00:02
We finally get in to the topic
of what’s known as tinea.
00:04
Now what does tinea mean to you?
It is fungi, but these
fungi are of the skin.
00:10
So therefore, these are superficial
type of dermatophytosis.
00:14
Fungal infection of dermatophytes.
00:16
In other words, of the skin.
00:18
There are particular organisms
that you want to keep in mind,
and at this point, I would ask you
to hone in on tricophyton, please.
00:26
Yes, you have
microsporum as well,
but tricophyton is something
that I need you to focus on
or at least know the
suffix, -phyton.
00:35
Organisms are capable of using
keratin as its source of energy.
00:41
Now, what are all the different tineas?
Now, we’ve mentioned tinea
a few times already.
00:45
We talked about tinea
affecting the scalp.
00:47
It’s called tinea capitis.
00:49
We’ve talked about how tinea
could affect the body.
00:51
It’s called tinea corporis.
00:53
Now, the common tineas that
we have in the U.S. include
athlete’s foot, jock itch,
maybe underneath the nail.
01:00
So therefore, we have tinea
unguium, tinea inguinal,
and we have tinea that would affect
your toes, so therefore, tinea pedis.
01:10
Let’s take a look.
01:11
So tinea infection further classified by
what part of the body’s been affected.
01:16
If it’s the scalp, the capitis.
01:19
Put a cap on your scalp.
01:20
If it’s corporis, the body, often
referred to in layman's terms as ringworm
and has nothing to
do with the worm.
01:28
What’s my causative agent?
A fungus.
01:32
And you have tinea
pedis, being the feet.
01:34
Please don’t forget that you
could also have tinea cruris,
which will be the jock itch
or in the inguinal region.
01:42
And then you can also have
what’s known as tinea versicolor
that you talked about in micro which
means that you have various colors,
and by that, I mean, it would
be areas that are hypopigmented
and areas that are hyperpigmented.
01:57
And if you remember from micro,
the name of that organism is –
“I want to call my
grandson Malassezia
and my I’m going to call
my granddaughter furfur.”
Malassezia furfur.
02:09
Can you even believe these are some
of the names of your organisms?
Tinea versicolor.
02:15
With infections, it varies
a bit with the location.
02:20
Well-demarcated annular plaque, with
an active scaling, scaling, scaling.
02:25
Lesions are often intensely pruritic,
let it be the head, let it be –
Think about the areas.
02:30
You have an athlete who might
be sweating quite a bit.
02:34
So therefore you can expect there
to be tinea pedis or tinea cruris,
either jock itch
or athlete’s foot.
02:40
I also told you about
tinea unguium.
02:42
All the different places where you could
have the tinea infection with the capitis.
02:49
Here, if we take a
look at the picture,
you’ll notice that we
have it between the toes.
02:55
So obviously, this has
to be tinea pedis.
02:58
Organism for the most part that you’re
thinking about is trichophyton.
03:02
The one exception was a
tinea versicolor in which –
“I’m naming my grandson Malassezia,
and my granddaughter furfur.”
Or was it the other way around?
Whatever.
03:12
You get the point.
03:14
I want you to take a look
at this patch of scalp here
in which the hair has been lost.
03:18
So there’s alopecia.
03:20
However, this has nothing to
do with autoimmune disease,
which means that this
rules out which alopecia?
Alopecia areata, right?
What if there’s hair that was complete lost
on the entire scalp and is autoimmune?
That is called alopecia totalis.
03:36
If it’s the entire body,
that’s called universalis.
03:41
Out topic is tinea capitis.
03:43
It’s a fungal infection, superficial
dermatomycosis or dermatophytosis.
03:50
And there’s alopecia taking
place in which literally,
the shaft of the hair is
going to then break off.
03:57
Look for that description.
03:59
Look for black dots in the patch
of the alopecia, which means what?
If you take a look at the
details in this patch here,
you’ll find that black dots referring
to the fact that the shaft
was then broken off.
04:12
Diagnosis would be KOH
and most commonly here,
will be Trichophyton tonsurans.
04:20
Tinea infection on KOH.
04:22
Well, if you are thinking
about finding the organism,
you would find these hyphae.
04:27
So let’s say that you’re
dealing with KOH prep,
and you’re suspecting
tinea capitis,
then you would find the hyphae as
being your organism, Trichophyton.
04:37
Management:
Ketoconazole,
oral antifungals if the infection is refractory to topical treatment.