the goal of teaching - university of belgrade filepathogenesis: • pityriasis versicolor (tinea...
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1. The morphology and biology of the
fungi
Classification of medically
important fungi
• Fungal morphology and structure
• Antifungal (AF) - Mechanisms of action
• Fungi - biology and physiology
• Fungal infections (FI) - classification
The goal of teaching: 2. Common fungi which primarily cause skin,
hair and nail FI
• Malassezia - morphology, biology
Pathogenesis of pitiriasis versicolor,
Pathogenesis of seborrheic dermatitis
• Trichophyton - morphology, biology
• Microsporum - morphology, biology
• Epidermophyton - morphology, biology
Pathogenesis of dermatomycoses
3. Common fungi which causes
superficial / invasive / oprtunistic FI
• Candida - morphology, biology
Pathogenesis
• Cryptococcus - morphology, biology.
Pathogenesis
• Aspergillus - morphology, biology.
Pathogenesis
• Fusarium - morphology, biology.
Pathogenesis
4. Other fungi which causes of superficial /
invasive oprtunistic FI
• Penicillium - morphology, biology
Pathogenesis
• Zygomycetes (Mucor, Rhisopus, Absidia) -
morphology, biology.
Pathogenesis
• Pneumocystis - morphology, biology.
Pathogenesis
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COMMON CAUSES OF FI Skin, hair, nail:
Malassezia
Trichophyton
Microsporum
Epidermophyton
Candida
Superficial mycoses: :
Malassezia
Exophiala (Cladosporum) werneckii
Trichosporon beigelli
Piedraea hortae
...
Cutaneous mycoses
dermatomycoses / tinea: Trichophyton
Microsporum
Epidermophyton
Candida
Aspergillus
…
Mucocutaneous mycoses:
Candida
Geotrichum
Rhinosporidium seeberi
...
Othomycoses:
Aspergillus
Candida
...
Keratomycoses:
Fusarium
Aspergillus
Onichomycoses:
Candida
Dermatophytes
Undermatophytes moluds
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Malassezia (Pityrosporum)
• Yeasts, NF of skin, lipophilic species:
M.furfur, M.sympodialis, M.globosa...
• Unlipophilic species:
M. pahidermatis
Pathogenesis: • Pityriasis versicolor
(tinea versicolor)
• Malassezia foliculitis
• Seborrheic dermatitis (pityriasis
simplex capitis - dandruff)
• Atopic dermatitis
(systemic infection - rare / lipid th)
LDg/ DMP
Culture
Th/ AF local
MM2
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Pytiriasis versicolor (tinea versicolor)
• Slight, recurrent disease of the
superficial layers of the skin (stratum corneum)
• Lesions- with small circular
flakes (scaling)
• Predisposing factors:
sweating, gender, genetic basis ...
• Predilection sites:
chest, back, shoulders
• System types: infants and adults, CVC
DDG: erithrasma, vitiligo
Hypo-pigmentation Hyper-pigmentation
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Dermatophytes
Trichophyton (around 20 species)
Microsporum (around 17 species)
Epidermophyton (2 species)
• Highly contagious, cosmopolitan distribution
• Keratinophilic: hair, nails, and superficial layer of skin
(reproduction)
Anthropophilic species
Zoophilic species
Geophilic species
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Dermatophytes
Zoophilic species:
Microsporum
M. canis
M. equinum
M. gallinae
Trichophyton
T. equinum
T. mentagrophytes
T. simii
T. verrucosum
The most frequent species in human: • Trichophyton rubrum
• Trichophyton interdigitale
• Epidermophyton floccosum
• Microsporum canis
• Trichophyton verrucosum
Geophilic species:
Microcporum
M. gypseum
M.nanum
M.persicolor
Trichophyton
T. ajeloii
Antropophilic species:
Microsporum
M. audouinii
M. ferrugineum
Trichophyton
T. concentricum
T. interdigitale
T. rubrum
T. schoenleinii
T. tonsurans
T. violaceum
Epidermophyton
E. floccosum
Source of infection: people, animals, soil
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Dermatophytes
Trichophyton
Microsporum
Epidermophyton
Macroconidia
(rare)
Microconidia
(numerous)
Macroconidia
(numerous)
Microconidia
(rare)
Macroconidia
(only)
Microconidia
(absent)
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• Macroconidia / multicellular
fusiform
cylindrical
drumstick shape
• Microconidia / unicellular
pyriform
in clusters
Microscopic characteristics of
dermatophytoses
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D E R M A T O F I T I
Localization of dermatophytes and
characteristics essential for identification
Trichophyton I group
(skin, nails, hair - type ectotrix)
» T. mentagrophytes
» T. rubrum
» T. verrucosum
Trichophyton II group
(skin, nails, hair - type endotrix)
» T. tonsurans
» T. schoenleinii
» T. violaceum
macroconidia rare (pencil shaped 3-8 cells ) numerous microconidia in clusters
Microsporum
(hair and skin)
Numerous macroconidia
(elliptical, fusiform 3-7 cells)
Macrodonidia by hyphae, one
Epidermophyton
(skin and nails)
Only macroconidia
(rounded, with 2-4 cells)
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DERMATOPHYTOSES TINEA/RINGWORM/DERMATOMYCOSES
Indicate infection of the superficial layers of skin, hair and nails
caused by dermatophytes or other fungi
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DERMATOPHYTOSIS (Tinea)
localization
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Trichophyton
(around 20 species)
Skin
Hair
Nails
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Herpes tonsurans
LDg/ DMP
Culture
Th/ AF MM2
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Herpes tonsurans
LDg/ DMP
Culture
Th/ AF
MM2
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Herpes tonsurans Trichophytia superficialis
Trichophyton mentagrophytes
LDg/ DMP
Culture
Th/ AF MM2
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Kerion Celsii Sycosis barbae
Trichophytia profunda
LDg/ DMP
Culture
Th/ AF MM2
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Kerion Celsi
LDg/ DMP
Culture
Th/ AF MM2
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Sycosis barbae
LDg/ DMP
Culture
Th/ AF MM2
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Favus -Trichophyton schoenleinii
LDg/ DMP
Culture
Th/ AF MM2
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Tinea imbricata - T. concentricum
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Trichophyton mentagrophytes v. interdigitale
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Onychomycosis - T. mentagrophytes
Itraconazole pulse
Dr Decroix , Belgium
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Microsporum
(17 species)
Skin
Hair – type ectotrix
rare - nails
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Microsporum gypseum
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Microsporum canis
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Microsporum gypseum Microsporum canis
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Microsporia
LDg/ DMP
Culture
Th/ AF
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Epidermophyton
(2 species)
Skin
Nails
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Epidermophyton floccosum
LDg/ DMP
Culture
Th/ AF
Tinea corporis
Tinea pedis
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Epidermophyton floccosum
Macroconida (phase contrast 400X) Macroconidia (LFCB 400X)
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Dermatophytid – immunopatological manifestation
Fungal Ag in complex with Ab in the skin
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Sima Milošević (1896-1943)
Epidermophyton floccosum (Harz) Langeron et Milochevitch
Trichophyton schoenleinii (Lebert) Langeron et Milochevitch
Langeron, 1950.
Trichophyton milochevitch