Fungal Infections

Question 1

M/C/C of Tinea Pedis (Athlete’s Foot)?

Answer 1

Trichophytan Rubrum

Question 2

What skin findings do you see with Tinea pedis?

Answer 2

• Erythema
• Scaling
• White, mushy, soft, cracked skin between toes
• Pruritis

Question 3

Tinea Manuum is often _______ and often associated with _______?

Answer 3

• Unilateral (M/C dominant hand)
• Tinea pedis

Question 4

With Tinea Manuum look for?

Answer 4

Diffuse scaling on palmer aspect + advancing border

Question 5

*What pts are more prone to fungal infections?

Answer 5

DIABETICS

Question 6

RF for fungal infections?

Answer 6

• Warm/humid weather
• Obesity
• Tight clothing
• Excessive sweating
• Chronic topical. steroid use

Question 7

Tinea Cruris

Answer 7

“Jock itch” (usu. itchy)

Question 8

T/F: You should use cortisone cream for fungal infections

Answer 8

False!!! It’s fertilizer for fungus BADDD

Question 9

With Tinea Faciei you get less scaling and more?

Answer 9

Inflammation (photosensitizing, gets red with sun exposure)

Question 10

If Tinea is mistreated with a topical steroid for a while what can develop?

Answer 10

Tinea Incognito (deep red/violaceous follicular papules/pustules)

Question 11

How can you dx a fungal infection?

Answer 11

• Biopsy
• KOH Test (look for hyphae)

Question 12

What’s the treatment for ALL Tinea infections besides T. Incognito, T. Capitus, & Onychomycosis)

Answer 12

TOPICAL Antifungals!
- Econazole
- Ketoconazole

Oral antifungals may be used in extensive/resistant cases or in areas where it makes sense that an oral med is needed (i.e hairy areas)

Question 13

Fungal infection of the nails

Answer 13

Onychomycosis

Question 14

What do you see with Tinea Capitis?
Who is it m/c in?

Answer 14

• Scaling, broken hairs, painful/boggy nodules on scalp
• Possible scarring alopecia
• M/C in toddlers, school-age kids, African Americans

Question 15

What is Tinea Versicolor?

Answer 15

Chronic, asx scaling dermatosis associated with the superficial overgrowth of Malassezia furfur (same fungus that causes seborrheic dermatitis)

Question 16

What skin findings do you see with Tinea Versicolor?
Where does it m/c occur?

Answer 16

• Well-demarcated, scaling patches with varying pigmentation
• M/C on trunk

Question 17

What do you see on KOH for Tinea Versicolor?

Answer 17

“Spaghetti and Meatballs”

Question 18

What is Pityrosporum Folliculitis?

Answer 18

Pruritic, monomorphic follicular papule/pustule commonly found on the trunk, NO comedones

Question 19

RF for Tinea Unguium “Onychomycosis”?

Answer 19

• DM
• Immunosuppression
• Occlusive footwear

Question 20

Thick yellow discoloration of the nail, m/c big toe

Answer 20

Onychomycosis

Question 21

How do you treat Onychomycosis?

Answer 21

Since topical antifungals aren’t super effective give oral antifungals like Terbinafine or Fluconazole PO

Question 22

What skin findings do you see with a Candida (m/c Candida albicans) infection?
Where is it m/c found?

Answer 22

• Beefy red erythema
• Red pinpoint papules/pustules which become umbilicated –> “Satellite lesions”
• Erosions, ulcerations, fissures
• M/C in warm moist skin folds (ex. diaper dermatitis)

Question 23

How id Candida treated?

Answer 23

• Systemic antifungals like Flucanazole (Diflucan)
• Topical antifungals (powder/drying agent)

Question 24

What is Angular Cheilitis “Perleche”?
Who is m/c affected?
Possible causes?

Answer 24

• Inflammation of the angles of the mouth which can lead to fissuring, bacterial, or yeast infection
• M/C in elderly
• Aging, poor fitting dentures, chronic lip licking