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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
White piedra (or tinea blanca) is a mycosis of the hair caused by several species of fungi in the genus "Trichosporon". It is characterized by soft nodules composed of yeast cells and arthroconidia that encompass hair shafts.
The uncomplicated appearance is that of a number of yellowish, circular, cup-shaped crusts (scutula) grouped in patches like a piece of honeycomb, each about the size of a split pea, with a hair projecting in the center. These increase in size and become crusted over, so that the characteristic lesion can only be seen round the edge of the scab. A mousy odour is often present. Growth continues to take place for several months, when scab and scutulum come away, leaving a shining bare patch destitute of hair. The disease is essentially chronic, lasting from ten to twenty years. It is caused by the growth of a fungus, and pathologically is the reaction of the tissues to the growth.
The fungus was named after a microscopic structure termed "achorion" (a term not used in modern science), seen in scrapings of infected skin, which consists of slender, mycelial threads matted together, bearing oval, nucleated fungal substrate-arthroconidia either free or jointed. This structure is currently called "scutula." The fungus itself is now called "Trichophyton schoenleinii".
During initial infection, the fungal spores would appear to enter through the unbroken cutaneous surface, and to germinate mostly in and around the hair follicle and sometimes in the shaft of the hair.
Favid (of "favus" Latin for "honeycomb" or tinea favosa) is a disease usually affecting the scalp, but occurring occasionally on any part of the skin, and even at times on mucous membranes.
The word “Favid” is more used than French word “favus”, which is close to the Latin etymology.
Tinea imbricata (also known as "Tokelau" and in parts of Indonesia as “Kaskado”) is a superficial fungal infection of the skin limited to southwest Polynesia, Melanesia, Southeast Asia, India, and Central America.The skin lesions are often itchy, and mainly in the torso and limbs. The name is derived from the Latin for "tiled" (imbricata) since the lesions are often lamellar. It is often treated with griseofulvin or terbinafine.
It is associated with "Trichophyton concentricum".
As the common name for this condition implies, it causes itching or a burning sensation in the groin area, thigh skin folds or anus. It may involve the inner thighs and genital areas, as well as extending back to the perineum and perianal areas.
Affected areas may appear red, tan, or brown, with flaking, rippling, peeling or cracking skin.
The acute infection begins with an area in the groin fold about a half-inch across, usually on both sides. The area may enlarge, and other sores may develop. The rash has sharply defined borders that may blister and ooze.
Tinea cruris does have similar symptoms to Inverse psoriasis.
This infection is caused by the fungus formerly classified as "Exophiala werneckii", but more recently classified as "Hortaea werneckii". The causative organism has also been described as "Phaeoannellomyces werneckii".
Lesions of erythrasma are initially pink, but progress quickly to become brown and scaly (as skin starts to shed), which are sharply distinguished. Erythrasmic patches are typically found in moist and intertriginous areas (skin fold areas—e.g. armpit, groin, under breast) and can be well-defined patches or irregular. The most common is interdigital erythrasama, which is of the foot, and may present as a scaling, fissuring, and chronic non-resolving break down of the toe web interspaces.The slightly webbed spaces between toes, or other body region skin folds, make it difficult to distinguish from various Tinea. The patient is commonly otherwise asymptomatic.
The dry scaling appearance is most noticeable during the winter as a result of dry air inside people's homes. During the summer, tanning of the surrounding normal skin makes the pale patches of pityriasis alba more prominent.
Individual lesions develop through 3 stages and sometimes are itchy:
1. Raised and red – although the redness is often mild and not noticed by parents
2. Raised and pale
3. Smooth flat pale patches
Lesions are round or oval raised or flat, of 0.5–2 cm in size although may be larger if they occur on the body (up to 4 cm), and usually number from 4 or 5 to over 20. The patches are dry with very fine scales. They most commonly occur on the face (cheeks), but in 20% appear also on the upper arms, neck, or shoulders.
The diagnostic differential should consider tinea and vitiligo amongst other causative factors.
Diagnosis of tinea nigra causing fungus is made on microscopic examination of skin scrapings, mixed with potassium hydroxide (KOH). The KOH the nonfungal debris.
It may have a variety of appearances; most easily identifiable are the enlarging raised red rings with a central area of clearing (ringworm). The same appearances of ringworm may also occur on the scalp (tinea capitis), beard area (tinea barbae) or the groin (tinea cruris, known as jock itch or dhobi itch).
