Chapter 160 - Superficial fungal Infection part II

Question 1

Local delayed type hypersensitivity response to Trichyophyton test and systemically absorbed fungal antigen

Answer 1

Dermatophytid reaction

Question 2

Criteria for id reaction

Answer 2

1. Dermatophytosis on another part of the body
2. Absence of fungal elements from id reaction
3. Resolution of id eruption with clearing if primary dermatophyte infection

Question 3

50% of all cases of onychodystrophy and 15% in children

Answer 3

Onychomycosis

Question 4

20% of dermatophyte infections among children

Answer 4

Onychomycosis

Question 5

Patients with CD4 count less than ___ tends to have more widespread and involve all 20 nails type of onychomycosis

Answer 5

400 cells/ul

Question 6

40% of onychomycosis have concomitant skin infections, 30% of which is ___

Answer 6

Tinea pedis

Question 7

Dermatophyte infection of the nail

Answer 7

Tinea unguium

Question 8

Fungal infection of the nail caused by dermatophytes, nondermatophyte, mold, yeasts

Answer 8

Onychomycosis

Question 9

Most common form of onychomycosis

Answer 9

Distolateral subungual type

Question 10

Marker of HIV disease

Answer 10

Proximal subungual type

Question 11

White superficial type is usually caused by

Answer 11

T. Interdigitalis

Question 12

On HPx of onychomycosis, hyphae are seen between the nail lamina parallel to surface with predilection for (3)

Answer 12

Ventral nail

Stratum corneum of nail bed

Question 13

Oral antifungal is required for onychomycosis involving the __

Answer 13

Matrix

Question 14

Oral antifungal for onychomycosis ((3)

Answer 14

Terbinafine 250mg/day for 6-12 weeks
Itraconazole 200mg/day for 2-3 mos
Or 400mg/ mo for 2-3 mos
Fluconazole 150-300mg/week for 3-12 mos

Question 15

In vitro fungicidal activity found in Eucalyptus citriodora (4)

Answer 15

Thymol
Camphor
Menthol
Oil

Question 16

Asymptomatic superficial fungal infection of hair shaft

Answer 16

Piedra
Or
trichomycosis nodularia

Question 17

Black piedra is caused by ___ and affects scalp hair

Answer 17

Piedra hortae

Question 18

Matching type

1. Scalp
2. Axillary
3. Genital

A. T. Asahi
B. T Inkin
C. T. Ovoides

Answer 18

C
A
B

Question 19

White piedra affects face, axilla, genitals more than scalp.

True or False

Answer 19

Tru

Question 20

Matching type

1. Broken hairs
2. Pseudoparenchyma
3. Inhibited by cycloheximide

A. Black piedra
B. White piedra

Answer 20

A
A
B

Question 21

Diff of trichomycosis nodularis vs trichomycosis axillaris

Answer 21

Trichomycosis axillaris are smaller and fluoresce under a Wood lamp

Question 22

Curative for piedra

Answer 22

Shaving

Question 23

Common mode of transmission of tinea barbae

Answer 23

Exposure to cattle, horses, or dogs

Question 24

Matching type

1. Involves the beard area
2. T. Violaceum
3. T. Verrucosum
4. T. Interdigitale
5. Scarring alopecia
6. MC clinical presentation

A. Superficial
B. Inflammatory
C. Both
D. None

Answer 24

C
A
B
B
B
B

Question 25

In tinea barbae, always rule out (2)

Answer 25

Herpes simplex | Halogenoderma

Question 26

Treatment for tinea barbae

Answer 26

``` Systemic corticosteroids for 1 week + Terbinafine 250mg/day x 2-4 weeks Itraconazole 200mg/day x 2-4 weeks Fluconazole 200mg/day x 4-6 weeks Griseofulvin 1g/day x 6 weeks ```

Question 27

Tinea capitis is most commonly observed in children between the ages of ___ due to fungistatic effect of ___

Answer 27

3 to 14 years old | FA in the sebum

Question 28

Common cause of tinea corporis in adults? In children?

Answer 28

T. Rubrum (adults) | M. Canis (children)

Question 29

MC cause of tinea incognito

Answer 29

Tinea rubrum

Question 30

Tinea capitis describes dermatophyte infection of hair and scalp caused by Trichophyton and Microsporum except

Answer 30

T. Concentricum

Question 31

Even after shedding, hairs may harbor infectious organisms for more than ___

Answer 31

1 year

Question 32

Matching type 1. M. Audouinii 2. T. Violaceum 3. T. Tonsurans 4. M. Canis 5. M. ferrugineum 6. T schoenleinii A. Noninflammatory B. Black dot C. Inflammatory D. Favus

Answer 32

