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BMS 622 Final Exam > Cutaneous Mycoses > Flashcards

Cutaneous Mycoses Flashcards

1
Q

What type of organism is Malassezia?

A

Lipophilic yeast.

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2
Q

What skin conditions are associated with Malassezia?

A

Pityriasis versicolor, seborrheic dermatitis, Malassezia folliculitis.

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3
Q

How does pityriasis versicolor present on the skin?

A

Hypo- or hyperpigmented macules.

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4
Q

What pattern is seen in KOH prep of Malassezia infections?

A

Spaghetti and meatball pattern.

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5
Q

What is the primary treatment for Malassezia infections?

A

Topical antifungals like selenium sulfide or ketoconazole.

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6
Q

In what cases is oral antifungal therapy for Malassezia used?

A

Extensive or resistant cases.

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7
Q

What types of tissue do dermatophytes infect?

A

Skin, hair, nails.

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8
Q

Name the three main genera of dermatophytes.

A

Trichophyton, Microsporum, Epidermophyton.

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9
Q

What is the presentation of tinea corporis?

A

Circular, erythematous, scaly lesions.

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10
Q

What is tinea capitis, and its common effect?

A

Scalp infection causing hair loss.

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11
Q

What does tinea pedis commonly affect?

A

Web spaces between toes.

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12
Q

What is tinea unguium?

A

Nail infection leading to thickening and discoloration.

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13
Q

How are dermatophyte infections diagnosed microscopically?

A

KOH prep showing septate hyphae.

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14
Q

What medium is used for dermatophyte cultures?

A

Sabouraud dextrose agar.

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15
Q

When are systemic antifungals indicated for dermatophyte infections?

A

Extensive infections or nail involvement.

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16
Q

What is Sporothrix schenckii’s common nickname?

A

Rose gardener’s disease.

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17
Q

How is Sporothrix schenckii typically introduced into the skin?

A

Trauma like thorn pricks.

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18
Q

What is the clinical progression of lymphocutaneous sporotrichosis?

A

Nodule at inoculation, then secondary nodules along lymphatics.

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19
Q

How is sporotrichosis diagnosed?

A

Culture showing yeast at 35°C and mold at 25°C.

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20
Q

What is the treatment of choice for sporotrichosis?

A

Itraconazole.

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21
Q

What side effects are associated with potassium iodide for sporotrichosis?

A

Nausea and salivary gland swelling.

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22
Q

In what climates is Sporothrix most prevalent?

A

Warmer climates.

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23
Q

What zoonotic transmissions are linked to sporotrichosis?

A

Infected cats and armadillos.

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24
Q

Which fungal infection can mimic squamous cell carcinoma?

A

Fixed cutaneous sporotrichosis.

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25
Q

What environmental conditions favor Malassezia?

A

Hot and humid conditions.

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26
Q

What diagnostic technique identifies branching septate hyphae?

A

KOH prep.

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27
Q

What systemic antifungal is used for severe dermatophyte infections?

A

Terbinafine or itraconazole.

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28
Q

Which fungal infection’s lesions spread along lymphatics?

A

Sporotrichosis.

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29
Q

What diagnostic pattern is unique to pityriasis versicolor?

A

Spaghetti and meatballs.

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30
Q

What is the mainstay of treatment for mild tinea infections?

A

Topical azoles.

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31
Q

How does Malassezia degrade lipids to become pathogenic?

A

Produces acid that damages melanocytes.

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32
Q

Which populations are at higher risk of Malassezia infections?

A

Immunosuppressed individuals.

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33
Q

What is a common location for pityriasis versicolor lesions?

A

Chest and back.

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34
Q

How can Malassezia infections be differentiated from vitiligo?

A

KOH prep shows ‘spaghetti and meatballs’ pattern.

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35
Q

What climate conditions increase Malassezia growth?

A

Hot and humid environments.

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36
Q

How is Malassezia treated when topical therapies fail?

A

Oral antifungals, like ketoconazole or itraconazole.

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37
Q

What enzyme allows dermatophytes to invade keratinized tissues?

A

Keratinase.

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38
Q

How is tinea versicolor different from tinea corporis?

A

Tinea versicolor is caused by Malassezia; tinea corporis by dermatophytes.

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39
Q

What feature distinguishes tinea capitis from seborrheic dermatitis?

A

Tinea capitis often causes hair loss and scaling.

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40
Q

What is the typical duration of treatment for onychomycosis with oral terbinafine?

A

6–12 weeks.

41
Q

What is the sensitivity of Wood’s lamp for Microsporum species?

A

Fluoresces under ultraviolet light.

42
Q

Which dermatophyte species is the most common cause of tinea corporis?

A

Trichophyton rubrum.

43
Q

How can moist environments increase dermatophyte infections?

A

Promote fungal growth and skin maceration.

44
Q

What precautions can reduce the risk of tinea infections?

A

Keeping skin dry and avoiding direct contact with infected animals.

45
Q

What is a diagnostic limitation of KOH prep in dermatophyte infections?

A

Cannot differentiate species.

46
Q

How does systemic terbinafine work against dermatophytes?

A

Inhibits ergosterol synthesis, disrupting fungal membranes.

47
Q

What populations are at higher risk of severe tinea infections?

A

Diabetic and immunocompromised patients.

48
Q

What is a hallmark clinical feature of lymphocutaneous sporotrichosis?

A

Nodules spreading along lymphatic channels.

