Transcript tinea cruris

真菌性皮肤病
Dermatomycoses
一 皮肤癣菌病
dermatophytoses
Dermatophyte
Infection
hair cutaneoushorny layer nail plate
dermatophytosis
According to different parts：tinea capitis tinea corporis
tinea cruris tinea manum tinea pedis onychomycosis tinea barbae
According to different parts：tinea capitis tinea corporis
tinea cruris tinea manum tinea pedis onychomycosis tinea barbae
According to different parts：tinea capitis tinea corporis
tinea cruris tinea manum tinea pedis onychomycosis tinea barbae
According to different parts：tinea capitis tinea corporis
tinea cruris tinea manum tinea pedis onychomycosis tinea barbae
dermatophytids
metabolite of trichophyton
blood circulation;
dermato-allergic reaction out of
focus
etiology
Trichophyton
Microsporum
Epidermophyton
human
infection
animal
dermatophytosis
1Leading
country
dermatophytes in our
dermatophytes
invasion
hair root 、hair strunk 、 nail plate 、 cutaneous corneum stratum
tinea barbae
onychomycosis
tinea corporis
tinea of feet and hands
the relationship between characters of
dermatophytes and clinic
Character: because of keratinophilic
Clinic: prone to invade stratum coreum.
Character: Growing in 25-28 oC
Clinic: happening at summer or autumn..
the relationship between characters of
dermatophytes and clinic
Character: Needing moderate
humidity
Clinic: infections exist at the moist and
sweaty places
Character: develop from center to
peripheral
Clinic: lesions looks like the ring.
the relationship between characters of
dermatophytes and clinic
Character: growing rapidly
Clinic: lesions happening after one week commonly
Character: having nothing to do with
sun light
Clinic: able exist in UV ,but fearing dry and high
temperature
Character: carbon and nitrogen are neccessary
Clinic:DM、 using long-term corticosteroids and
thick lamina corticalis are easy to infect.
the relationship between characters of
dermatophytes and clinic
Character: human 、soil and animal are
susceptibe.
Clinic: different infected sources ,
different clinical appearance
tinea corporis of cruris
Primary lesions ：
papule、blister 、
papulovesicle
tinea cruris
differential diagnosis：circumduction erythema
、pityriasis rosea、neurodermatitis 、eczema
treatment ：
topical treatment :Compound Benzoic Acid liniment（tinea corporis）
Bid ×2-4weeks
Compound Resorcinol Liniment (tinea cruris)
Bid ×2-4weeks
3％miconazole cream
、terbinafine cream 、
ketoconazole cream etc (tinea corporis and cruris)
Bid ×2-4weeks.
Generalized corporis tinea
Sporanox 200mg/d/ adult×1
Terbinafine 0.25g qd×1-2weeks
Fluconazol 0.15g qw ×1-2weeks
Tinea of hands and feet
EEfinition: finger and toe web and palma,
metatarsus infect dermatophyte are called tinea
of hands and feet.
1>.thick horny layer in hands and feet
2>.easily scrape
3>. sweaty, damp stuffy in feet.
inducing dermatophytosis of hands and feet.
Clinical grouping
scale- blister type 、 maceration -erosion
mode 、hyperkeratotic pattern
scale- blister type
hyperkeratotic pattern
角化过度型
maceration -erosion mode
differential diagnosis ：extremity
eczema 、 pompholyx 、exfoliative keratolysis
Tinea of hands and feet treatment
1、scale- blister type
soaking with 10％glacial acetic acid
Compound Benzoic Acid liniment miconazole cream
pulvis pro pedibus ext
2、maceration -erosion mode
Compound Resorcinol Liniment
miconazole cream and pulvis pro pedibus ext
slight effusion:radiomycin anthraco paste
miconazole cream and pulvis pro pedibus
considerable effusion: 0.5 ％fradiomycin FL、
miconazole cream and pulvis pro pedibus
second infection ：using the antibiotic
3、hyperkeratotic pattern
Whitfield ointment 、miconazole cream
companion with rhagades : carbamide lip etc.
note to ringworm of hand:
avoidance miscellaneous physical o chemical stimulus.
tinea capitis ：both dandruff and hair are infected dermatophytes.
clinical manifestation: papule ;blister; scale; pustule .
clinical appearance
susceptible population : favus
child or adult.
tinea alba
child.
black dot tinea child or adult.
cutaneous lesion:
sick hair ：
favus
papule ,pustule ,
scutulum, atrophic scar.
tinea alba
seborrheic dermatitis’ scale
child and mother patch
black dot tinea seborrheic dermatitis’ scale
;macula
favus
tinea alba
black dot tinea
Wood light ：
dry and no luster, easy brisement,
different leng.
brisement part
from 2-4mm
patient’scalp. 。
fracture part from patient’scalp.
favus
tinea alba
black dot tinea
dark green fluorescence
bright green fluorescence
no fluorescence
direct microscope ：
Microsporum lanosum
、Microsporum
corrosion
fungus culture
Trichophyton violaceum Trichophyton tonsurans .
course of disease
favus
tinea alba
black dot tinea
slow proceeding ;
inability autotherapy ; scar
rapid proceeding ;
adolescent age autotherapy; no scar
slow proceeding
inability autotherapy minority scar
Kerion
Definition: a deep, pustular type of tinea resembling a carbuncle
or kerion is observed on the glabrous skin ,
which is a topical allergic response.
Clinical manifestation: one or several
manifest inflammation abscesses
with overt edge feel fluctuant,
hair become loosening and broken off easily.
Common lingering effects are scar
and nonvolatile alopecia.
Differential diagnosis: dandruff eczema
seborrheic dermatitis
amianth pityriasis
psoriasis alopecia areata.
prevention and cure of
tinea capitis
1.overdose
terbinafine : <20kg 62.5mg qd 2w at least
20kg∽40kg 125mg qd 2w at least
>40kg 250mg qd 2w at least
fluconazol: 3∽6mg/kg/d, 2w at least
itraconazole: 3∽6mg/kg/d, 2w at least.
prevention and cure of tinea
capitis
2.drug for external: miconazole cream ext
,bid×2m
3. shampoo: sulfur soap/d , ×2m
4. shaving head: cutting all hairs,qw×2m.
5.megatemperature disinfection: towel,
sheeting,pillowcase, comb etc.
Kerion: forbidding incision and drainage.
Onychomycosis
Definition: it is difined as the infection of the nail
by fungus and represents up to 30％ of diagnosed
superficial fungal infections.
Clinical appearance: thick nail plate nail
segregation colouration alteration and breakage,etc.
prevention and cure of
onychomycosis
1. removing morbid nails: wafering mornid nails after
painting 40％carbamide cream, then getting rid of them.
2. drug for external: 30％glacial acetic acid or 2％
miconazole tincture, ext bid ×3∽6m
3. overdose : terbinafine :0.25g qd ×3∽4m
fluconazol: 0.15g qw ×3∽4m
itraconazole: 0.2g qd 1w/m ×3∽4m