``` A B B C A D ```

Question 33

Noninflammatory type or gray patch type of tinea capitis often occurs on ___ with ___ alopecia

Answer 33

Occiput | Nonscarring

Question 34

Inflammatory type of tinea capitis results in (2)

Answer 34

Scarring alopecia | Posterior cervical lymphadenopathy

Question 35

Clinical pearl in diff tinea capitis from other inflamm disorders involving the scalp

Answer 35

Posterior cervical lymphadenopathy

Question 36

Tinea capitis often involves __ hairs

Answer 36

Mid to late anagen hairs

Question 37

Arthroconidia are usually noted in infected hairs of favus. | True or False

Answer 37

False, not noted

Question 38

Topical therapy alone is sufficient for management of tinea capitis. True or False

Answer 38

False, not sufficient

Question 39

For tinea capitis, the ff should be ruled out (2)

Answer 39

DLE, syphilis

Question 40

Thrice weekly use of (2) by all household members also reduces transmission by decreasing shedding of spores

Answer 40

Ketoconazole 2% shampoo | Selenium sulfide 2.5%

Question 41

DOC for tinea capitis (M. Canis)

Answer 41

Griseofulvin 20-25mkday for 6-8 weeks (micro)

Question 42

DOC for tinea capitis (T. Tonsurans)

Answer 42

Terbinafine x 2-4 weeks <20kg: 62.5mg/day 20-40kg: 125mg/day >40kg: 250mg/day

Question 43

Dermatophytosis of glabrous skin except palms, soles, and the groin

Answer 43

Tinea corporis

Question 44

Tinea corporis gladiatorum is caused by

Answer 44

T. Tonsurans

Question 45

Superficial and subcutaneous dermatophytic infection involving deeper portions of hair follicles

Answer 45

Majocchi granuloma

Question 46

Majocchi granuloma is most commonly caused (3)

Answer 46

T. Rubrum T. Interdigitale M. Canis

Question 47

Etiologic agent of tinea imbricata

Answer 47

Tinea concentricum

Question 48

Second most common dermatophytosis worldwide

Answer 48

Tinea cruris

Question 49

Tinea crusis is ___ times more common in men and adults

Answer 49

3

Question 50

Tinea cruris with involvement of genitocrural crease and medial upper thigh

Answer 50

E. Floccosum

Question 51

Tinea cruris with extension to pubic, perianal, buttock, and lower abdominal areas

Answer 51

T. Rubrum

Question 52

Chronic dermatophyte infection of scalp that rarely involves glabrous skin and or nails characterized by thick yellow crusts (scutula) within the hair follicles that lead to scarring alopecia

Answer 52

Tinea favosa

Question 53

Most common cause of human favus

Answer 53

T. Schoenleinii

Question 54

Tinea nigra is caused by superficial dermatomycosis caused by dematiaceous darkly pigmented

Answer 54

Hortaea werneckii

Question 55

Tinea nigra has ___ predilection

Answer 55

Female

Question 56

Asymtomatic mottled brown to greenish black macule or patch with minimal to no scale on palms and soles and darkest at advancing border

Answer 56

Tinea nigra

Question 57

Treatment of tinea nigra

Answer 57

Keratolytic (Whitfield ointment, 2% SSA) Tincture of iodine Topical antifungal

Question 58

Most common dermatophytosis worldwide

Answer 58

Tinea manuum and tinea pedis

Question 59

Fine dry scaling of palm accentuated in the creases

Answer 59

Tinea manuum

Question 60

Most common presentation of tinea pedis

Answer 60

Interdigital type, between lateral 3rd and 4th, 4th and 5th toes

Question 61

Most common pathogen of moccasin type of tinea pedis

Answer 61

T. Rubrum

Question 62

Vesiculobullous type of tinea pedis is caused by

Answer 62

T. Interdigitale

Question 63

Responsible for malodor of athlete’s foot

Answer 63

Pseudomonas | Proteus

Question 64

Highest rate of positive findings of KOH in tinea pedis

Answer 64

Blister roof of vesicles or bulla

Question 65

Treatment for mild interdigital tinea pedis

Answer 65

Terbinafine cream applied BID for 1 week