15- Fungi And Yeasts (Superficial) Flashcards
Black dot ringworm, seborrheic like scaling and inflammatory kerion
This organism in tinea capitis produces spores WITHIN the hair shaft
Do not produce fluorescence in Wood’s lamp
Trichophyton tonsurans
Organism in tinea capitis that produce spores OUTSIDE the hair shaft
Fluoresce under Wood’s lamp
Scaly, erythematous papules with loose and broken off hairs
Microsporum canis
Deep tender boggy plaques exuding pus in tinea capitis
Scarring, permanent alopecia
Kerion celsii
Appears chiefly on scalp but may affect glabrous skin and nails
Scalp- concave yellow sulfur crusts around loose wiry hairs
Atrophic scarring- glossy smooth white patch
Glabrous skin- cup shaped crusts with mousy odor
Favus
Cup shaped crusts usually pierced by a hair on skin with a distinctive mousy odor in tinea infection
Scutulae
Infected tinea hairs will fluoresce what color in Wood’s light?
Bright green or yellow green
Trichophyton- does not fluoresce
Treatment for tinea capitis in children
Griseofulvin 10mg/kg/day
2-4 months
Treatment for trichophyton infections in tinea
Terbinafine 3-6mg/kg/day x 1-4 weeks
Adjunct: selenium sulfide shampoo or ketoconazole shampoo 5 mins 3x a week
Tinea barbae is different from staphylococcal folliculitis (sycosis vulgaris) by
Sparing of upper lip
Unilateral involvement
Circular, sharply circumscribed, slightly erythematous, dry, scaly hypopigmented patches
Progressive central clearing
Found in the body except in face, scalp, beard, hands, feet and groin
Tinea corporis
Treatment for tinea corporis
Topical- miconazole, clotrimazole BID X 2-4 weeks
ketoconazole, terbinafine- OD
Terbinafine- 1 week
Systemic- trichophyton: griseofulvin, terbinafine, fluconazole
Deep pustular tinea circinata resembling a carbuncle or kerion on glabrous skin
Follicles distended with purulent material
Most often on shin or wrist
Fungal folliculitis
Majocchi granuloma
Tinea incognito is an atypical lesion that are widespread and may lack an advancing scaly border
It is usually caused by
Treatment with topical corticosteroid or calcineurin inhibitors
Infection of the nail plate by a fungus is called
Onychomycosis
Tinea unguium
Onychomycosis caused by what organism?
Starts at distal corner of the nail and involves the junction of the nail and bed
Yellow discoloration, spreads proximally
Nail becomes brittle
T. rubrum
Treatment of onychomycosis
Terbinafine 250mg/day x 6-8 weeks
Toenails- 12-16 weeks
Itraconazole, fluconazole
Side effect that should be noted when using itraconazole and terbinafine, ketoconazole
Hepatotoxicity
Grayish white membranous plaques found on the surface of the mucous membrane
Base is moist reddish and macerated
Often first manifestation of AIDS
Oral candidiasis (thrush)
Treatment for oral thrush
Fluconazole 150mg single dose
Maceration and transverse fissuring of the oral commissures
Bilateral involvement
Perlèche (angular cheilitis)
Pruritic intertriginous eruptions between folds
Pink to red moist patches surrounded by a colarette scale
Candidal intertrigo
Candidal intertrigo treatment
Topical anticandidal ( clotrimazole, ketoconazole, miconazole, nystatin, terbinafine)
+ topical midstrength steroid
Treatment for diaper candidiasis
Topical anticandidal agents
Zinc oxide- barrier against urine
Infection with Candida limited to mucosal surfaces, skin and nails
Onset before 6 years old
Hyperkeratotic, horn like or granulomatous lesions
Chronic mucocutaneous candidiasis
Gold standard for systemic candidiasis treatment
Amphotericin B
Common in tropics
Brown or black spots on palms and soles, may be mistaken for nevi
Common in the tropics
Pigment confined to stratum corneum and scrapes of easily
Tinea nigra
Dark pinhead to pebble sized formations on the hairs of scalp, brows, lashes or beard
Distributed irregularly on the hair shaft
Black piedra
Yellow or beige colored soft slimy sheath coating the hair shaft caused by trichosporon
White piedra
Treatment for piedra
Cutting/ shaving hair
Black- oral and topical terbinafine
White- oral itraconazole, topical imidazoles
Hypo or hyperpigmented coalescing scaly macules on the trunk and upper arms
Favors oily areas of the skin, occurs during summer
Mild itching and inflammation around patches
Tinea versicolor
Treatment for tinea versicolor
Selenium sulfide lotion 10mins daily x 1 week
Zinc pyrithione soap
Ketoconazole
Oral itraconazole 200mg OD X 7 days
