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Clinical Med I > Derm - Dermatophyte Infections - Exam 1 > Flashcards

Derm - Dermatophyte Infections - Exam 1 Flashcards

1
Q

How is Tinea Capitis acquired?

A

Via direct contact with an infected individual or animal

Via contaminated object (comb, brush, tiara, wig, hat)

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2
Q

What are the ways in which Tinea Capitis can present clinically?

A
  • Scaly patches with alopecia
  • Patches of alopecia with black dots
  • Widespread scaling with subtle hair loss
  • Kerion
  • Favus
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3
Q

What is a kerion?

A

A boggy edematous painful plaque

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4
Q

What are some associated signs of Tinea Capitis?

A
  • Cervical adenopathy
  • Dermatophytid reaction
  • Erythema Nodosum
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5
Q

What is the most effective treatment for Tinea Capitis?

A

Topical Griseofulvin

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6
Q

How does Tinea Corporis present as clinically?

A
  • Pruritic, annular, erythematous plaque
  • Central clearing
  • Raised, advancing border
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7
Q

What is the most effective treatment for Tinea Corporis?

A

Clotrimazole (topical antifungal) for at least 2 weeks

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8
Q

What is the treatment choice in special circumstances/resistant cases of Tinea Corporis?

A

Oral itraconazole

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9
Q

What are some factors that contribute to the development of Tinea Cruris?

A
  • Male
  • Sweaty/humid
  • Obesity/skin folds
  • Occlusive clothing
  • Athlete’s foot
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10
Q

How does Tinea Cruris present as clinically?

A
  • Well-marginated, scaly, annular plaque with raised border
  • Extends from the inguinal fold to the inner thigh
  • Scrotum typically spared
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11
Q

What is the most effective treatment for Tinea Cruris?

A
  • Clotrimazole (topical antifungal)
  • Treat associated Tinea pedis and/or onychomycosis
  • Daily drying powder
  • Lifestyle considerations such as avoiding tight clothing and weight loss
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12
Q

What is the most effective medication for resistant cases of Tinea Cruris?

A

Oral itraconazole

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13
Q

What is the most common dermatophytosis in the world?

A

Tinea Pedis

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14
Q

What are risk factors of Tinea Pedis?

A
  • Occlusive footwear

- Communal baths/showers/pools

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15
Q

How does acute Tinea Pedis present as clinically?

A
  • Itchy/painful vesicles or bulla following sweating

- Secondary staph infections are common

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16
Q

How does chronic Tinea Pedis commonly present as clinically?

A
  • Erosions/scales between toes (especially 3rd and 4th)

- Interdigital fissures

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17
Q

It is known that chronic Tinea pedis can present clinically as scales and fissures between toes, but how else can it present?

A
  • “Moccasin Ringworm”
  • Sharp demarcation with accumulated scale in the skin creases
  • May present with tinea manuum (two feet, one hand)
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18
Q

What is the most effective treatment for Tinea pedis?

A
  • Clotrimazole (topical antifungal)
  • Burow’s wet dressings for vesiculation or maceration, 20 minutes BID-TID
  • Treat secondary infections
  • Lifestyle considerations (foot powder, treatment of shoes, proper footwear)
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19
Q

What is the most effective medication treatment for chronic/extensive Tinea pedis?

A

Oral itraconazole

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20
Q

What are risk factors for Onychomycosis?

A
  • Advanced age
  • Tinea pedis
  • Genetics
  • Immunodeficiency
  • Household infection
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21
Q

What are the three common ways in which Onychomycosis can present?

A
  • Distal subungual onychomycosis
  • Proximal subungual onychomycosis
  • White superficial onychomycosis
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22
Q

What is the most common presentation of Onychomycosis?

A

Distal subungual onychomycosis

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23
Q

What are the common characteristics of Distal subungual onychomycosis?

A
  • Typically starts with great toe
  • White/brown/yellow discoloration starts at distal corner and spreads towards the cuticle
  • Distal end of the nail breaks, exposing the nail bed
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24
Q

What are the common characteristics of Proximal subungual onychomycosis?

A
  • Starts near cuticle and progresses distally

- Usually seen in severely immunocompromised population (AIDS)

25
Q

What are the common characteristics of White superficial onychomycosis?

A
  • Starts with dull white spots on surface of the nail plate
  • Spreads centrifugally until entire nail is involved
  • Lesions can be scraped for lab sample
26
Q

What is a common pathogen of fingernail onychomycosis?

A

Yeast usually due to Candida Albicans

27
Q

What can fingernail onychomycosis cause?

