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  1. Tinea Versicolor
    Tinea versicolor is caused by the Malassezia furfur.

    It usually affects the upper trunk and produces a variegated hypo-or hyperpigmentation.
    1. Treatment
      1. Topical treatment
        1. Imidazoles cream e.g. clotrimazole, miconazole, isoconazole
        2. Ketoconazole shampoo
        3. 2.5% selenium sulphide shamoo
        4. 3% salicylic acid in spirit
        5. 20% sodium thiosulphate in spirit
      2. Systemic treatment
        1. Oral ketoconazole 400 mg stat
        2. Oral fluconazole 400 mg stat
        3. Oral itraconazole 200 mg daily for 5 days
  2.  Tinea Negra
    This disease, caused by the hortaea werneckii or mansonii (these are synonyms for Hormodendrum), There are brown or black asymptomatic annular lesions, mostly on palmar stratum corneum which usually respond to keratolytics, e.g., 2% salicylic acid, Whitfield’s ointment.
  3.  Piedra
    Trichosporosis causes nodes on the hair which are white, brown or black.
    There are essentially two varieties: white and black.
    It occurs in patients in the tropics, with occasional cases in the temperate zones, mostly on the scalp.

    It does not fluoresce under Wood's light. The treatment is shaving, or formalin preparations.
    a. White piedra – Trichosporon
    b. Black piedra – Piedraia hortae
  4. Trichomycosis Axillaris
    Small yellow-red or black axillary spots form should be included in Bacterial Onj. NOT in fungal. It fluoresces under Wood's light, and clothing is usually stained by the colored sweat.
    Treatment: Oral antibiotics and antibiotic vanishing creams are a somewhat more elegant way to clear these lesions & shaving.
  5. Erythrasma
    Erythrasma is caused by a gram-positive bacteria, Corynebacterium minutissimum, occurring in humid climates. It fluoresces with a coral red color and responds to systemic antibiotics, especially erythromycin, tetracycline and Chloromycetin; and occasionally in widespread cases, this is the only way you can cure them. Penicillin and griseofulvin do not help, and generally keratolytic ointments are sufficient to clear them
  6.  Tinea Pedis– Most common, dermatophytoses worldwide.
    It is a fungal infection of the toe webspaces and the soles. Trichophyton rubrum (T. rubrum), T. Mentagrophytes Var. interdigitale and Epidermophyton floccosum are the commonest causative organisms. There are 3 main clinical patterns.
    1. Chronic Plantar Scaling
      It presents as a "Moccasin" distribution, on plantar surface and the edges of feet. Peeling of skin and scales are common. Hyperkeratosis may develop on weight-bearing areas.
    2. Acute Vesicular Tinea Pedis Sudden eruption of pruritic or painful vesicles develop on the soles. The eruption is usually unilateral. This pattern may give rise to Id reaction presenting as symmetrical, vesicular pompholyx like lesions at sites distant from the site of active fungal infection.
    3. Interdigital Tinea Pedis (Athelet’s foot) This is most common type of tinea pedis.
      Peeling, maceration and fissuring occurs frequently in the lateral toe clefts. It is usually very itchy and is more common in people with sweaty feet or occlusive foot-wear.
  7. Tinea Manuum
    T. rubrum is the commonest cause. There is unilateral scaling particularly in the skin creases and the nails are usually involved.
  8.  Tinea Unguium
    Infection of nail plate and/or the nail bed with dermatophyte fungi is usually due to T. rubrum. It presents as distal nail edge onycholysis with subungual tan crumbly debris, subungual hyperkeratosis and brownish discoloration from secondary colonization by non-pathogenic fungi e.g. Aspergillus.


  1. Onychomycosis- It denotes any infection of nail caused by dermatophyte, non-dermatophyte fungi, or yeast. Tinea unguium, however, refers strictly to dermatophyte infection of nail.
  2. Types-
  3. Distal and lateral subungual onychomycosis (DLSO) - most common pattern.
  4. Proximal subungual onychomycosis (PSO)- Associated with HIV infection and immunosuppression
  5. Superficial white onychomycosis (SWO)
  1. Tinea Cruris
    Tinea cruris presents as itchy advancing red, sharply demarcated skin rashes enlarging from inguinal folds down inner thigh or into pubic area. Central healing followed by post-inflammatory hypopigmentation is its characteristic. It is usually caused by Trichophyton rubrum, Epidermophyton floccosum and T. mentagrophytes var. interdigitale.
  2. Tinea Capitis
    1. Tinea capitis is caused by any dermatophyte except Epidermophyton floccosum and Trichophyton concentricum. Microsporum usually fluoresce with a bright green color, chiefly M. canis, and M. audouinii. These usually clear at puberty, except for a small percentage of favus and endothrix, Trichophyton infections, e.g., the tonsurans and violaceum infections. Chronicity is associated with a lack of inflammatory response, and while kerion is curative in many cases, it is extremely unpleasant.
    2. T. tonsurans is the chief cause there of tinea capitis. T. violaceum and M. gypseum, contracted from soil and animals, do not fluoresce and can affect adults. Most other microsporum affect children, but not adults. Occasionally in the tropics, T. rubrum can produce tinea capitis, and then it is endothrix. Cultures should always be made to identify the fungus. Rapid diagnosis can be made by placing epilated hair on a glass slide, applying a few drops of 10% KOH, placing a coverslip on top, heating over an alcohol lamp and examining with a low-power microscope directly.
    3. Griseofulvin is curative for most cases of tinea capitis.
    4. Many people with cases of tinea tonsurans have to be kept on this treatment for 3 or 4 months.
  1. Tinea Corporis
    It refers to the dermatophyte infection of smooth skin. The lesion is identical to that of tinea cruris but occurs on the trunk and limbs. It is easily misdiagnosed as discoid eczema or pityriasis rosea.
    Feature Disease Investigation
    Central clearing
    Central Scarring
    Central Crusting
    Tinea corporis
    Lupus Vulgaris
    KOH Smear
    LD body demonstration
  2. Tinea Faciei
    It presents as an amorphous, asymptomatic reddish patch, which may be photosensitive. The skin lesion may be mistaken for polymorphic light eruption, lupus erythematosus and contact dermatitis. It is commonly caused by Trichophyton rubrum, T. mentagrophytes and Microsporum species.
    1. Diagnosis
      1. Wood's light (more useful in Tinea capitis)
      2. Microscopic examination of scrapings and clippings in 10% - 30% KOH
      3. Culture

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