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Dermatology 1 > Candidiasis > Flashcards

Candidiasis Flashcards

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Dermatology Board Prep flashcards
1
Q

What is candidiasis?

A

Group of yeast infections, usually C. albicans

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2
Q

Where is C. albicans found?

A

often part of normal flora in the mouth, GI tract, and vagina

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3
Q

Risk factors for candidiasis?

A
  • neonates and adults >65 yo
  • pregnancy
  • occlusion of epithelial surfaces
  • warm/humid environment
  • immunodeficiency
  • diabetes
  • obesity
  • use of medications such as oral glucocorticoids and antibiotics
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4
Q

Which species is MCC (most common cause) of fungal infection?

A

Candida sp.

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5
Q

What will you see on KOH prep?

A

budding yeast and pseudohyphae (strings of connected budding cells)

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6
Q

Define mucocutaneous candidiasis

A

Acute pseudomembranous candidiasis or thrush- MC form of oral candidiasis

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7
Q

What are predisposing factors of mucocutaneous candidiasis?

A
  • diabetes mellitus
  • systemic steroid (topical also) and antibiotic use
  • pernicious anemia
  • malignancy
  • radiation to head and neck
  • cell-mediated immunodeficiency
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8
Q

How does oral candidiasis present?

A
  • often asymptomatic

- burning or pain on eating spices/acidic foods, diminished taste sensation

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9
Q

Oral candidiasis on PE

A
  • discrete white patches on the buccal mucosa, tongue, palate, gingivae, and pharynx extending down into the esophagus and tracheobronchial tree
  • removal of pseudomembrane with a dry gauze leaves erythematous mucosal surface
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10
Q

What is atrophic candidiasis?

A
  • on tongue, depapillated atrophic patches with minimal pseudomembrane formation
  • most often in the setting of broad-spectrum antibiotic or systemic glucocorticoid therapy and human immunodeficiency virus infection
  • denture stomatitis- 24%–60% of denture wearers
  • chronic erythema and edema of the palatal mucosal surface in contact with the dentures
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11
Q

Tx of mucocutaneous candidiasis

A
  • for mild to moderate infections in the mouth or throat: nystatin or fluconazole in form of lozenges or a liquid to swish and swallow for 7 to 14 days
  • for severe infections or immunocompromised- usually oral fluconazole
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12
Q

Explain the angular cheilitis/ candidal cheilosis/ perleche

A
  • erythema, fissuring, maceration, and soreness at the angles of the mouth.
  • white colonies of candida at time
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13
Q

Who is at risk for angular cheilitis/ candidal cheilosis/ perleche?

A
  • habitual lip lickers and in elderly patients with deeper furrows at the oral commissures
  • loss of dentition, poorly fitting dentures, malocclusion, andriboflavindeficiency also predispose
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14
Q

Tx of angular cheilitis/ candidal cheilosis/ perleche

A
  • tx with both topical antifungal and mild topical steroid.
  • emphasize very frequent application of emollient ointment
  • tx vitamin deficiencies if present
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15
Q

What are the risk factors for vaginal and vulvovaginal candidiasis?

A
  • systemic antibiotic or steroid use
  • diabetes mellitus
  • presence of an intrauterine device
  • wearing of tight-fitting and synthetic clothing
  • immunosuppression
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16
Q

How does vaginal/vulvovaginal candidiasis occur?

A

Disruption of vaginal flora of lactobacilli that inhibits overgrowth ofCandida

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17
Q

S/sx of vaginal/vulvovaginal candidiasis and PE

A
  • pt presents with a vaginal discharge associated with vulvar pruritus, burning, and occasional dysuria or dyspareunia
  • on PE: thick curd-like whitish plaques on the vaginal wall, erythema, edema
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18
Q

Tx of vaginal/vulvovaginal candidiasis

A
  • OTC: clotrimazole or miconazole

- Rx: Butoconazole, terconazole, oral fluconazole

19
Q

What is balanitis?

