% KOH and Parker ink or calcofluor white mounts. Specimens should be inoculated onto primary isolation media, like Sabouraud's dextrose agar containing cycloheximide (actidione) and incubated at 26-28C for 4 weeks.

Microsporum canis - wikipedia, free encyclopedia, Microsporum canis pathogenic, asexual fungus phylum ascomycota infects upper, dead layers skin domesticated cats, occasionally dogs .
However, the presence of the fungus and its metabolic products usually induces an allergic and inflammatory eczematous response in the host. Secondly, the dermatophytes are the only fungi that have evolved a dependency on human or animal infection for the survival and dissemination of their species.
Zoophilic species are primarily parasitic on animals and infections may be transmitted to humans following contact with the animal host (Table 1). In proximal subungual onychomycosis, the fungus invades under the cuticle and infects the proximal rather than the distal nail bed causing yellowish-white spots which slowly invade the lunula and then the nail plate. Ectothrix invasion is characterised by the development of arthroconidia on the outside of the hair shaft. Endothrix hair invasion is characterised by the development of arthroconidia within the hair shaft only. Favus usually caused by Trichophyton schoenleinii, produces favus-like crusts or scutula and corresponding hair loss. For a laboratory diagnosis, clinicians should be aware of the need to generate an adequate amount of suitable clinical material.
Using a blunt scalpel, tweezers, or a bone curette, firmly scrape the lesion, particularly at the advancing border.
For instance uncomplicated single cutaneous lesions can be adequately treated with a topical antifungal agent, however topical treatment of scalp and nail infections is often ineffective and systemic therapy is usually needed to cure these conditions. On the other hand, geophilic species normally inhabit the soil where they are believed to decompose keratinaceous debris. Therefore transmission may take place by indirect contact long after the infective debris has been shed.
It should also be recognised that individuals with chronic or subclinical toe web infections are carriers and represent a public health risk to the general population, in that they are constantly shedding infectious skin scales.

The fungus invades the distal nail bed causing hyperkeratosis of the nail bed with eventual onycholysis, and thickening of the nail plate. The cuticle of the hair is destroyed and infected hairs usually fluoresce a bright greenish yellow colour under Wood's ultraviolet light. The cuticle of the hair remains intact and infected hairs do not fluoresce under Wood's ultraviolet light. Unfortunately many specimens submitted are either of an inadequate amount or are not appropriate to make a definitive diagnosis.
In cases of vesicular tinea pedis, the tops of any fresh vesicles should be removed as the fungus is often plentiful in the roof of the vesicle.
Culture is often more reliable and permits the species of fungus involved to be accurately identified. Clinical manifestations and management of superficial fungal infection in the compromised patient.
In this site infections are often chronic and may remain subclinical for many years only to become apparent when spread to another site, usually the groin or skin. Repeat collections should always be considered in cases of suspected dermatophytosis with negative laboratory reports. Routine turn around times for direct microscopy should be less than 24 hours, however culture may take several weeks. Ideally, mycological confirmation of the clinical diagnosis should be gained before systemic antifungal treatment is commenced.
Guidelines for the diagnosis, prevention and control of dermatophytosis in man and animals.

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16.01.2014 admin

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