Tinea is transmitted via the feet by desquamated skin scales in substrates like carpet and matting. 15
手足癣－治疗原则


水疱型－温和搽剂和霜剂 角化过度型－先角质剥脱剂，再用抗真 菌霜剂 浸渍糜烂型－粉剂收干，抗继发感染， 再温和抗真菌
主要致病性真菌
浅部真菌感染（致病性真菌感染和
条件致病性真菌感染）
深部真菌感染（致病性真菌感染和
条件致病性真菌感染）
1
浅部感染真菌
表面感染真菌 皮肤癣真菌 皮下组织真菌感染
2
3
表面感染真菌




位置：寄居于人体皮肤和毛干的最表层。 因不接触组织细胞，很少引起宿主细胞 反应 统称：角层癣菌 代表：秕糠马拉癣菌(Malassezia furfur) 症状：由于此菌能产生对黑色素细胞有 抑制作用的二羧酸，使花斑癣局部色素 减退，如汗渍斑点，俗称汗斑。 诱发因素为高温多汗
指（趾）甲 皮肤 毛发
毛癣菌属 表皮癣菌属
小孢子癣菌属
+ +
-
+ +
+
+ +
13
14
Tinea pedis caused by T. rubrum. Sub-clinical infection (left) showing mild maceration under the little toe and more severe infection (right) showing extensive maceration of all toe web spaces
4
Malassezia furfur




Tinea versicolor on skin surface (sweat stain) The lesions are small hypopigmented or hyperpigmented macules Most common site : back, underarm, upper arm, chest, neck Most common in adolescent and young adult males Associated with increased sweating
– Infancy, pregnancy, old age – Disorders of immune function, e.g., leukemia, corticosteroid therapy – Chemotherapy, e.g., immunosuppressive, antibiotic – Endocrine disease, e.g., diabetes mellitus – Carcinoma
Tinea alba
发外孢子
22
Tinea Capitis (scalp ringworm)
脓 癣
23
头癣－治疗原则

剪发 洗发 搽药


服药
消毒
24
Candidiasis of skin, mucous membranes and nails

Predisposing factors
7
Piedraia hortae (何德毛结节菌)

It usually affected the scalp hair The nodules are darker in color, harder, and more firmly attached to the hairs

Black Piedra
16
Tinea Unguium来自usually caused by Trichophyton sp
17
甲癣－治疗原则

局部治疗－甲涂剂 系统治疗－伊曲康唑，特比萘芬等 联合治疗－配合拔甲或削甲治疗
18
Tinea Corporis:
caused by M. canis, following contact with infectious kittens
25
5
Pityriasis versicolor showing hyperpigmented lesions in a Caucasian and hyphopigmented lesions in an Australian Aborigine
6
Culture of Malassezia furfur on Dixon's agar (contains glycerol mono-oleate)
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11
皮肤癣真菌




引起皮肤浅部感染 皮肤癣是人类最多见的真菌病 统称：皮肤癣菌，大约40多个种，分属于3 个属 嗜角质蛋白，37℃不能生长，侵犯部位：角 化的表皮，毛发，指（趾）甲 病理变化：由真菌增殖及代谢产物刺激宿 主引起
12
致病性
一种皮肤癣菌可在不同部位引起病变 相同部位的病变也可由不同的皮肤癣菌引起
8
Piedraia hortae forms a hard superficial pigmented nodule around the hair shaft
(在毛干上形成硬的黑色结节，如沙粒状)
9
Fungal otitis externa



Fungal infection of the external auditory canal Caused by several species of Aspergillus (most often A.niger), but Candida albicans is also capable of infecting this site The major symptoms are itching and feeling of fullness in ear
19
Tinea Cruris (Jock itch):
Infection of the groin, mainly seen in men
20
Tinea Capitis (scalp ringworm)
Tinea favosa
发内孢子
21
Tinea Capitis (scalp ringworm)