Tinea

Etiologia:
  • Dermatófitos
      • 💡
      • A keratophilic fungi that infects skin, hair, nails
    • Antigamente pensava-se que eram 3 géneros. Agora são 9:
      • Microsporum, Epidermophyton, Trichophyton
      • Arthroderma, Laphophyton, Nannizzia, Guarromyces, Parophyton +1
    • Dermatófitos, ao contrário da maioria dos outros fungos, produzem keratinases, que permitem a invasão dos fungos no tecido queratinizado.
    • Mannans (PAMPs - pathogen associated microbial patterns) in the cell walls of dermatophytes have immune-inhibitory effects
    • Transmissão:
        • Antropofílico
        Geofílico
        Zoofílico
        Humano para humano
        Solo para humano ou animal
        Animal para humano
        Inflamação ligeira, crónica
        Causa epidemias
        Inflamação moderada
        Inflamação intensa (pústulas, vesículas), agudo
        T. rubrum

        E. floccosum
        M. audouinii
        M. ferrugineum
        T. concentricum
        T. megninii
        T. mentagrophytes
        T. schoenleinii
        T. soudanense
        T. tonsurans
        T. violaceum

        Immuno-inhibitory properties: T. rubrum can produce mannans and other substances that inhibit macrophages
        M. gypseum
        M. nanum
        M. vanbreuseghemii
        M. canis

        M. gallinae
        M. nanum
        T. equinum
        T. mentagrophytes
        T. verrucosum
        Legenda: T: Trycophytum; E: Epidermophytum; M: Microsporum
    • Geographic distribution
        • Universal
        Endemic
        T. rubrum
        M. canis
        T. metagrophutes/interdigitae
        T. tonsurans
        E. floccosum
        M. audouinii?
        T. verrucosum
        N. gypseum
        T mentagrophytes genotype VIII (T. indotineae)
        T. violaceum (Africa, Asia [Europe])
        T. gouvilli (C&W Africa)
        T. megninii (Portugal, Sardinia)
        T. concentricum (South Pacific, Asia, Central&South America)
 
Risk Behavior:
  • Wrestlers - tinea gladiatorum from T. tonsurans
    • R/ oral or topical for 72h - is it enough?
  • Swimming pools
    • Can survive in clorinated swiming pool
  • Acquiring a pet
  • Recycling clothes & shoes
  • Potential sexual transmission (sex workes, MSM)
  • Diagnosis
    • Bedside
      • Woodslight (microsporum)
      • Dermoscopy (comma hairs, …)
    • Microbiological
      • Direct microscopy
      • Culture (& resistance)
      • Molecular diagnostic
        • PCR
        • MALDI-tof
 
Treatment according to species
  • Oral
    • Terbinafine (for tricophytum)
    • Griseofulvin (microsporum)
    • Itraconazol (for both)
    • Increasing terbinafine resistance for T. Indotineae
  • Topical antimycotics
  • Other
    • Disinfection
    • Source of infection
      • notion image
 
Tineas topográficas
Tinea faciei
Tinea Barbae (not sycosis barbae)
Tinea Capitis
Tinea Cruris
Tinea Pedis
Tinea Manuum
Onychomycosis
Tinea corporis
 
Outras tineas
Tinea inflamatória
Tinea Incógnita
Tinea Majochi