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  • Mycoses are divided among 3 forms: superficial, subcutaneous, and deep/systemic.

  • Superficial fungal infection is defined as a dermatophyte infection of keratinized tissues including skin, hair, and nails.

  • Dermatophyte species are contained in 3 genera (Epidermophyton, Microsporum, and Trichophyton), which are further divided according to 3 natural habitats (humans, animals, and soil).

  • Trichophyton is the most common genera isolated in the United States.

  • Trichophyton rubrum is the most common cause of dermatophytosis of the skin.

  • Trichophyton tonsurans is the most common cause of tinea capitis in the United States.

  • Piedra, which consists of white and black forms, is an asymptomatic superficial fungal infection of the hair shaft.

  • Onychomycosis is the name given to dermatophytosis of the nails.

  • Microscopic examination, culture, Wood light evaluation, and histopathology may all be useful in confirming diagnosis.

  • Several topical and oral antifungals are available for effective treatment of dermatophytosis.

  • Infections involving hair bearing skin and nails typically require oral treatment.


Mycoses are divided among 3 forms: (a) superficial, involving stratum corneum, hair, and nails; (b) subcutaneous, involving dermis and/or subcutaneous tissue; and (c) deep/systemic, representing hematogenous spread of organisms including opportunistic pathogens in immunocompromised hosts. This chapter focuses on the superficial mycoses and their patterns of integumentary infections (Table 160-1). Table 160-2 is a glossary of terms used in this chapter.

Table 160-1Patterns of Integumentary Infections by Superficial Mycoses
Table 160-2Glossary of Terms


The kingdom of fungi comprises more than 1.5 million species worldwide. Dermatophytes (the term is derived from the Greek words for “skin plant”) are represented by approximately 40 species divided among the 3 genera Trichophyton, Microsporum, and ...

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