HOLY NAME UNIVERSITY

MT 122 – Mycology and Virology

Menissa Acierto, RMT, MEd
CUTANEOUS MYCOSES
 Dermatophytoses
 Three genera are causative agents:
a. Trichophyton
b. Microsporum
c. Epidermophyton
 Species are called KERATINOPHILIC – adapted to grow on hair, nails and cutaneous layers of the skin that contains SCLEROPROTEIN KERATIN
 Infection of deep tissue is rare but occasionally extensive inflammation and nail bed involvement or disseminated disease may result.
 Agents under cutaneous mycoses are characterized under:
a. GEOPHILIC
- Primarily inhabits the soil
- Produce large number of conidia (readily identified)
b. ZOOPHILIC
- Dermatophytes typically adapted to live on animals
- Not commonly found living freely in soil or in dead organic substrates
- Causes infection in animals and can be spread as agents of disease in humans
- Produces fewer conidia
c. ANTHROPHILIC
- Adapted exclusively to human hosts
- Almost always encountered as agents of human disease
- Infections are seldom inflammatory
- Produce few conidia
 Dermatophytes typically forms two sizes of reproductive cells: MACROCONIDIUM and MICROCONIDIUM
 Both anamorphic and asexual conidia
 Live freely in the environment
 Few adapted to exclusively living on human tissues and are rarely recovered from any other sources
 Distribution is generally worldwide (few are found only in restricted geographic regions)
CHARACTERISTICS CLINICAL FEATURES FUNGI RESPONSIBLE
INFECTION INVOLVING HAIR:
1. Tinea favosa (favus) - Infection of the hair follicle -Crusty, cup-shaped flakes called - Trichophyton schoenleinii
- Progresses to crusty lesion made up SCUTULA are formed
of epithelial cells and fungal mycelia -Hair loss and scar tissue formation
commonly follows

Ana Rhea P. Boncales

 HOLY NAME UNIVERSITY
MT 122 – Mycology and Virology
Menissa Acierto, RMT, MEd
2.
Tinea capitis
- Common childhood disease easily -Fungus colonizes primarily the outer - Microsporum audouinii
 Gray Patch Ringworm spread among children portion of the hair shafts, so- - Microsporum ferrugineum
- Lesions are seldom inflamed, but called ECTOTHRIX HAIR
lustre and colour of the hair shaft involvement
may be lost

- Hair follicle is the initial site of -Involvement of ENDOTHRIX HAIR - Trichophyton tonsurans
 Black Dot Ringworm infection - Trichophyton violacuemf
- Fungal growth continues within the
hair shaft, causing it to weaken
- Brittle, infected hair shaft breaks off
at the scalp
- Leaves a black dot stubs

INFECTION INVOLVING NAILS

1. Onychomycosis - Most often caused by dermatophytes - There is direct association between - Trichophyton rubrum
- May also be the result of infection by dermatophytic infections of the - Trichophyton mentagrophytes
other fungi feet or hands and infection of the - Trichophyton tonsurans
- Nail and nail bed infection may be nails - Epidermophyton floccosum
among the most difficult
dermatophytes to treat
- Unlikely for anyone suffering from
tinea pedis will escape some extent
of onychomycosis
- SUBUNGUAL
o most common form of
onychomycosis
o described as lateral, distal or
proximal
o either end of the nail is first
infected with spread continuing
to the nail plate
o Nails become thick, discoloured

Ana Rhea P. Boncales

 HOLY NAME UNIVERSITY
MT 122 – Mycology and Virology
Menissa Acierto, RMT, MEd

and flaky
2. Tinea pedis (Athlete’s - Infection arises from infected skin - Infection of the glabrous skin range -
Foot) scales coming into contact with from mild with only minimal
exposed skin via carpet, shower or scaling and erythema to severely
other environment inflamed lesions
- Individual has a genetic
predisposition in developing the
disease
- Not everyone encountering infected
skin scales becomes infected
- Family infection is common
- Various sites if foot may be involved
- Usually affects the sole of the feet
and toe webs
- Scale on the foot may develop
extensive scaling with fissuring and
erythema (SEVERE CASE)
- Disease may progress around the
sides of the foot from the sole,
condition known as MOCCASIN
FOOT (it will look like wearing a
moccasin shoes)

Ana Rhea P. Boncales

 HOLY NAME UNIVERSITY
MT 122 – Mycology and Virology
Menissa Acierto, RMT, MEd

SYSTEMIC DERMATOPHYTE INFECTION

 Occurs in immunocompromised persons
 Disseminated disease appears in different forms
 Systemic means the infection has spread into other areas
 In some patients, it manifests as granulomas while others develop into nodules (pea to walnut-sized)
 Biopsy of nodules reveal fungal elements easily recovered in culture
 Occurs primarily in kidney transplant patients (due to the depression of the immune system to avoid organ rejection)
 Thought to have spread from athlete’s foot or onychomycosis
AGENT CLINICAL FEATURES
1. Epidermophyton floccusom - Worldwide distribution
- Produce only MACROCONIDIA
- Smooth, thin-walled macroconidia produced in clusters
or singly
- DISTAL END of the conidium is broad/spatulate
(BEAVER’S TAIL)
- Occasionally, conidia may be single-celled but usually
they are separated into TWO TO FIVE cells by
PERPENDICULAR CROSS WALLS
- Colonies are YELLOW to YELLOW-TAN, FLAT with
FEATHERED EDGES and SMALL in diameter.
- Isolates are notorious for developing PLEOMORPHIC
TUFTS of STERILE hyphae in older cultures
2. Microsporum canis - Worldwide distribution
- MACROCONIDIA are SPINDLE-SHAPED with
echinulate, thick walls; measures 25 um x 35-110 um
and have 3-15 cells
- Tapering, sometimes elongated, spiny distal ends (KEY
FEATURES)
- Macroconidia abundantly formed by most isolates
- Colonies are FLUFFY and WHITE, with REVERSE
SIDE usually developing a LEMON YELLOW
PIGMENT especially on POTATO DEXTRSO AGAR
(PDA)

