Antifungals, Dermatophyte infections, Threadworms

Question 1

Dermatophyte infections

Answer 1

Skin, Hair or Nail infections - fungal origin.
- NAIL - (EXAM Q) OTC referral eg 3 infected nails.

Waqar PPT on OTC conditions - check drugs

Risk factors:
Diabetes, HIV (immunocompromised), poor circulation, peripheral arterial disease.
- refer diabetics.

Question 2

Topical Vs Oral Antifungals

Answer 2

Topical for more localised skin infections.

Systemic IF:
- Topical Fails
- Many affected areas
- Site of infection difficult to reach eg nails/scalps
- Oral TERBINAFINE & ITRACONAZOLE (broad spec) preferred over griseofulvin
- Tinea capitis usually treated systemically with additional topical. (reduces transmission risk)

Question 3

Helminth (worm) Infections

Answer 3

Threadworms
Anthelminthics - Effective

Combine with hygiene measure as very contagious

Treat ALL family members

MEBENDAZOLE [Ovex] (PTs>6months age)
- Single dose of 100mg
- 2nd dose may be given after 2 weeks to prevent reinfection
- Can be sold OTC for over 2 yrs old should supply <800mg

Whipworm/Hookworm
>1 yrs and up:
100mg BD 3 days

Roundworm
1yrs 100mg BD 3 days
2 yrs +: 100mg BD 3 days
ALT 500mg 1 dose