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LECTURE BLOCK 8 201 5 Awalia Febriana

LECTURE BLOCK 8 201 5 Awalia Febriana. School of Medicine Gadjah Mada University YOGYAKARTA. FUNGAL INFECTION IN DERMATOLOGY. Agnes Sri Siswati Dermato-venereology department Faculty of Medicine Gadjah Mada University Yogyakarta. FUNGAL INFECTION. CLASIFICATION:

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LECTURE BLOCK 8 201 5 Awalia Febriana

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  1. LECTURE BLOCK 8 2015Awalia Febriana School of Medicine Gadjah Mada University YOGYAKARTA

  2. FUNGAL INFECTION IN DERMATOLOGY Agnes Sri Siswati Dermato-venereology department Faculty of Medicine Gadjah Mada University Yogyakarta.

  3. FUNGAL INFECTION CLASIFICATION: SUPERFICIAL MYCOSIS SUB CUTAN/DEEP MYCOSIS SYSTEMIC MYCOSIS SUPERFICIAL MYCOSIS Dermatophyta Non Dermatophyta

  4. CLINICAL MANIFESTATION Erythematous patch/papule with scale circinate Active border Central healing Itchy, esp. sweating

  5. LABORATORY EXAMINATION 1. Wood’s Lamp: Blue-green fluorescence 2. Microscopy: KOH 10-30% 3. Culture: Saboraud’s agar 4. Byopsi 5. Skin test

  6. DERMATOPHYTOSIS GENUS:Trichophyton Sp. Epidermophyton Sp. Mycrosporon Sp. TINEA………..

  7. CLASSIFISATION 1. ANTHROPOPHILIC 2. ZOOPHILIC 3. GEOPHILIC TRANSMISION: DIRECT : SKIN TO SKIN CONTACT INDIRECT:TOWEL, WEAR, COMB, ETC.

  8. TINEA CAPITIS

  9. TINEA CORPORIS

  10. TINEA CRURIS

  11. NON DERMATOPHYTOSIS 1. CANDIDIASIS

  12. CUTANEUS CANDIDIASIS EPIDEMIOLOGY Age: Any age. Etiology: Candida albicans Predisposing factors: Diabetes, obesity, hyperhidrosis, heat, maceration, polyendocrinopathies, systemis and topical corticosteroid

  13. CUTANEUS CANDIDIASIS • LABORATORY Direct microscopy: scraping using Gram’s stain or KOH preparation (10-30%) Fungal culture: Saboraud medium • MANAGEMENT Prevention: Keeping intertriginous areas dry Therapy : Topical antifungal

  14. MUCOSAL CANDIDIASIS • Mucosal candiddiasis is a Candida infection occuring on the mucosa of the upper aerodigestive tract and vulvovagina. • EPIDEMIOLOGY Age : All ages Etiology : Candida albicans Transmission : Overgrowth associated with local or systemic suppression of immunity or antibiotic therapy

  15. MUCOSAL CANDIDIASIS • RISK FACTORS: • HIV infection • debilitation • diabetes mellitus • broad spectrum antibiotic therapy • topical or parenteral corticosteroid • Parenteral hyperalimentation • corpus alienum

  16. MUCOSAL CANDIDIASIS • PHYSICAL EXAMINATION • Vaginitis/vulvovaginitis candida Vaginitis with white discharge, vaginal erythema and edema. White plaques that can be wiped off on vaginal and/or cervical mucosa. 2. Oropharyngeal candidiasis Pseudomembranous candidiasis (thrush). Removable white plaques on any mucosal surface.

  17. MUCOSAL CANDIDIASIS MANAGEMENT: Topical and systemic antifungal

  18. 2. PITYRIASIS VERCISOLOR • Pityriasis versicolor is a chronic asymptomatic scaling dermatoses caused by overgrowth of Pityrosporum ovale. • EPIDEMIOLOGY • Age; young adult • Etiology: P. ovale (Malassezia furfur) • Predisposing factors: high humidity, high rate sebum production

  19. PITYRIASIS VERSICOLOR • SKIN SYMPTOM Usually none or mild pruritus • SKIN LESIONS Macule, white to brown color, sharply marginated with fine scaling (finger nail sign)

  20. PITYRIASIS VERSICOLOR • LABORATORY EXAMINATIONS Direct microscopy KOH 10 to30%. Sphageti and meat ball

  21. TREATMENT Systemic antifungal Griseovulfin :Dermatophytosis Azole group: All fungal Terbinafin: Dermatophytosis, PVC Topical Azole : all fungal terbenafin, whitfield oint : Dermatophyta Selenium sulfide, Na thiosulfate : PVC

  22. EPYZOONOSIS .

  23. ECTOPARASITIC INFECTION • Risk factors: • 1. Social - economic • 2. Health education • 3. Hygiene • 4. Etc. • Epidemiology: • Parasitic infection are • endemic in many developing countries

  24. CLASSIFICATION 1. Completed inflammation: a. Amoebiasis of the skin b. Insect bites 2. Incomplete inflammation: • a. scabies • b. larva migrans (creeping Eruption) • c. pediculosis

  25. Insect bites Caused : insect toxin Symptoms and Signs : • erythema with central necrosis • papule and punctum • nodus/urtika with punctum • vesicula  bulla

  26. TOXIC IRITANT DERMATITISec insect poison

  27. SCABIES General Considerations : • Itching especially during night • Sign : papule, pustule, excoriation, hyper pigmentation • cunniculus (burrow) • Transmitted by skin to skin contact or sexually

  28. Caused: Sarcoptes Scabiei Predilection: Adult: hands, wrist, elbows, anterior axillary fold, abdomen, buttocks, areolas of female breasts, genital. Infant : head, neck, palm and sole

  29. THERAPY CAUSATIVE THERAPY PERMETHRIN GAMEKSAN BENZYL BENZOAT 2-4 OINT (SULFUR) IVERMECTIN ORAL (NOT AVAILABLE) SYMPTOMATIC THERAPY ANTIHISTAMIN

  30. Cutaneus Larva migrans( creeping’s eruption) Aetiology: larva Ankylostoma braziliensis Characteristic sign : A serpiginous, linear,raised, tunnel-like erythematous lesions, outlining the path of migration of the larva. Skin Symptom: Local pruritus (Itchy)

  31. MANAGEMENT: • Anti parasite : • Anti helmint gol albendazole, tiabendazole • Cryo surgery • Nitrogen liquid

  32. REFERRENCES • Odom,.R., James,W., Berger,T., 2000. Andrews’ Diseases of the skin, 9 th ed., WB Saunders Company • JawetzMelnick JL. Adelberg EA, Brokks GF, Butel JS and Ornston LN 2004 Medical Microbiology, 21 th ed. Simon and Schuster Asia Pte Ltd, Singapore. • JAAD

  33. THANK YOU

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