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== Introduction<br> ==

== Introduction  ==

Dermatophytes are pigmented, saprophytic organisms called Phaeohyphomycetes and were previously called 'Fungi Imperfecti'. The two main species of veterinary interest are ''Microsporum'' and ''Trichophton ''and these are found worldwide.<br>

Dermatophytes are pigmented, saprophytic organisms called Phaeohyphomycetes and were previously called 'Fungi Imperfecti'. The two main species of veterinary interest are ''Microsporum'' and ''Trichophton ''and these are found worldwide.  

They are usually secondary invaders and are able to penetrate all layers of [[Skin - Anatomy & Physiology|skin]], but are generally restricted to the keratin layer and its appendages.&nbsp;Therefore the condition is most often seen in subcuticular or cutaneous sites. A lack of tolerance to body temperature and antifungal activity in serum and body fluids prevent the fungi invading subcutaneously. Secondary invasion by Staphylococcus aureus and Staphylococcus intermedius are common and cause pustules in the hair follicles. Epidermal hyperplasia then follows with inflammation.<br>

They are usually secondary invaders and are able to penetrate all layers of [[Skin - Anatomy & Physiology|skin]], but are generally restricted to the keratin layer and its appendages. Therefore the condition is most often seen in subcuticular or cutaneous sites. A lack of tolerance to body temperature and antifungal activity in serum and body fluids prevent the fungi invading subcutaneously. Secondary invasion by ''[[Staphylococcus aureus]]'' and ''[[Staphylococcus intermedius]]'' are common and cause pustules in the hair follicles. Epidermal hyperplasia then follows with inflammation.

Dermatophytes are transmitted by direct or indirect contact e.g. on brushes, fomites etc. Signs vary in severity, but immunuocompromised hosts may develop systemic infections.  

Dermatophytes are transmitted by direct or indirect contact e.g. on brushes, fomites etc. Signs vary in severity, but immunocompromised hosts may develop systemic infections.  

There are certain types of dermatophytes: Microsporum is zoophilic and so parasites of animals, Trichophyton is geophilic and inhabits soil but will also parasitise animals. Epidermophyton is anthropophilic and so is a parasite of people. <br>

There are certain types of dermatophytes: ''Microsporum'' is zoophilic and so parasites of animals, ''Trichophyton'' is geophilic and inhabits soil but will also parasitise animals. ''Epidermophyton'' is anthropophilic and so is a parasite of people.  

Microsporum canis is the most common dermatophyte to infect small animals and will be the cause of&nbsp; 90% of feline infections and 60% of canine infections. Trichophyton mentagrophytes affects around 30% of daogs, especially Terrier breeds. Trichophyton verrucosum causes most cases in cattle and sheep and Trichophyton equinum is the commonest cause in horses.<br>

''Microsporum canis'' is the most common dermatophyte to infect small animals and will be the cause of 90% of feline infections and 60% of canine infections. ''Trichophyton mentagrophytes'' affects around 30% of dogs, especially Terrier breeds. ''Trichophyton verrucosum'' causes most cases in cattle and sheep and ''Trichophyton equinum'' is the commonest cause in horses.

== Clinical Signs<br> ==

== Diagnosis ==

There will be a presence of circular or irregular lesions (dependent on infectant organism) and these may coalesce. There will be scaly and crusty patches and alopecia in these areas due to broken hair shafts and hairs lost from inflammed regions of skin. Follicular papules and pustules will also be present. There will be a peripheral red ring (rignworm) due to dead fungi in areas of inflammation at centre of lesions and viable fungi peripherally. There is usually a varying degree of pruritus. <br>

Clinical signs are characteristic of the disease. '''Wood's Lamp''' can be used to shine UV light onto the lesion and it will fluoresce in 50% of cases (if ''Microsporum'' fungi are present). Therefore it is a good diagnostic tool in small animals but is not incredibly reliable. If there is no fluoresence, it does not mean there are no dermatophytes or no ''Microsporum''.  

Clinical signs are characteristic of the disease. Wood's Lamp can be used. Here, UV light is shined onto th lesion and it will fluoresce 50% if Microsporum fungi are present. Therefore it is a good diagnostic tool in small animals but is not incredibly reliable. Ifnot fluoresence, it does not mean there is no dermatophytes or no Microsporum.

A '''biopsy''' can also be taken and examined histologically. Signs will include epidermal hyperplasia (hyperkeratosis, parakeratosis, acanthosis) and inflammation.

 

 

Sabouraud's Dextrose agar containing cyclohexamide and chloramphenicol can be used to culture the dermatophyte at room temperature for a month. <br>

 

A biopsy can also be taken and examined histologically. Signs will include epidermal hyperplasia (hyperkeratosis, parakeratosis, acanthosis) and inflammation  

 

== Treatment  ==

== Treatment  ==

The affected animal should be isolated and precautions should be taken to prevent human infection, such as wearing gloves. Hair should be clipped around the skin lesions.<br>

The affected animal should be isolated and precautions should be taken to prevent human infection, such as wearing gloves. Hair should be clipped around the skin lesions.

