| types of fungi: | dermatophyte
yeast budding
dimorphic
molds |
| fungi pathogenic mechanisms: | toxins(amanita phalloide,
muscarin molds mycotoxins)
allergen( Cladosporium,
Fusarium sepcies, mykides)
tissue infection - mycosis(systemic, mucous membr) |
| dermatophytes: | obligate parasites/pathogens
keratinase
species:
Trichophyton species
Microsporum species
Epidermophyton floccosum |
| yeast: | Facultative parasite, opportunistic pathogens
flora
candida genus
cycle: Budding, Conjugation ,Spore |
| #molds: | not obligate pathogens
tubular branching hyphae(mycelium) |
| Dimorphic fungi: | obligate pathogen
temperature dependent morphology |
| mycosis
pathomechanism: | Host defense function(skin)
fungi(Accommodation to the host) |
| Mycoses (tinea) forms: | superficial
Deep mycosis
Systemic |
| superficial mycoses: | dermatophytes
candidiasis
Malassezia furfur(Lipophilic yeast - microbiom on scalp) |
| Deep mycosis: | Dermis, subcutis, bone |
| Systemic: | Facultative parasites (Candida albicans)
Inhalation |
| dermatophytes: | tricophyton, Microsporum, Epidermophyton
1-3 weeks, common infection
sources are people, animals, or soil
candidiasis
begins erythematous, scaly plaque
---->central resolution, annular shape,
inflammation, scale, crust, papules, vesicles, and even bullae
, especially in the border, pain, Pruritus tropical and systemic therapy |
| Intertrigo: | folds
Dermatophytes and yeast - inflammation
fungi: T. rubrum, T. mentagrophytes, T. interdigitale, Epidermophyton
floccosum, Candida species
Tinea capitis, Mycosis/Tineabarbae profunda
Tinea pedis |
| Onychomycosis: | Involve: matrix, nail plate, nail bed
cosmetic, pain, discomfort, disfigurement
common
risk factors: environmental ,occupational
types: Dystrophic ,Dystal lateral subungual (DLSO), White superficial (WSO),
Endonyx onychomycosis (EO), Proximal subungual (PSO)
treatments: terbinafine, itraconazole, fluconasol (EUR) |
| fungus: | Dermatophytes(T. rubrum 90%, T. mentagrophytes 20%)
Molds (Fusarium species, Aspergillus species )
Candida – (Mucocutane candidiasis) |
| Candidiasis: | Candida
Skin mucous membrane, systemic infections
candidiasis oris, candida paronychia, vulvovaginitis candidosa, balanitis candidosa
candida sepsis, candidiasis mucocutanea,candida abscess |
| Deep fungal infections: | oppurtunistic
Sporothrix schenckii(Sporotrichosis)
rose thorn
cutaneous
pulmonary
disseminated |
| Chromoblastomycosis: | a long term chronic subcutaneous
mycosis
tropical
minor trauma
Fonsecaea , Phialophora,Cladosporium
azol e s and surgery. |
| Mycetoma(Madura leg): | chronic subcutaneous infection caused by bacteria or fungi.
Granulomatous can extend to the underlying bone.
azoles, sulfamethoxazole |
| Opportunistic systemic mycosis: | Candidiasis
Aspergillosis
Cryptococcosis
Zygomycosis |
| Topical pharmacokinetics: | diffusion
adsorption
absorption
resorption
metabolism |
| powders: | Inorganic: zinc oxide, titanium dioxide, talc
Organic: starches, zinc stearate
anti mycotic:
antibacterial |
| Liquids(solutions): | cooling, soothing, drying
Burow’s
Potassium permanganate
Silver nitrate
antiseptics: Povidone-iodine (Betadine)
Octenisept (oktenidin-dihidroklorid and
fenoxiethanol) |
| Bath, Wet dressings: | cleaning (detergents,soaps, syndet)
thermal bath (antiinflammatory)
PUVA bath therapy (treatment of psoriasis) |
| Antiseptic solutions: | Povidone-iodine (Betadine)
Octenisept (oktenidin-dihidroklorid and
fenoxiethanol) |
| psoriasis solutions(steroids): | psoriasis solutions(steroids):
Scalp psoriasis, seborrhoea capitis: mometasone (Elocom), hydrocortison butyrate (Locoid), salicylic acid + betametasone (Diprosalic)
Androgenic alpopecia: estradiol + prednisolone (Alpicort F) |
| Spray (solution): | Anaesthetic: Lidocain - mucous membrane
Antiinflammatory: Hydrocortison+tetracyclin (Oxycort)
Antimycotic: Tolnaftat (Chinofungin), terbinafin (Lamisil) |
| Shake lotions: | suspension of solid material in water, ethanol or oil
two phase system
wash off: with water or oil
adhesion is improved by addition of glycerol
erythematous exanthemas
acut contact dermatitis, dyshidrosis ,pityriasis rosea, urticaria |
| pastes: | Mixture of powder and ointment (2 phase system):
Drying (liquid) pastes: drying, soothing, good vehicle for an
active medicament
Cream (soft) pastes , Protective (hard) pastes |
| Corticosteroids: | inhibit: cytokine production, lipoid mediator synthesis of macrophages
cytokine productions, eosinophile production, ig
weak, moderate, strong, very strongstrong |
| Furthertopicaltreatments: | sunscreens, chemical peeling, bleaching |
| Treatment of chronic wounds: | Treatment of chronic wounds
Topical disinfectants
Ointment containing salicylic acid, boric acid |
| Stimulation of granulation and epithelisation
of thewound: | Hydrocolloid
Medical honey |
| herpes treatment: | – acut (within 4 days!)
