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Fall 2014 - CM Dermatology > Fungal Derm > Flashcards

Fungal Derm Flashcards

1
Q

Candidiasis

A
  • candida albicans most common
  • infects skin and mucus membranes
  • reproduce via budding
  • failure of body to control growth
  • likes to grow in warm, dark, moist areas eg groin, axilla
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2
Q

CANDIDA BALANITIS

  1. Definition
  2. Etiology
A
  1. infection and inflammation of glans penis

2. Candida albicans

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3
Q

CANDIDA BALANITIS

  1. Predisposing conditions
  2. Clinical features
A
  1. uncircumcised males, DM, immunosuppression, antibiotic use; may or may not be associated w/ intercourse w/ infected partner
  2. tenderness, edema, erythematous papules/pustules/erosions, exudate, satellite lesions, inability to retract foreskin
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4
Q

CANDIDA BALANITIS

  1. Diagnosis
  2. Differential diagnosis
A
  1. clinical presentation, location, KOH, cultures

2. molluscum contagiosum, warts, psoriasis, eczema, herpes, squamous cell carcinoma, scabies

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5
Q

CANDIDA BALANITIS

  1. Treatment
  2. Prevention
A
  1. topical antifungal, look for cause (eg uncontrolled DM), gentle retraction of foreskin and soak in warm water; avoid steroids! (can get rebound)
  2. keep skin dry, hygiene, powders, yogurt, probiotics
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6
Q

CANDIDA INTERTRIGO

  1. Definition
  2. Etiology
A
  1. superficial infection of intertriginous areas

2. candida albicans

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7
Q

CANDIDA INTERTRIGO

  1. Predisposing conditions
  2. Clinical features
A
  1. obesity, pendulous breasts, DM, poor hygiene, tight clothing, hot/humid weather
  2. erythematous macerated (super wrinkly like under a band aid) skin, glistening, bilateral, satellite lesions, pruritus; common sites - groin, gluteal folds, under breast or panna, axilla
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8
Q

CANDIDA INTERTRIGO

  1. Diagnosis
  2. Differential diagnosis
A
  1. clinical presentation, location, KOH/culture

2. staph/strep, psoriasis, seborrhea, atopic, erythrasma

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9
Q

CANDIDA INTERTRIGO

  1. Treatment
  2. Prevention
A
  1. topical antifungal, vinegar wet dressings, burrows solution, air, proper hygiene
  2. powders, ointments, weight loss, zinc oxide ointment (Desitin)
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10
Q

ORAL CANDIDIASIS (THRUSH)

  1. Definition
  2. Etiology
A
  1. mucous membrane infection (of the mouth, palate, esophagus, pharynx)
  2. candida albicans
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11
Q

ORAL CANDIDIASIS (THRUSH)

  1. Predisposing conditions
  2. Clinical features
A
  1. neonate, DM, antibiotic use, HIV, immunosuppression, steroid therapy (if you see this in adult, be suspicious of DM or HIV)
  2. burning, diminished taste; stuck-on creamy exudates/plaques with underlying erythema; can be asymptomatic
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12
Q

ORAL CANDIDIASIS (THRUSH)

  1. Diagnosis
  2. Differential Diagnosis
  3. Treatment
A
  1. appearance, KOH
  2. lichen planus, geographic tongue, oral hairy leukoplakia, condyloma acuminatum
  3. topical antifungals
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13
Q

ANGULAR CHEILITIS (Perleche)

  1. Definition
  2. Etiology
A
  1. inflammation, superficial infection at angles of mouth, secondary to saliva maceration
  2. candida, chronic irritation
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14
Q

ANGULAR CHEILITIS (Perleche)

  1. Predisposing conditions
  2. Clinical features
A
  1. lip licking, elderly, dentures, mouth breathing, Accutane use
  2. macerated angles of mouth, erythema, fissures
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15
Q

ANGULAR CHEILITIS (Perleche)

  1. Diagnosis
  2. Differential diagnosis
  3. Treatment
A
  1. clinical presentation, location, cultures
  2. candida, staph infection, B12 deficiency, lichen planus, contact dermatitis, impetigo, intertrigo
  3. topical antifungal, barriers, address underlying cause, aquaphor (vaseline-type barrier)
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16
Q

PITYRIASIS (TINEA) VERSICOLOR

  1. Definition
  2. Etiology
A
  1. superficial fungal infection; chronic, asymptomatic dermatosis of the torso
  2. Malassezia furfur, M globosa
17
Q

PITYRIASIS (TINEA) VERSICOLOR

  1. Predisposing conditions
  2. Clinical features
A
  1. oily skin, heat, moisture, sweating, pregnancy, steroid use, poor nutrition, immunodeficient
  2. macule with fine scale, patches, vitiligo appearance (pale/white patches due to melanocyte malfunction), insidious (slow/subtle) onset
18
Q

PITYRIASIS (TINEA) VERSICOLOR

  1. Diagnosis
  2. Differential diagnosis
A
  1. appearance, KOH, Wood’s lamp (pale yellow, white, or green)
  2. vitiligo, seborrheic dermatitis, syphilis, psoriasis, eczema, tinea corporis
19
Q