Other classic features of tinea corporis include:
- The edge of the rash appears elevated and is scaly to touch.
- Sometimes the skin surrounding the rash may be dry and flaky.
- Almost invariably, there will be hair loss in areas of the infection.
Infections on the body may give rise to typical enlarging raised red rings of ringworm. Infection on the skin of the feet may cause athlete's foot and in the groin, jock itch. Involvement of the nails is termed onychomycosis, and they may thicken, discolour, and finally crumble and fall off. They are common in most adult people, with up to 20% of the population having one of these infections at any given moment.
Animals such as dogs and cats can also be affected by ringworm, and the disease can be transmitted between animals and humans, making it a zoonotic disease.
Specific signs can be:
- red, scaly, itchy or raised patches
- patches may be redder on outside edges or resemble a ring
- patches that begin to ooze or develop blister
- bald patches may develop, when the scalp is affected
- nails may thicken, discolour or begin to crack
Erythrasma is a superficial skin infection that causes brown, scaly skin patches. It is caused by "Corynebacterium minutissimum," a normal part of skin flora (the microorganisms that are normally present on the skin).
There are two types of erythrasma: generalized and interdigital. Interdigital is the most common bacterial infection of the feet and normally does not show any symptoms. Not only is this an aesthetically unappealing condition, but there is evidence to support that disciform erythrasma can be an early sign of type 2 diabetes mellitus. The generalized erythrasma is most commonly seen in Diabetes mellitus type 2 where the lesions go beyond the areas of the body where skin is rubbing together. It is prevalent among diabetics and the obese, and in warm climates; it is worsened by wearing occlusive clothing.
The presence of erythrasma is approximately 4% and is more likely to be found in the subtropical and tropical areas compared to the rest of the world. It is found more commonly in African Americans due to the darker skin and even though both sexes are affected, it is usually found more frequently in males for the thigh and leg regions. A great contributor to this infection is a weakened immune system which comes with aging, therefore the elderly are more susceptible to this disease than the young; this does not mean the young cannot be affected. The epidemiology background of erythrasma remains partially unsolved.
The most common symptom of a fungal nail infection is the nail becoming thickened and discoloured: white, black, yellow or green. As the infection progresses the nail can become brittle, with pieces breaking off or coming away from the toe or finger completely. If left untreated, the skin underneath and around the nail can become inflamed and painful. There may also be white or yellow patches on the nailbed or scaly skin next to the nail, and a foul smell. There is usually no pain or other bodily symptoms, unless the disease is severe. People with onychomycosis may experience significant psychosocial problems due to the appearance of the nail, particularly when fingers – which are always visible – rather than toenails are affected.
Dermatophytids are fungus-free skin lesions that sometimes form as a result of a fungus infection in another part of the body. This could take the form of a rash or itch in an area of the body that is not infected with the fungus. Dermatophytids can be thought of as an allergic reaction to the fungus.
Pityriasis rotunda (also known as "Pityriasis circinata" and "Tinea circinata") is a disorder of keratisation of the skin that manifests as a perfectly circular, scaly patches on the torso and proximal portions of the extremities. It may be associated with diseases like hepatocellular carcinoma in racially predisposed groups.
The most common term for the infection, "ringworm", is a misnomer, since the condition is caused by fungi of several different species and not by parasitic worms.
In both healthy and immunocompromised hosts, Majocchi's granuloma often presents as nodules and papules on areas that are most exposed to mechanical abuse—wear and tear—such as the upper and lower extremities. Patients will complain about papules, pustules, or even plaques and nodules at the site of infection. The papules will be pink-red and will be located in a perifollicular location. Hair shafts can be easily removed from the pustules and papules. Itching is also very common. Firm or fluctuant subcutaneous nodules or abscesses represent a second form of MG that is generally observed in immunosuppressed hosts. Nodules may develop in any hair-bearing part of the body but are most often observed on the forearms, hands, and legs of infected individuals. Involvement of the scalp and face is rarely observed. Lesions start as solitary or multiple well-circumscribed perifollicular papulopustules and nodules with or without background erythema and scaling. In rare circumstances, the lesions may have keloidal features.
Pityriasis alba is a common skin condition mostly occurring in children and usually seen as dry, fine-scaled, pale patches on the face. It is self-limiting and usually only requires use of moisturizer creams.