A

inflammation of the glans penis d/t yeast overgrowth

20
Q

Predisposing factors for balanitis

A

diabetes mellitus, an uncircumcised state, and candidal vaginal infection in sexual partners

21
Q

S/sx of balanitis

A

C/o pruritus and burning, dysuria

22
Q

PE of balanitis

A

White patches, fragile vesiculopustules, erythematous erosions with a collarette of whitish scale on the glans or prepuce

23
Q

Tx of balanitis

A

Tx same as for vulvovaginal

24
Q

What is cutaneous Candidiasis/Moniliasis?

A

intertriginous candidiasis

C. albicans predilection for colonizing skin folds, intertriginous zones, where moist and warm

25
Q

What areas are affected by intertriginous candidiasis?

A
  • genitocrural
  • gluteal
  • interdigital
  • inframammary areas
  • beneath the pannus and axillary areas
26
Q

Predisposing factors to intertriginous candidiasis

A

obesity, diabetes mellitus, wearing of occlusive clothing

27
Q

S/sx and PE of intertriginous candidiasis

A

S/sx: pruritus, tenderness, and pain

PE:macerated erythematous plaques with satellite vesiculopustules

28
Q

Tx of intertriginous candidiasis

A

Tx with topical antifungals (including econazole, ketoconazole, oxiconazole, naftifine, terconazole, ciclopirox), or oral for severe or nonresponsive

29
Q

Define intertrigo

A

Superficial inflammatory dermatitis where skin surfaces in opposition, esp hot humid weather

30
Q

What causes intertrigo?

A

Friction, heat, moisture

31
Q

S/sx of intertrigo

A

Burning and itching with erythematous, macerated plaques and possibly secondarily infected with candida or bacteria

**NO satellite lesions

32
Q

What is streptococcal intertrigo?

A
  • favors neck, axillary and inguinal folds of children.
  • presents as fiery red, moist shiny surface with foul smell

***NO satellite lesions

33
Q

Tx of intertrigo

A
  • low potency topical steroids/tacrolimus to reduce inflammation but in combo with antifungal or antimicrobial
  • eliminate maceration: Drysol, zeasorb powder; application gentian violet
34
Q

Define tinea versicolor/pityriasis versicolor

A
  • caused by group of yeasts, Malassezia ssp.
  • mainly Malassezia globose
  • Malassezia normal inhabitant to skin of 90% adults not causing sxs
  • proliferates causing skin disorder
35
Q

Predisposing factors for tinea versicolor/pityriasis versicolor

A
  • humidity, sweating, oily skin

- may clear in the winter months and recur each summer

36
Q

tinea versicolor/pityriasis versicolor on PE

A
  • hypo- or hyperpigmented oval to round mildly scaly macules/patches that coalesce
  • patches coppery brown, paler than surrounding skin, or pink
37
Q

What areas are commonly affected by tinea versicolor/pityriasis versicolor?

A

Trunk, neck, arms, groin, intertriginous

38
Q

S/sx of tinea versicolor/pityriasis versicolor

A

Asx to mild itch, especially when hot or out of shower

39
Q

Dx of tinea versicolor/pityriasis versicolor

A
  • topical azole cream/shampoo/foam (econazole, ketoconazole), Selenium sulfide, Ciclopirox cream/solution/shampoo
  • oral itraconazoleandfluconazole for widespread or non responsive
  • oral ketoconazole with black box warning d/t liver problems.
  • oral Terbinafine not helpful
40
Q

How does tinea versicolor/pityriasis versicolor look under Wood’s lamp?

A

pale yellow fluorescence

41
Q

Define Pityrosporum (Malassezia) folliculitis

A
  • caused by Malassezia
  • follicular papules and papulopustules with perifollicular erythema on the upper trunk, neck, and upper arms of young and middle-aged adults
  • pruritic
42
Q

What conditions contribute to Pityrosporum (Malassezia) folliculitis?

A
  • warm humid conditions

- occlusion of the skin and hair follicles with cosmetics, lotions, sunscreens, emollients, olive oil, or clothing

43
Q

Dx of Pityrosporum (Malassezia) folliculitis

A

KOH or bx if needed

44
Q

Tx of Pityrosporum (Malassezia) folliculitis

A
  • Tx topical and oral antifungal agents as with TV

- Recurrences common- consider maintenance meds

Dermatology 1 (19 decks)

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