Fungal Disorders Flashcards
1
Q
KOH Exam
dissolves what? to make it easier to see what?
A
- keratinocytes
- fungal hyphae
2
Q
KOH Exam
procedural steps
6
A
- clean/moisten skin (alcohol swab)
- collect scale w/ 15 blade
- scrap over skin to allow scal to accumulate
- place coverslip on top of slide
- add 1-2 drops KOH
- scan at low power, then zoom to identify hyphae at 10X
3
Q
Tinea Capitis
typically caused by?
A
- Trichophyton tonsurans
- Microsporum canis
4
Q
Tinea Capitis
typically affects who?
A
- children, immunocomp
- African Americans
5
Q
Tinea Capitis
risk factors
A
poor hygiene
6
Q
Tinea Capitis
mode of transmission?
A
- contact w/ infected person or fomites
7
Q
Tinea Capitis
clinical presentation
A
- patches of alopecia w/ black dots or scaly patches of hair loss
- erythema or pruritis common
- Kerion
8
Q
Tinea Capitis
what is kerion?
4 components
A
- development of inflammatory boggy edematous plaque w/ pustules, thick crusting, drainage.
- suppurative folliculitis
- painful/tender
- can lead to scarring
9
Q
Tinea Capitis
Diagnosis
A
- clinical
- KOH
- Wood lamp
- fungal culture
10
Q
Tinea Capitis
Tx
oral tx
A
- oral girseofulvin
- oral terbinafine
11
Q
Tinea Capitis
non PO tx option
A
- anti-fungal shampoo 2x wkly
12
Q
Tinea Capitis
prevention
A
- treat all family members
- avoid sharing hats, brushes/combs, hair clippers
13
Q
Tinea Corporis
where on body?
A
trunk and limbs
14
Q
Tinea Corporis
caused by what pathogen?
A
- trichophyton rubrum
- microsporum spp
15
Q
Tinea Corporis
clinical presentation
A
- solitary or multiple erythematous, scaly, circular/oval plaques or patches
- central clearing
- well-defined raised borders that spread outward
- pruritic
16
Q
Tinea Corporis
dx
A
- KOH prep
- Fungal culture to confirm
17
Q
Tinea Corporis
tx
A
- topical anti fungals: BID, 1-3 wks
- refractory infection: terbinafine PO
17
Q
Tinea Manuum
occurs where? from what pathogen?
A
- hands
- Trichophyton spp
18
Q
Tinea Manuum
risk factors
3
A
- manual laborers
- hyperhidrosis
- existing hand dermatitis
19
Q
Tinea Manuum
Clinical presentation
A
- erythematous, scaly patch or plaque w/ raised, well-defined border
- slow extended area of peeling, xerosis, and mild pruritis
- increased skin markings or vesicles/bullae
20
Q
Tinea Manuum
dx
A
- KOH prep
- fungal culture to confirm
21
Q
Tinea Manuum
tx
A
- topical anti-fungals
- if refractory: terbinafine PO
22
Q
Tinea Cruris
infection where? from?
A
- groin or inner thigh
- Trichophyton rubrum
23
Q
Tinea Cruris
risk factors
4
A
- male
- copious sweating
- immunocompromised
- existing fungal infection
24
# Tinea Cruris
clinical presentation
* **pruritus, annular, well-demarcated, hyperpigmented patches or plaques w/ diffuse erythema**
* may have vesicles
* spares scrotum
25
# Tinea Cruris
dx
* KOH prep
* fungal culture to confirm
26
# Tinea Cruris
tx
* topical anti-fungals
27
# Tinea Cruris
general preventive measures
| 3
1. desiccant powders
2. avoid tight fitting clothes
3. socks on before undies
28
# Tinea Pedis
infection where? from what?
1. feet/between toes
2. *Trichophyton Rubrum*
29
# Tinea Pedis
clinical presentation
| 4
1. scaling & redness between toes
2. maceration (moist, looks soggy)
3. look for 1 hand, 2 feet syndrome
4. Moccassin/chronic hyperkeratotic type
30
# Tinea Pedis
describe moccasin/chronic, hyperkeratotic type
* sharply marginated scale
* distributed along lateral borders of feet, heels, soles
* associated w/ onychomycosis
31
# Tinea Pedis
dx
KOH prep
32
# Tinea Pedis
tx
| first line vs second line
1. allyamine (terbinafine, naftifine, butenafine) cream, QD/BID, 1-2 wks
2. imidazole (clotrimazole, miconazole, ketoconazole) cream, BID, 4-6 wks
| ALLYAMINES ARE EXPENSIVE
33
# Tinea Versicolor
colonization of what yeast?
*Malassezia furfur*
34
# Tinea Versicolor
most common during what season?
summer
35
# Tinea Versicolor
why is it called versicolor?
can be like any color
36
# Tinea Versicolor
clinical presentation
* well-demarcated, hypo or hyper pigemented macules or patches
* primarily on trunk/arms
* macules will grow & coalesce into various shapes/sizes
* asymmetric distribution
* no visible scale, but when rubbed it is readily seen
37
# Tinea Versicolor
dx
KOH
38
# Tinea Versicolor
tx
| shampoos, creams, PO
* Shampoo: selenium sulfide (2.5%, 1 wk), ketoconzole (2%, 3 days), zinc pyrithione (1-2%, 2 wks)
* Creams: imidazole creams (QD/BID, 1-4 wks)
* PO: fluconazole (300mg, 1 pill/week, 2 wks)
39
# Tinea Versicolor
what do you need to monitor if you prescribe PO fluconazole?
LFTs