[[Antifungal Drugs#Griseofluvin|Griseofulvin]] is the best method of systemic treatment, however it can be expensive and prolonged oral treatment may be required. Griseofulvin is no longer licensed for small animals but has been used for many years with useful results. Typical dose is 25-50 mg/kg in divided doses for 2 weeks after clinical and mycological cure. Griseofulvin is teratogenic and contra-indicated in pregnancy. Haematological side effects have been reported, including neutropenia in FIV-positive cats. Owners handling tablets must wear gloves. <br>

[[Antifungal Drugs]]:

Itraconazole is now licensed for cats in the U.K. (Itrafungol, Janssen). The manufacturers suggest 3 cycles of therapy, one week on, one week off, reflecting the lipophilic properties of the drug that leads to its persistence in the stratum corneum. Laboratory infection models of M. canis infection in kittens have shown that griseofulvin and itraconazole have comparable efficacy. <br>

[[Antifungal Drugs#Griseofluvin|'''Griseofulvin''']] is the best method of systemic treatment, however it can be expensive and prolonged oral treatment may be required. Griseofulvin is no longer licensed for small animals but has been used for many years with useful results. The treatment is continued for 2 weeks after clinical and mycological cure. Griseofulvin is teratogenic and contra-indicated in pregnancy. Haematological side effects have been reported, including neutropenia in [[FIV]]-positive cats. Owners handling tablets must wear gloves.  

Apply topical therapy. Topical therapy alone is unlikely to shorten the course of disease because the agents do not penetrate into infected hairs. However, it does assist in removal of surface organisms and reduces environmental contamination. Enilconazole (Imaverol) is licensed for use in dogs and should be applied every three days, in conjunction with systemic therapy. Fatal idiosyncratic reactions have been reported in cats treated with enilconazole. A miconazole + chlorhexidine shampoo (Malaseb, VetXX) is helpful in cats and dogs, and is licensed in the former species for use in conjunction with griseofulvin. <br>

'''Itraconazole''' is now licensed for cats in the U.K. (Itrafungol, Janssen). The manufacturers suggest 3 cycles of therapy, one week on, one week off, reflecting the lipophilic properties of the drug that leads to its persistence in the stratum corneum. Laboratory infection models of ''M. canis'' infection in kittens have shown that griseofulvin and itraconazole have comparable efficacy.  

 

 

== Image Gallery  ==

== Image Gallery  ==

[[Image:Microsporum canis lesions.jpg|thumb|right|100px|<small><center><i>Microsporum canis</i> alopecia and scaling lesions (Courtesy of Bristol BioMed Image Archive)</center></small>]] [[Image:Ringworm dog.jpg|thumb|right|100px|<small><center>Ringworm in a dog (Courtesy of Bristol BioMed Image Archive)</center></small>]] [[Image:Trichophyton mentagrophytes dog.jpg|thumb|right|100px|<small><center>Trichophyton mentagrophytes in a dog (Courtesy of Bristol BioMed Image Archive)</center></small>]]  

[[Image:Microsporum canis lesions.jpg|thumb|right|100px|<small><center><i>Microsporum canis</i> alopecia and scaling lesions (Courtesy of Bristol BioMed Image Archive)</center></small>]] [[Image:Ringworm dog.jpg|thumb|right|100px|<small><center>Ringworm in a dog (Courtesy of Bristol BioMed Image Archive)</center></small>]] [[Image:Trichophyton mentagrophytes dog.jpg|thumb|right|100px|<small><center>Trichophyton mentagrophytes in a dog (Courtesy of Bristol BioMed Image Archive)</center></small>]]  

== Test yourself with the Dermatophytosis Flashcards  ==

== Test yourself with the Dermatophytosis Flashcards  ==

[[Dermatophytosis - Flashcards|Dermatophytosis Flashcards]]  

[[Dermatophytosis - Flashcards|Dermatophytosis Flashcards]]  

== References<br> ==

== References ==

 

 

 

 

Foster, A, and Foll, C. (2003) BSAVA small animal dermatology (second edition) British Small Animal Veterinary Association<br>Merck &amp; Co (2008) The Merck Veterinary Manual (Eighth Edition) Merial<br>Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier. <br>Quinn, P.J., Markey, B.K., Carter, M.E., Donnelly, W.J., Leonard, F.C. (2007) Veterinary Microbiology and Microbial Disease Blackwell Publishing<br>Radostits, O.M, Arundel, J.H, and Gay, C.C. (2000) Veterinary Medicine: a textbook of the diseases of cattle, sheep, pigs, goats and horses Elsevier Health Sciences<br>Tilley, L.P. and Smith, F.W.K.(2004)The 5-minute Veterinary Consult (Third edition) Lippincott, Williams &amp; Wilkins. <br>

Radostits, O.M, Arundel, J.H, and Gay, C.C. (2000) '''Veterinary Medicine: a textbook of the diseases of cattle, sheep, pigs, goats and horses''''' Elsevier Health Sciences''

[[Category:To_Do_-_Review]] [[Category:Dermatological_Diseases_-_Dog]] [[Category:Cutaneous_Mycoses]]

[[Category:Expert_Review]] [[Category:Dermatological_Diseases_-_Dog]] [[Category:Dermatological_Diseases_-_Cat]][[Category:Dermatological_Diseases_-_Horse]][[Category:Dermatological_Diseases_-_Cattle]][[Category:Dermatological_Diseases_-_Sheep]][[Category:Cutaneous_Mycoses]]