Cutaneous fungal Infections Flashcards
Which 3 types of fungi commonly cause skin infection?
Dermatophytes: Tinea (Ringworm)
Yeasts: Candida albicans
Moulds: Aspergillus
2 common features of fungal skin infection presentation
Itchy
Unilateral/ asymmetrical
3 features of Tinea Pedis
Most common dermatophyte infection
Moist scaling + fissuring in toe-webs
Spreads to sole + dorsum of foot
How is dermatophyte infection most commonly acquired?
Contact with keratin debris carrying fungal hyphae
3 features of Tinea Cruris
M > F
Scaly erythematous margin spreads down medial thighs, may extend back to perineum + bum
Source often feet
2 features of Tinea Corporis
Clearly defined raised, scaly edge
Annular lesions on trunk + limbs
Presentation of Tinea Manuum
Palm: mild scaling erythema
Dorsum: inflammatory change with well defined edge
3 features of Tinea Unguium
Common + associated with athletes foot
Starts distally with yellow streaks in nail plate
Whole nail thickens, discolours, friable
4 features of Tinea Capitis
Kids > Adults
>,1 patches of partial hair loss
Scaly + hair broken off just above surface
+/- Inflammation/ pustule formation
3 features of Kerion
Severe inflammatory scalp ringworm
Pustules + Abscesses
Often fungus of Cattle ringworm
3 features of Cattle ringworm
Affects face + forearms
Marked inflammatory reaction
Young farmers/ kids visiting farms at risk
3 features of Tinea Incognito
Fungal infection appearance altered by inappropriate tx with topical steroids
Top. steroids suppress inflammatory response to fungus
Scaly erythematous margin disappears leaving ill-defined patchy scaling erythema studded with pustules
Ix for suspected dermatophyte infection
Skin scrapings, nail clippings + plucked hair
Tx for dermatophyte infection
Small: Terbinafine TOP
Extensive/ Nails: Terbinafine PO
Tx for tines capitis
1: Griseofulvin PO (Safe for kids)
2: Terbinafine/ Itraconazole PO
Aetiology of Candida albicans infection
Normal commensal
Pathogenic when favourable conditions to multiplication arise e.g. Immune suppression, Steroids, Broad spectrum Abx, DM, apposition of skin to warm moist environment
Ix for candidiasis
Swab + culture
2 features of buccal mucosal candidiasis
White, curd-like plaques adhere to buccal mucosa
Scraped off to reveal inflamed + friable epithelium
Tx for buccal mucosal candidiasis
Miconazole gel Fluconazole PO (Severe)
What inflammation process at the corners of the mouth may be caused by Candida?
Angular chelitis
Tx for Candidal angular chelitis
Miconazole TOP / Nystatin Fluconazole PO (Severe)
What is chronic Candidal paronychia? Who does it predominantly occur in?
Inflammatory process affecting proximal nail fold + nail matrix
Those whose hands are repeatedly immersed in water
3 features of chronic Candidal paronychia
Thickening + erythema of proximal nail fold- Bolstering
Loss of cuticle- access of irritant substances
Associated nail dystrophy
Tx for chronic Candidal paronychia
Keep hands dry as poss
Miconazole TOP
Presentation of balanitis
Small white patches/ eroded areas on foreskin/ glans
3 risk factors for balanitis
Poor penile hygeine
DM
Sexual partner with candida vulvovaginitis
Presentation of vulvovagintis
Creamy discharge
Itchy erythema of vulva
3 risk factors for vulvovaginitis
Pregnancy
OCP
DM
Tx for balanitis
Ketoconazole/ Miconazole TOP
Tx for vulvovaginitis
- Fluconazole PO
2. Clotrimazole PV
Intertrigo
Maceration which occurs when 2 skin surfaces are in apposition
Groins, Axillae, Submammary regions, beneath abdominal fat apron
RF: Obesity + poor hygeine
What suggests candida super infection in Intertrigo?
Creamy ‘satellite’ pustules at margins of affected areas
Easily rupture leaving collarette of scale + scalloped edge
Tx for Intertrigo
Terbinafine/ Imidazole TOP
Hydrocortisone TOP
Hygiene
2 features of Pityriasis versicolor
YA most commonly Malassezia yeasts (commensals in pilosebaceous follicles)
Presentation of Pityriasis versicolor
Asymptomatic
Fair: Light-brown macules with fine surface scale, trunk + upper arms
Dark: Patchy hypopigmentation
Ix for Pityriasis versicolor
Skin scrapings + microscopy
Tx for Pityriasis versicolor
Limited: Clotrimazole cream
Extensive: Ketoconazole shampoo
