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Dermatophyte

dermatophyte, dermatophyte infection
Dermatophytes derived from Greek "δέρματος" dermatos, from "δέρμα", which means "skin" and -"phyte", from "phutón", meaning "plant" are a common label for a group of three types of fungus that commonly causes skin disease in animals and humans1 These anamorphic asexual or imperfect fungi genera are: Microsporum, Epidermophyton and Trichophyton There are about 40 species in these three genera Species capable of reproducing sexually belong in the teleomorphic genus Arthroderma, of the Ascomycota see Teleomorph, anamorph and holomorph for more information on this type of fungal life cycle

Dermatophytes cause infections of the skin, hair and nails, obtaining nutrients from keratinized material2 The organisms colonize the keratin tissues causing inflammation as the host responds to metabolic by-products Colonies of dematophytes are usually restricted to the nonliving cornified layer of the epidermis because of their inability to penetrate viable tissue of an immunocompetent host Invasion does elicit a host response ranging from mild to severe Acid proteinases, elastase, keratinases, and other proteinases reportedly act as virulence factors The development of cell-mediated immunity correlated with delayed hypersensitivity and an inflammatory response is associated with clinical cure, whereas the lack of or a defective cell-mediated immunity predisposes the host to chronic or recurrent dermatophyte infection

Some of these skin infections are known as ringworm or tinea Toenail and fingernail infections are referred to as onychomycosis Dermatophytes usually do not invade living tissues, but colonize the outer layer of the skin Occasionally the organisms do invade subcutaneous tissues, resulting in kerion development

Contents

  • 1 Types of dermatophyte infections
    • 11 Tinea pedis or athlete's foot
    • 12 Tinea cruris or jock itch
    • 13 Tinea corpora or ringworm of the body
    • 14 Tinea faciei or facial ringworm
    • 15 Tinea capitis or blackdot ringworm
    • 16 Tinea capitis or scalp ringworm
    • 17 Tinea manuum or ringworm of the hands
    • 18 Onychomycosis, tines unguium, or ringworm of the nail
  • 2 Diagnosis and identification
  • 3 Transmission
  • 4 Classification
  • 5 Frequency of species
  • 6 Medications
  • 7 Treatment
  • 8 See also
  • 9 References
  • 10 External links

Types of dermatophyte infectionsedit

Tinea pedis or athlete's footedit

Contrary to the name, tinea pedis affects not solely athletes Tinea pedis affects men more than women; it can be seen initially affecting the webs between the toes, before spreading to the sole of the foot in a "moccasin" pattern

Tinea cruris or jock itchedit

Frequently, the feet are also involved The theory is that the feet get infected first from contact with the ground The fungus spores are carried to the groin from scratching, from putting on underclothing or pants Frequently extend from the groin to the perianal skin and gluteal cleft

Tinea corpora or ringworm of the bodyedit

Round, red, scaly, patches with well-defined, raised edges; central clearing and very itchy Usually on trunk, limbs and also in other body parts

Tinea faciei or facial ringwormedit

Can be misdiagnosed for other conditions like psoriasis, discoid lupus, etc Can be aggravated by treatment with topical steroid or immunosuppressive creams3

Tinea capitis or blackdot ringwormedit

Infected hair shafts are broken off just at the base, leaving a black dot just under the surface of the skin Scraping these residual black dot will yield the best diagnostic scrapings for microscopic exam Numerous green arthrospores will be seen under the microscope inside the stubbles of broken hair shafts at 400x Tinea capitis can not be treated topically, and must be treated systemically with antifungals4

Tinea capitis or scalp ringwormedit

Trichophyton tonsurans is the most common cause of out breaks of tinea capitis in children, and is the main cause of endothrix inside hair infections Trichophyton rubrum is also a very common cause of favus, a form of tinea capitis in which crusts are seen on the scalp

Tinea manuum or ringworm of the handsedit

In most cases of tinea manuum, only one hand is involved Frequently both feet are involved concurrently, thus the saying "one hand, two feet"5

Onychomycosis, tines unguium, or ringworm of the nailedit

See Onychomycosis

Diagnosis and identificationedit

Rapid in office testing can be done with scraping of the nail, skin, or scalp Characteristic hyphae can be seen interspersed among the epithelial cells Trichophyton tonsurans, the causative agent of tinea capitis scalp infection can be seen as solidly packed arthrospores within the broken hairshafts scraped from the plugged black dots of the scalp

Fungal culture medium is used for positive identification of the species Usually fungal growth is noted in 5 to 14 days Microscopic morphology of the micro- and macroconidia is the most reliable identification character, but a good slide preparation is needed, and also needed is the stimulation of sporulation in some strains Culture characteristics such as surface texture, topography and pigmentation are variable so they are the least reliable criteria for identification Clinical information such as the appearance of the lesion, site, geographic location, travel history, animal contacts and race is also important, especially in identifying rare non-sporulating species like Trichophyton concentricum, Microsporum audouinii and Trichophyton schoenleinii

