Fungal Skin Diseases
An 8-year-old boy presented with multiple scaly patches with hair loss on the scalp of two months duration. O/E; the hairs in the involved areas were lusterless and easily and painlessly pulled-out of their follicles. It was diagnosed as gray-patch tinea capitis on clinical background and was given oral griseofulvin 20 mg per day in 2 divided doses taken with fatty meals. One month later, a dramatic response was seen and the patient was advised to continue his treatment for further 2 weeks.
A young adult male presented with asymptomatic white-yellowish concretions on axillary hairs. The condition was greatly improved with a topical erythromycin cream.
A 6-month-old female infant presented with red glazed rash involved the groin area including the inguinal flexures. It started as as napkin irritant contact dermatitis with superimposed candidiasis of one month duration. The rash is well-demarcated erythemtous with peripheral scales and many characteristic satellite papules and pustules. KOH smear yielded short wide hyphae and budding candidal cells Nustatin cream plus Hydrocortisone 2.5% cream applied twice daily for 2 weeks have cured the rash.
A 36-year-old house-wife woman presented with an asymptomatic, cosmetically-disfiguring nail discoloration involved all fingernails of many years duration. On examination: yellowish greenish nails’ discoloration particularely at the lateral borders and the base of the nail plates, paronychia and longtudinal split of the middle fingernail of the right hand. Nail clippings with KOH mounting showed fungal hyphae and spores and short budded hyphae and culture on Sabouraud’s agar yielded growth of both Candida albicans and Trichophyton rubrum. A prolonged course of oral Terbinafine (Lamisil) 250 mg single oral daily dose for 4 months gave good result.
A-26 year-old male presented with widely distributed hyperpigmented patches covered with fine scales involved the trunk and proximal parts of the upper extremities of many years duration. Wood’s lamp showed yellow fluorescence over the affected sites.
Hypopigmented pityriasis versicolor is commonly encountered during daily dermatologic practice especially in dark-complexioned individuals during summer time. The neck, chest and upper back are the commonest sites involved. The major concern of most patients is the cosmetic appearance and for some people fear of vitiligo. The current patient is a 21-year-old male presented with relatively large hypopigmented patches on the nape of the neck. On wood’s lamp examination, these patches showed golden yellow fluorescence.
Asymptomatic, scaly hypopigmented patches involved the forarm. KOH smear of scales showed huphae and spores. Treatment with clotrimazole cream twice daily for 4 weeks has vanished the rash.
A 47-year-old woman presented with an itchy, erythematous, scaly plaque with an active border involved most of the lower half of the face of one year duration. The patient had used many topical corticosteroid preparations prescribed by GPs. Of these preparations, clobetasol propionate and betamethasone valerate in cream and ointment bases had been applied for long periods. Each time she noticed partially and transiently improvement on these agents but shortly later deteriorates with extension of the rash. A cure was obtained on oral Griseofulvin 500 mg twice daily for one month.