49
Q

What animals are common reservoirs for Sporothrix schenckii?

A

Cats and armadillos.

50
Q

What are the side effects of potassium iodide treatment for sporotrichosis?

A

Nausea and swelling of salivary glands.

51
Q

Why is itraconazole preferred over potassium iodide for sporotrichosis?

A

Fewer side effects and better efficacy.

52
Q

What is the role of heat application in treating sporotrichosis?

A

Local heat kills fungal cells and resolves lesions.

53
Q

How can sporotrichosis mimic other conditions?

A

Fixed cutaneous lesions may resemble squamous cell carcinoma.

54
Q

How is sporotrichosis transmitted from infected cats?

A

Through scratches or bites.

55
Q

What are the diagnostic limitations of serologic tests for sporotrichosis?

A

Rarely utilized due to low specificity.

56
Q

What is the temperature phase for Sporothrix’s yeast form?

A

37°C (in tissues).

57
Q

What is the significance of granulomas in Sporothrix infections?

A

Indicate chronic inflammatory response.

58
Q

What systemic antifungal is effective for both tinea and Sporothrix infections?

A

Itraconazole.

59
Q

What is the role of Sabouraud agar in fungal diagnostics?

A

Supports fungal growth for species identification.

60
Q

Why is regular shoe hygiene important in preventing tinea pedis?

A

Reduces fungal exposure in moist environments.

61
Q

What is the clinical importance of branching septate hyphae on KOH prep?

A

Confirms dermatophyte infection.

62
Q

How can gardeners reduce their risk of Sporothrix infections?

A

Wear gloves and protective clothing.

63
Q

Why are immunocompromised individuals prone to disseminated fungal infections?

A

Weakened immune response allows fungal spread.

64
Q

What is the advantage of itraconazole over fluconazole in treating fungal infections?

A

Broader spectrum of activity.

65
Q

What are common symptoms of fungal lymphangitis?

A

Painless nodules along lymphatic vessels.

66
Q

What diagnostic test is used for Malassezia infections?

A

KOH preparation.

67
Q

What is the typical appearance of fungal infections under KOH prep?

A

Yeast and hyphae.

68
Q

How is tinea corporis commonly spread?

A

Direct contact with infected individuals or surfaces.

69
Q

What is the most common symptom of tinea cruris?

A

Itchy, red rash in the groin area.

70
Q

What antifungal is commonly used for tinea pedis?

A

Topical azoles or terbinafine.

71
Q

What systemic antifungal is used for severe dermatophyte infections?

A

Itraconazole or terbinafine.

72
Q

How can dermatophyte infections be prevented?

A

Avoid sharing personal items and keep skin dry.

73
Q

What is a complication of untreated onychomycosis?

A

Permanent nail damage or deformity.

74
Q

How does temperature affect Sporothrix schenckii?

A

Dimorphic: mold at 25°C, yeast at 37°C.

75
Q

What is the primary habitat of Sporothrix schenckii?

A

Soil and plant matter.

76
Q

What occupations are most at risk for Sporothrix infections?

A

Gardeners and agricultural workers.

77
Q

What fungal species cause tinea capitis?

A

Trichophyton and Microsporum.

78
Q

How is tinea capitis typically treated in children?

A

Oral griseofulvin or terbinafine.

79
Q

What is the significance of ‘asteroid bodies’ in Sporothrix diagnosis?

A

Indicates Splendore-Hoeppli reaction.

80
Q

How does Malassezia stay confined to the stratum corneum?

A

Cannot penetrate deeper layers of skin.

81
Q

What environmental factor increases risk of fungal infections?

A

High humidity and poor ventilation.

82
Q

What is the primary clinical feature of tinea versicolor?

A

Pigment changes on skin.

83
Q

Why is potassium iodide rarely used for Sporothrix now?

A

Associated with high side effects.

84
Q

How is Sporothrix infection confirmed?

A

Culture of pus or biopsy material.

85
Q

What is the common name for dermatophytosis?

A

Ringworm.

86
Q

What is the role of Wood’s lamp in dermatophyte diagnosis?

A

Detects fluorescence in some species.

87
Q

What makes terbinafine effective against fungal infections?

A

Inhibits ergosterol synthesis.

88
Q

What systemic antifungal is preferred for onychomycosis?

A

Terbinafine.

89
Q

Why are antifungal creams preferred for mild infections?

A

Localized effect with fewer side effects.

90
Q

How can fungal infections be distinguished from eczema?

A

Microscopic examination or culture.

91
Q

What is the duration of treatment for tinea pedis with topical therapy?

A

2–4 weeks.

92
Q

What secondary bacterial infection may occur with tinea pedis?

A

Cellulitis.

93
Q

How does griseofulvin work against dermatophytes?

A

Disrupts fungal mitosis.

94
Q

What is the role of prophylactic antifungals in recurrent tinea?

A

Prevent recurrence in high-risk patients.

95
Q

What are the symptoms of disseminated sporotrichosis?

A

Fever, widespread nodules, organ involvement.

96
Q

What is the significance of lymphangitis in fungal infections?

A

Suggests lymphatic spread, seen in Sporothrix.

97
Q

What systemic condition predisposes patients to severe fungal infections?

A

Diabetes.

98
Q

Why should pets be examined for tinea infections?

A

They can be carriers and spread the fungus.

99
Q

How does itraconazole differ from fluconazole?

A

Broader activity against dimorphic fungi.

BMS 622 Final Exam (2 decks)

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