A special agar called Dermatophyte Test Medium DTM has been formulated to grow and identify dermatophytes6 Without having to look at the colony, the hyphae, or macroconidia - one can identify the dermatophyte by a simple color test The specimen scraping from skin, nail, or hair is embedded in the DTM culture medium It is incubated at room temperature for 10 to 14 days If the fungus is a dermatophyte, the medium will turn bright red If the fungus is not a dermatophyte, no color change will be noted If kept beyond 14 days, false positive can result even with non-dermatophytes Specimen from the DTM can be sent for species identification if desired

Transmissionedit

Dermatophytes are transmitted by direct contact with infected host human or animal or by direct or indirect contact with infected exfoliated skin or hair in clothing, combs, hair brushes, theatre seats, caps, furniture, bed linens, shoes,7 socks,7 towels, hotel rugs, sauna, bathhouse, and locker room floors Depending on the species the organism may be viable in the environment for up to 15 months There is an increased susceptibility to infection when there is a preexisting injury to the skin such as scars, burns, excessive temperature and humidity Adaptation to growth on humans by most geophilic species resulted in diminished loss of sporulation, sexuality, and other soil-associated characteristics

Classificationedit

Dermatophytes are classified as anthropophilic humans, zoophilic animals or geophilic soil according to their normal habitat

  • Anthropophilic dermatophytes are restricted to human hosts and produce a mild, chronic inflammation
  • Zoophilic organisms are found primarily in animals and cause marked inflammatory reactions in humans who have contact with infected cats, dogs, cattle, horses, birds, or other animals This is followed by a rapid termination of the infection
  • Geophilic species are usually recovered from the soil but occasionally infect humans and animals They cause a marked inflammatory reaction, which limits the spread of the infection and may lead to a spontaneous cure but may also leave scars

Frequency of speciesedit

  • About 76% of the dermatophyte species isolated from humans are Trichophyton rubrum
  • 27% are Trichophyton mentagrophytes
  • 7% are Trichophyton verrucosum
  • 3% are Trichophyton tonsurans
  • Infrequently isolated less than 1% are Epidermophyton floccosum, Microsporum audouinii, Microsporum canis, Microsporum equinum, Microsporum nanum, Microsporum versicolor, Trichophyton equinum, Trichophyton kanei, Trichophyton raubitschekii, and Trichophyton violaceumcitation needed

The mixture of species is quite different in domesticated animals and pets see ringworm for details

Medicationsedit

  • Topical medications like clotrimazole, butenafine, miconazole, and terbinafine
  • Systemic medications oral like fluconazole, griseofulvin, terbinafine, and itraconizole
  • Tea tree oil

Treatmentedit

Tinea corpora body, tinea manus hands, tinea cruris groin, tinea pedis foot and tinea facie face can be treated topically

Tinea unguum nails usually will require oral treatment with terbinafine, itraconizole, or griseofulvin Griseofulvin is usually not as effective as terbinafine or itraconizole A lacquer Penlac can be used daily, but is ineffective unless combined with aggressive debridement of the affected nail

Tinea capitis scalp must be treated orally, as the medication must be present deep in the hair follicles to eradicate the fungus Usually griseofulvin is given orally for 2 to 3 months Clinically dosage up to twice the recommended dose might be used due to relative resistance of some strains of dermatophytes

Tinea pedis is usually treated with topical medicines, like ketoconazole or terbinafine, and pills, or with medicines that contains miconazole, clotrimazole, or tolnaftate Antibiotics may be necessary to treat secondary bacterial infections that occur in addition to the fungus for example, from scratching

See alsoedit

  • Hair perforation test
  • National Center for Mycology

Referencesedit

  1. ^ "dermatophyte" at Dorland's Medical Dictionary
  2. ^ Midgley, G; Moore, M K; Cook, J C; Phan, Q G 1994 "Mycology of nail disorders" Journal of the American Academy of Dermatology 31 3 Pt 2: S68–74 PMID 8077512 doi:101016/s0190-96220881272-8 
  3. ^ http://wwwdermnetnzorg/fungal/tinea-facieihtml
  4. ^ http://wwwemedicinecom/derm/topic420htm
  5. ^ http://dermnetnzorg/fungal/tinea-manuumhtml
  6. ^ "BBL Prepared Tubed and Bottled Medium for Detection and Presumptive Identification of Dermatophytes Dermatophyte Test Medium DTM, Modified with Chloramphenicol" Becton, Dickinson and Company Retrieved 2008-12-07 
  7. ^ a b Ajello L, Getz ME 1954 "Recovery of dermatophytes from shoes and a shower stall" J Invest Dermat 22 1: 17–22 PMID 13118251 doi:101038/jid19545 

External linksedit

  • Images and descriptions of dermatophytes

dermatophyte, dermatophyte fungus, dermatophyte infection, dermatophyte infection pictures, dermatophyte infection treatment, dermatophyte test medium, dermatophytes fungi, dermatophytes pictures, dermatophytes toenail fungus, dermatophytes treatment


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Dermatophyte


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    Dermatophyte beatiful post thanks!

    29.10.2014


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