PITYRIASIS (TINEA) VERSICOLOR

  1. Treatment
  2. Complications
A
  1. topical antifungal (selsun blue shampoo), selenium sulfide, oral?, wash clothing, sunlight may accelerate re-pigmentation
  2. pigment changes, recurrence
20
Q

Tinea

A
  • dermatophyte
  • group of fungi capable of infecting skin, hair, nails
  • most common of all mucocutaneous infections
  • predisposing: wrestlers, pets, etc
21
Q

TINEA CAPITIS

  1. Definition
  2. Etiology
A
  1. scalp infection; most common dermatophytosis in kids; invasion of stratum corneum and hair shaft with fungal hyphae
  2. Tricophyton (90%)&raquo_space; Microsporum
22
Q

TINEA CAPITIS

  1. Predisposing conditions
  2. Clinical features
A
  1. pets/cats, close contact, malnutrition, kids, rural (soil), debilitation/limited mobility
  2. seborrheic vs. noninflammatory vs pustular; lymphadenopathy (occipital), inflammatory (kerion)
23
Q

TINEA CAPITIS

  1. Diagnosis
  2. Differential diagnosis
  3. Treatment
A
  1. clinical presentation, KOH, Wood’s lamp for microsporum (bright green), cultures
  2. seborrhea (cradle cap), psoriasis, eczema, alopecia, lichen simplex, scabies
  3. oral and topical antifungal, clean contaminated objects, treat family if needed
24
Q

KERION

  1. Definition
  2. Etiology
A
  1. inflammatory (sterile?) scalp infection

2. Tricophyton, Microsporum

25
Q

KERION

  1. Predisposing conditions
  2. Clinical features
A
  1. chronic carrier state, DM, children, friction, ingrown hairs, malnutrition, EtOH, hyperhidrosis, obesity, athletes
  2. tender, boggy area; fever; alopecia; lymphadenopathy
26
Q

KERION

  1. Diagnosis
  2. Differential diagnosis
  3. Treatment
A
  1. appearance, KOH, Wood’s lamp for Microsporum
  2. hidradenitis suppurativa, herpes simplex, ruptured cyst, furuncle/carbuncle
  3. refer to specialist; likely to scar; very difficult to treat
27
Q

TINEA CORPORIS

  1. Definition
  2. Etiology
A
  1. trunk/body infection, “ring worm”

2. Tricophyton rubrum, Microsporum canis or tonsurans

28
Q

TINEA CORPORIS

  1. Predisposing conditions
  2. Clinical features
A
  1. warm climates, contact, other tinea infections, contaminated soil
  2. scaly papules/macules, raised sharply marginated border, itch, chronic, borders extend and leave central clearing or brownish color
29
Q

TINEA CORPORIS

  1. Diagnosis
  2. Differential diagnosis
  3. Treatment
A
  1. clinical presentation, location, cultures, KOH, Wood’s lamp
  2. eczema, psoriasis, dermatitis, tinea/pityriasis versicolor
  3. NO STEROIDS; topical antifungal or oral
30
Q

TINEA CRURIS

  1. Definition
  2. Etiology
A
  1. tinea of the groin, “jock itch”

2. T. rubrum or T. mentagrophytes

31
Q

TINEA CRURIS

  1. Predisposing conditions
  2. Clinical features
A
  1. location, swimming, sweating, obesity, steroids, males, tinea pedis
  2. itching increases as moisture increases, bilateral plaques with scale, erythema or brown, spares the penis/scrotum but migrates to butt
32
Q

TINEA CRURIS

  1. Diagnosis
  2. Differential diagnosis
  3. Treatment
A
  1. appearance, KOH, culture, Wood’s lamp
  2. intertrigo, psoriasis
  3. drying well, hygiene, topical antifungals, powders; treat pedis/manus; avoid restrictive clothing
33
Q

TINEA MANUS

  1. Definition
  2. Etiology
A
  1. fungal hand infection

2. T. rubrum

34
Q

TINEA MANUS

  1. Predisposing conditions
  2. Clinical features
A
  1. tinea pedis/cruris

2. scaling, itch, papules, bullae (look different on dorsal vs. volar surface)

35
Q

TINEA MANUS

  1. Diagnosis
  2. Differential diagnosis
  3. Treatment
A
  1. appearance, KOH
  2. eczema, dermatitis, psoriasis, SCC, lichen simplex
  3. treat other regions; topical/oral antifungals (topicals often fail), hygiene, can recur if nails not clear
36
Q

TINEA PEDIS

  1. Definition
  2. Etiology
A
  1. fungal infection, athlete’s foot

2. T. rubrum, T. mentagrophytes, E. floccusum

37
Q

TINEA PEDIS

  1. Predisposing conditions
  2. Clinical features
A
  1. gym use, sweating, atopic
  2. many variations; scaling, macerated, erythema, bulla formation, moccasin distribution, between digits, dorsal foot, toenails
38
Q

TINEA PEDIS

  1. Diagnosis
  2. Differential diagnosis
A
  1. clinical presentation/location, cultures, KOH, negative Wood’s lamp
  2. psoriasis, staph, contact dermatitis, impetigo, eczema
39
Q

TINEA PEDIS

  1. Treatment
  2. Prevention
A
  1. change socks, air, hygiene (shower shoes, dry well), antifungals
  2. aquasocks

Fall 2014 - CM Dermatology (11 decks)

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