Dermatophytes

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Species and Classification

  • Three common genii:
    • Epidermophyton
    • Microsporum
    • Trichophyton
  • Three categories: anthropophilic, zoophilic, and geophilic

Presentation

  • Clinical presentation is usually ringworm
    • Most active form in the periphery of the ring
    • Can invade immunocompromised patients, e.g. Majocchi's granuloma and kerion
  • Named by anatomic location
    • Tinea capitis: head
    • Tinea corporis: body
    • Tinea cruris: groin
    • Tinea unguun: nails

Diagnosis

Specimen collection

  • Hair: need the root, with sterile forceps
  • Skin: disinfect with alcohol or sterile water, then scrape the border with a blunt scalpel
  • Nails: alcohol gauze to clean, then scrape subungual debris

Laboratory Testing

  • Direct microscopy: KOH (potassium hydroxide) calcofluor of skin scraping, under UV light
  • Culture with Littman agar w streptomycin, Sabouraud agar with chloram+gent, Sabouraud agar with CG+cyclohexamide
    • Incubate for 2-3 weeks at 30ºC

Indentification

  • Chemical properties
    • Growth at 37ºC
    • Urease production/urea hydrolysis
    • BCP-MSG reaction (important)
    • Hair perforation test
    • Vitamin requirements with trichophyton agars T1 to T7
    • Growth on polished rice grain
  • Colony features
    • Speed of growth
    • Colour on surface
    • Texture
    • Colour on reverse
  • Microscopic features
    • Macroconidia, microconidia, septae