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CMT > Fungal Disorders > Flashcards

Fungal Disorders Flashcards

1
Q

KOH Exam

dissolves what? to make it easier to see what?

A
  1. keratinocytes
  2. fungal hyphae
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2
Q

KOH Exam

procedural steps

6

A
  1. clean/moisten skin (alcohol swab)
  2. collect scale w/ 15 blade
  3. scrap over skin to allow scal to accumulate
  4. place coverslip on top of slide
  5. add 1-2 drops KOH
  6. scan at low power, then zoom to identify hyphae at 10X
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3
Q

Tinea Capitis

typically caused by?

A
  1. Trichophyton tonsurans
  2. Microsporum canis
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4
Q

Tinea Capitis

typically affects who?

A
  1. children, immunocomp
  2. African Americans
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5
Q

Tinea Capitis

risk factors

A

poor hygiene

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6
Q

Tinea Capitis

mode of transmission?

A
  • contact w/ infected person or fomites
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7
Q

Tinea Capitis

clinical presentation

A
  • patches of alopecia w/ black dots or scaly patches of hair loss
  • erythema or pruritis common
  • Kerion
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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
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9
Q

Tinea Capitis

Diagnosis

A
  • clinical
  • KOH
  • Wood lamp
  • fungal culture
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10
Q

Tinea Capitis

Tx

oral tx

A
  1. oral girseofulvin
  2. oral terbinafine
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11
Q

Tinea Capitis

non PO tx option

A
  • anti-fungal shampoo 2x wkly
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12
Q

Tinea Capitis

prevention

A
  • treat all family members
  • avoid sharing hats, brushes/combs, hair clippers
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13
Q

Tinea Corporis

where on body?

A

trunk and limbs

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14
Q

Tinea Corporis

caused by what pathogen?

A
  • trichophyton rubrum
  • microsporum spp
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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
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16
Q

Tinea Corporis

dx

A
  • KOH prep
  • Fungal culture to confirm
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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
  1. hands
  2. Trichophyton spp
18
Q

Tinea Manuum

risk factors

3

A
  1. manual laborers
  2. hyperhidrosis
  3. 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
  1. male
  2. copious sweating
  3. immunocompromised
  4. existing fungal infection
24
Q

Tinea Cruris

clinical presentation

A
  • pruritus, annular, well-demarcated, hyperpigmented patches or plaques w/ diffuse erythema
  • may have vesicles
  • spares scrotum
25
Q

Tinea Cruris

dx

A
  • KOH prep
  • fungal culture to confirm
26
Q

Tinea Cruris

tx

A
  • topical anti-fungals
27
Q

Tinea Cruris

general preventive measures

3

A
  1. desiccant powders
  2. avoid tight fitting clothes
  3. socks on before undies
28
Q

Tinea Pedis

infection where? from what?

A
  1. feet/between toes
  2. Trichophyton Rubrum
29
Q

Tinea Pedis

clinical presentation

4

A
  1. scaling & redness between toes
  2. maceration (moist, looks soggy)
  3. look for 1 hand, 2 feet syndrome
  4. Moccassin/chronic hyperkeratotic type
30
Q

Tinea Pedis

describe moccasin/chronic, hyperkeratotic type

A
  • sharply marginated scale
  • distributed along lateral borders of feet, heels, soles
  • associated w/ onychomycosis
31
Q

Tinea Pedis

dx

A

KOH prep

32
Q

Tinea Pedis

tx

first line vs second line

A
  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
Q

Tinea Versicolor

colonization of what yeast?

A

Malassezia furfur

34
Q

Tinea Versicolor

most common during what season?

A

summer

35
Q

Tinea Versicolor

why is it called versicolor?

A

can be like any color

36
Q

Tinea Versicolor

clinical presentation

A
  • 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
Q

Tinea Versicolor

dx

A

KOH

38
Q

Tinea Versicolor

tx

shampoos, creams, PO

A
  • 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
Q

Tinea Versicolor

what do you need to monitor if you prescribe PO fluconazole?

A

LFTs

CMT (78 decks)

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