• acyclovir 5x 200mg 5 days,
• famcyclovir 3x 250 mg 5 nap
– recurrent (>6/y)
• acyclovir 3-2x 200mg 6 months
• famcyclovir 2x 250 mg 5 nap
• local: acyclovir, antibiotics |
| VZV Pathogenezis : | Sensory nerves → sensory ganglion → latent infection(dormant virus
Sensory ganglion → viral replication → sensory nerve → exanthema |
| herpes zoster: | >50% trunk, 10-20% trigeminal, 10-20% lumbosacral
and cervical
Sensory and motoric nerve damage:
– Ramsay-Hunt syndrome (facial and acoustic nerve)
-Ophthalmic zoster
acyclovir 5x 800mg 7 days per os vagy 3x
5-10 mg/kg/d iv, |
| Human papilloma viruses: | HPV-1 és HPV-4 verruca vulgaris
HPV-6 és HPV-11 condylomata acuminata
HPV-16 cervix carcinoma (E6→p53, E7→Rb) |
| molluscum contagosum: | poxvirus (DNA)
skin/skin contact, Self limiting (spontaneous healing)
Liquid nitrogen
Curettage |
| Childhood cont. Diaseases: | "Morbilli
Rubeola
Erythema infectiosum (Parvovirus B19)
Exanthema subitum (HHV-6)
Roseola (Coxsackie)" |
| Gianotti–Crosti syndrome: " | "Gianotti–Crosti syndrome (/dʒəˈnɒti ˈkrɒsti/), also known as infantile is a reaction of the skin to a viral infection
Hepatitis B virus and Epstein–Barr virus
fever (27%)
– lymphadenopathia (31%)
– hepatosplenomegalia (4%)
– pharyngitis, oropharyngeal ulcers and vesicles,
tonsillitis |
| heat injury: | The local action of excessive heat
causes burns or scalds;#
First-degree burns~
active cogestion of blood vessels --->erythema--->
peeling |
| second degree burn: | superficial: vesicles beneath the outer
layer of epidermis, recovery without scarring
deep: pale, injury to reticular dermis, damage
to appendages, healing more than month
with scarring |
| third degree burn: | loss of full dermis+subcutneous tissue
---> ulcerating wound with no epithelium
----> scarring
require grafting |
| fourth degree burn: | all skin and subcut fat and tendons destroyed
require grafting |
| factors affecting burn symptoms: | location
depth
size |
| which group has greater death rate in burn injuries? | infants and women and toddlers |
| Excessive scarring from burn can cause: | contractures
deformities and dysfunction of the joints
chronic ulcerations from impairment
of local circulation
squamous cell carcinomas# |
| what are the key components of the
critical care of burns? | Fluid resuscitation
treatment of inhalation injury
hypercatabolism
monitoring
early intervention of sepsis pain
control
environmental control
nutritional support |
| lightening injuries: | lethal type of strike
cardiac arrest or other internal injuries
Linear burns in areas with sweat
Burns in a feathery or arborescent pattern
Punctate burns with multiple, deep, circular lesions
Thermal burns from ignited clothing or heated metal |
| what to remove tar from burns with? | polymyxin B ointment
vitamin E ointment
sunflower oil |
