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Chapter 19 Lecture 9 (Cutaneous Mycoses (Diagnosis, treatment, and…

- - - - Microsporum
      - Trichophyton
      - Epidermophyton floccosum
  - - - Use keratin as nutrient source
    - - Fungi must invade living layers of skin
  - - - Anthropophilic: associated with humans
      - Zoophilic: associated with animals
      - Geophilic: soil fungi
- - - - Caused by four species of ascomycete fungi
      - Painless lesions form that progressively worsen
      - Presence of golden brown bodies in skin sample is diagnostic
      - Treatment requires removal of infected tissues and administration of antifungal drugs
      - People who work barefoot in the soil are at risk
        
        Wearing shoes reduces number of infections
    - - Caused by over 30 genera of fungi
      - Acquired when spores enter wounds
      - Disease is variable in presentation
        
        Depends on site of fungal colonization
      - Diagnosed by observation of hyphae in skin sample, biopsy material, or cerebrospinal fluid
      - Some cases can be treated with itraconazole
      - Disease is permanently destructive to tissues
    - - Caused by several genera of soil fungi
        
        Pricks and scrapes introduce fungi into humans
        
        People who work barefoot in soil most at risk
      - Tumorlike lesions form on skin, fascia, and bones
      - Infections are prevalent in countries near the equator
      - Diagnosis based on symptoms and presence of fungi in clinical samples
      - Treatment involves surgical removal of mycetoma and antifungal therapy
    - - Caused by Sporothrix schenckii
        
        Resides in the soil
      - Pricks and splinters introduce fungi into humans
      - Occurs most often in gardeners and farmers
      - Subcutaneous infection usually limited to the arms and legs
      - Fixed sporotrichosis remains localized
      - Lymphocutaneous sporotrichosis occurs when the fungus enters the lymphatic system
      - Diagnosis based on patient’s history, clinical signs, and observation of fungi in clinical samples
      - Cutaneous lesions are treated with antifungal drugs
      - Prevention requires wearing proper attire to avoid inoculation of the fungus