The condition is so named for the fine scaly appearance initially present (pityriasis) and the pallor of the patches that develop (while "alba" is Latin for white, the patches in this condition are not totally depigmented).
Onychomycosis, also known as tinea unguium, is a fungal infection of the nail. This condition may affect toenails or fingernails, but toenail infections are particularly common.
Treatment may be based on the signs. Treatment may be with the medication terbinafine.
It occurs in about 10 percent of the adult population. It is the most common disease of the nails and constitutes about half of all nail abnormalities.
The term is from Ancient Greek ὄνυξ "ónux" "nail", μύκης "múkēs" "fungus" and -ωσις "ōsis" "functional disease."
Pityriasis amiantacea (also known as "Tinea amiantacea") is an eczematous condition of the scalp in which thick tenaciously adherent scale infiltrates and surrounds the base of a group of scalp hairs. It does not result in scarring or alopecia.
Pityriasis amiantacea was first described by Alibert in 1832. Pityriasis amiantacea affects the scalp as shiny asbestos-like (amiantaceus) thick scales attached in layers to the hair shaft. The scales surround and bind down tufts of hair. The condition can be localised or covering over the entire scalp. Temporary alopecia and scarring alopecia may occur due to repeated removal of hairs attached to the scale. It is a rare disease with a female predilection.
Pityriasis amiantacea can easily be misdiagnosed due its close resemblance to other scalp diseases such as psoriasis, seborrhoeic dermatitis or lichen planus. However in pityriasis amiantacea the scales are attached to both the hair shaft and the scalp. Pityriasis amiantacea may be present with other inflammatory conditions such as atopic dermatitis or seborrhoeic dermatitis and sebaceous scales and alopecia can occur. According to the dermatology text Bolognia this condition is most often seen in psoriasis, but may also be seen in secondarily infected atopic dermatitis, seborrheic dermatitis, and tinea capitis.
There may be loss of hair as hair will come out easily. Sometimes, there is growth of organisms. Lymph and fever symptoms may be present. This condition can be mistaken for a case of impetigo.
Fungal folliculitis (also known as Majocchi granuloma) is a skin condition characterized by a deep, pustular type of tinea circinata resembling a carbuncle or kerion.
Tinea cruris, also known as crotch itch, crotch rot, Dhobi itch, eczema marginatum, gym itch, jock itch, jock rot, scrot rot and ringworm of the groin is a dermatophyte fungal infection of the groin region in any sex, though more often seen in males.
Tinea corporis (also known as ringworm, tinea circinata, and tinea glabrosa) is a superficial fungal infection (dermatophytosis) of the arms and legs, especially on glabrous skin; however, it may occur on any part of the body. It is similar to other forms of tinea.
The bacteria staphylococci are present in the majority of cases. Treatment with systemic antibiotics and coal tar shampoo can completely clear the condition when Staphylococcus aureus bacteria are found. Fungal infections such as tinea capitis are known to mimic the symptoms of the condition and can be cleared with antifungal treatment.
Tinea capitis (also known as "herpes tonsurans", "ringworm of the hair", "ringworm of the scalp", "scalp ringworm", and "tinea tonsurans") is a cutaneous fungal infection (dermatophytosis) of the scalp. The disease is primarily caused by dermatophytes in the "Trichophyton" and "Microsporum" genera that invade the hair shaft. The clinical presentation is typically single or multiple patches of hair loss, sometimes with a 'black dot' pattern (often with broken-off hairs), that may be accompanied by inflammation, scaling, pustules, and itching. Uncommon in adults, tinea capitis is predominantly seen in pre-pubertal children, more often boys than girls.
At least eight species of dermatophytes are associated with tinea capitis. Cases of "Trichophyton" infection predominate from Central America to the United States and in parts of Western Europe. Infections from "Microsporum" species are mainly in South America, Southern and Central Europe, Africa and the Middle East. The disease is infectious and can be transmitted by humans, animals, or objects that harbor the fungus. The fungus can also exist in a carrier state on the scalp, without clinical symptomatology. Treatment of tinea capitis requires an oral antifungal agent; griseofulvin is the most commonly used drug, but other newer antimycotic drugs, such as terbinafine, itraconazole, and fluconazole have started to gain acceptance.