Ana Rhea P. Boncales

 HOLY NAME UNIVERSITY
MT 122 – Mycology and Virology
Menissa Acierto, RMT, MEd
3. - FUSIFORM,
Microsporum gypseum moderately thick-walled conidia measuring 8-15 um x
25-60 um and can have as many as 6 cells
- In some isolates, DISTAL END of the macroconidium
might bear a THIN, FILAMENTOUS TAIL
- Abundant macroconidia and microconidia produced by
isolates result in a POWDERY, GRANULAR
appearance on colony surfaces
- Colonies that form TAN to BUFF CONIDIAL MASSES
are typical of FRESH ISOLATES but develops
PLEOMORPHIC TUFTS of WHITE STERILE HYPHAE
in aging cultures
- Abundant BROWN to RED PIGMENT can form
beneath some strains, other remains colorless
- RAPIDLY GROWING GEOPHILIC species found in
SOILS worldwide
4. Microsporum audouinii - SLOW GROWING ANTHROMORPHIC dermatophyte
- Conidia are rarely produced
- Some isolates form chlamydoconidium-like swellings
terminally on hyphae
- Colonies appear COTTONY WHITE and generally form
LITTLE or NO PIGMENT on reverse

Ana Rhea P. Boncales

 HOLY NAME UNIVERSITY
MT 122 – Mycology and Virology
Menissa Acierto, RMT, MEd
5. - MICROCONIDIA are
Trichophyton mentagrophytes primarily GLOBOSE but may appear TEAR-SHAPED
and measures 2.5 – 4 um in diameter; found in clusters
described as grape-like
- MACROCONIDIA are thin-walled, smooth, CIGAR-
SHAPED with 4-5 cells separated by parallel cross
walls; measure about 7 um x 20-50 um and dare
produced singly on UNDIFFERENTIATED hyphae
- Colony morphology varies; granular colonies are noted
when abundant microconidia are formed
- RAPID GROWING
- Worldwide distribution

6. Trichophyton rubrum - Produce 3-8 CELLED MACROCONIDIA measuring

smaller than T. mentagrophytes but are SELDOM seen
in clinical isolates
- Typical microscopic feature is CLAVATE or PEG-
SHAPED microconidia formed along undifferentiated
hyphae and may even be sparse
- Colonies usually remain WHITE on the SURFACE but
may be YELLOW to RED
- MOST STRAINS develop RED to DEEP BURGANDY
WINE color pigment on the reverse
- Worldwide distribution

Ana Rhea P. Boncales

 HOLY NAME UNIVERSITY
MT 122 – Mycology and Virology
Menissa Acierto, RMT, MEd
7. - Possess a
Trichophyton tonsurans MICROCONIDIA that are extremely variable in shape
ranging from ROUND to PEG shapes
- On SDA, colonies usually form a RUST-COLORED
pigments on the colony’s reverse
- LEADING CAUSE of TINEA CAPITIS in children in
many parts of the world

Ana Rhea P. Boncales

 HOLY NAME UNIVERSITY
MT 122 – Mycology and Virology
Menissa Acierto, RMT, MEd

SOME CLINICAL FEATURES OF DERMATOPHYTE INFECTIONS

SKIN DISEASE LOCATION OF LESION CLINICAL FEATURES FUNGI MOST FREQUENTLY
RESPONSIBLE
1. Tinea corporis  Non-hairy  Circular patches  Trichophyton rubrum
(ringworm)  Smooth skin  Advancing red, vesiculated  Epidermophyton floccosum
border and central scaling
 Pruritic
2. Tinea pedis  Interdigital spaces on feet of  ACUTE: itching, red vesicular  Trichophyton rubrum
(athlete’s foot) person wearing shoes  CHRONIC: itching, scaling,  Trichophyton mentagrophytes
fissures  Epidermophyton floccosum
3. Tinea cruris  Groin  Erythematous scaling lesions  Trichophyton rubrum
in intertriginous area  Trichophyton mentagrophytes
 Pruritic  Epidermophyton floccosum

4. Tinea capitis  SCALP HAIR  Circular bald patches  Trichophyton mentagrophytes

 ENDOTHRIX: fungus  Short hair stubs or broken  Microsporum canis
inside hair shaft hair follicle  Trichophyton tonsurans
 ECTOTHRIX: fungus on  Kerion rare
surface of hair  Microsporum-infected hair
fluoresce
5. Tinea barbae  Beard hair  Edematous  Trichophyton mentagrophytes
 Erythematous lesions  Trichophyton rubrum
 Trichophyton verrucosum

6. Tinea unguim  Nail  Nails thickened or crumbling  Trichophyton mentagrophytes

(onychomycosis) distally  Trichophyton rubrum
 Discolored  Epidermophyton floccusom
 Lusterless
 Usually associated with
Tinea pedis
7. Dermatophytid  Usually sides and flexor  Pruritic vesicular to bullous  No fungi present in lesion
aspects of fingers lesions  May become secondarily
 Palm  Commonly associated with infected with bacteria
 Any site of the body Tinea pedis

Ana Rhea P. Boncales