主要致口病性真菌.pptVIP

浅部感染真菌 表面感染真菌 皮肤癣真菌 皮下组织真菌感染 表面感染真菌 位置：寄居于人体皮肤和毛干的最表层。因不接触组织细胞，很少引起宿主细胞反应 统称：角层癣菌 代表：秕糠马拉癣菌(Malassezia furfur) 症状：由于此菌能产生对黑色素细胞有抑制作用的二羧酸，使花斑癣局部色素减退，如汗渍斑点，俗称汗斑。 诱发因素为高温多汗 Malassezia furfur Tinea versicolor on skin surface (sweat stain) The lesions are small hypopigmented or hyperpigmented macules Most common site : back, underarm, upper arm, chest, neck Most common in adolescent and young adult males Associated with increased sweating Piedraia hortae (何德毛结节菌) It usually affected the scalp hair The nodules are darker in color, harder, and more firmly attached to the hairs Black Piedra Fungal otitis externa Fungal infection of the external auditory canal Caused by several species of Aspergillus (most often A.niger), but Candida albicans is also capable of infecting this site The major symptoms are itching and feeling of fullness in ear 皮肤癣真菌 引起皮肤浅部感染 皮肤癣是人类最多见的真菌病 统称：皮肤癣菌，大约40多个种，分属于3个属 嗜角质蛋白，37℃不能生长，侵犯部位：角化的表皮，毛发，指（趾）甲 病理变化：由真菌增殖及代谢产物刺激宿 主引起 致病性 指（趾）甲 皮肤 毛发 毛癣菌属 + + + 表皮癣菌属 + + - 小孢子癣菌属 - + + 手足癣－治疗原则 水疱型－温和搽剂和霜剂 角化过度型－先角质剥脱剂，再用抗真菌霜剂 浸渍糜烂型－粉剂收干，抗继发感染，再温和抗真菌 Tinea Unguium usually caused by Trichophyton sp 甲癣－治疗原则 局部治疗－甲涂剂 系统治疗－伊曲康唑，特比萘芬等 联合治疗－配合拔甲或削甲治疗 Tinea Corporis:caused by M. canis, following contact with infectious kittens Tinea Cruris (Jock itch):Infection of the groin, mainly seen in men Tinea Capitis (scalp ringworm) Tinea Capitis (scalp ringworm) Tinea Capitis (scalp ringworm) 头癣－治疗原则 Candidiasis of skin, mucous membranes and nails Predisposing factors Infancy, pregnancy, old age Disorders of immune function, e.g., leukemia, corticosteroid therapy Chemotherapy, e.g., immunosuppressive, antibiotic Endocrine disease, e.g., diabetes mellitus Carcinoma 念珠菌性间擦疹 Cutaneous candidiasis : including Interdigital candidiasis, diaper candidiasis, paronychia and onychomycosis V