A
  • Thickening of nail with yellow/brown discoloration

- Chronic paronychia

28
Q

How is the diagnosis of Onychomycosis confirmed?

A
  • KOH prep of nail scrapings
  • Culture
  • Histopathology (biopsy)
29
Q

When should treatment for Onychomycosis be considered?

A
  • Has a history of cellulitis
  • Diabetic
  • Desires cosmetic improvement
  • Complains of discomfort/pain
30
Q

What is the most effective treatment for Nondermatophyte onychomyosis?

A

Oral itraconazole

  • 6 weeks for fingernails
  • 12 weeks for toenails
31
Q

What is the most effective treatment for Dermatophyte onychomyosis?

A

Oral terbinafine

  • 6 weeks for fingernails
  • 12 weeks for toenails
32
Q

What is Intertrigo?

A

Any infectious or noninfectious inflammatory condition of two closely opposed skin surfaces

33
Q

What are risk factors for Intertrigo?

A
  • Moisture
  • Skin friction
  • Immunocompromised
34
Q

What does Candidal Intertrigo typically affect?

A

The groin, mammary/abdominal folds, web spaces, and axilla

35
Q

What are the common characteristics of Candidal Intertrigo?

A
  • Erythematous, macerated plaques and erosions
  • Satellite papules/pustules
  • Fine peripheral scaling
36
Q

What is typically the most effective treatment for Candidal Intertrigo?

A

Topical Nystatin x 2-4 weeks

37
Q

What is typically the most effective treatment for resistant/severe cases of Candidal Intertrigo?

A

Oral Fluconazole x 2-6 weeks

38
Q

What are preventative measures for Candidal Intertrigo?

A
  • Drying agents
  • Weight loss
  • Address underlying medical conditions
39
Q

What is Tinea Versicolor?

A

Fungal infection of the skin

40
Q

Tinea Versicolor is most common in which populations?

A
  • Tropical climate

- Adolescents/young adults

41
Q

What are risk factors for Tinea Versicolor?

A
  • Hyperhidrosis
  • Genetics
  • Immunosuppresion
42
Q

What are some common characteristics of Tinea Versicolor?

A
  • Macules, patches, plaques on trunk/UE
  • Can coalesce
  • Often have fine scale
  • Typically asymptomatic but can be mildly pruritic
43
Q

How is Tinea Versicolor diagnosed?

A
  • Physical exam
  • KOH prep
  • Wood’s lamp (yellow to yellow-green fluorescene in 1/3)
44
Q

How is Tinea Versicolor typically treated?

A
  • Clotrimazole, a topical antifungal
  • Selenium sulfide (lotion, shampoo, foam)
  • Zinc Pyrithione shampoos
45
Q

When is systemic treatment used in Tinea Versicolor? What medication is the most effective?

A
  • Reserved for extensive disease or failed topical therapy
  • Oral itraconazole x 5-7 days
  • Not used in children
46
Q

What does Scabies classically present with?

A
  • Initial lesion
  • Burrow is pathognomonic
  • Head and back are often spared
  • Severe pruritus which is worse at night
47
Q

How can Scabies be diagnosed?

A
  • Visualization of burrow
  • Microscopic identification of the mite, eggs, or fecal pellets
  • Dermatoscope
48
Q

How can Scabies be treated?

A
  • Permethrin 5% cream - initial treatment + 2nd application 10-14 days later
  • Oral Ivermectin - single dose repeated two weeks later
49
Q

What population is most commonly affected by pubic lice?

A

Teens and young adults

50
Q

How are pubic lice transmitted?

A

Primarily via sexual contact

51
Q

How does pubic lice present?

A

Itching in the groin/axilla

52
Q

What is the treatment for pubic lice?

A
  • Permethrin 1% cream - initial treatment + 2nd application 10 days later
53
Q

Onychomycosis increases the risk of other infections, especially in which other population?

A

The immunocompromised population

54
Q

What does the term Versicolor refer to?

A

The variety of colors that the infection may present with (hypopigmented, hyperpigmented, erythematous)

55
Q

How can Tinea Capitis be diagnosed?

A
  • Physical exam
  • Wood’s lamp
  • KOH prep
  • Dermascope
  • Culture
56
Q

How is Tinea Pedis diagnosed?

A
  • History and physical exam
  • KOH prep
  • Culture
  • Gram stain if bacterial infection suspected
60
Q

Describe Favus and what condition is it related to?

A

Multiple cup-shaped yellow crusts

Seen in tinea capitus

61
Q

What happens in Norwegian scabies?

A

The lesions become crusted over and fissures provide an avenue for bacteria which can lead to sepsis.

Oral medications are required.

Clinical Med I (24 decks)

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