Fungal Infections Flashcards
List types of dermatophyte infections
Tinea pedis
Tinea corporis
tinea unguium
Tinea capitis
Tinea cruris
Tinea manuum
What are the signs and symptoms of tinea pedis? (sx, location)
Location = feet, between toes (can spread)
Characterised = itching, redness, flaking, moistness
May have unpleasant odour
What are the signs and symptoms of tinea corporis? (sx, location)
Location = trunk, legs, arms, neck
Characterised = pink/red scaly lesions, slightly elevated and well defined border w/ active outer edge, itch (mild- moderate)
May be singular or numerous
What are the signs and symptoms of tinea unguium? (sx, location)
Location = nails
Early characteristic = distal/lateral yellow/white discolouration of nail
Late characteristics = nail thickens, nail plate lifts off nail bed
Nail becomes brittle –> crumbles and falls off
What are the signs and symptoms of tinea capitis? (sx, location)
Location = head
Characteristics = may be asymptomatic or slight itch, redness/scales, hair breaking off
May be inflamed and/or pus-filled
Severe case = fungal abscess can occur
Systematic treated required due to hair follicle involvement
What are the signs and symptoms of tinea cruris? (sx, location)
Location = groin
Characteristics =scaly red margin from groin down to inner thigh, well defined raised patches
Margin can have small pustules, usually mildly itchy
What are the signs and symptoms of tinea manuum? (sx, location)
Location = hands
Characteristics = scaly, annular (circular or round) rash with active border
List the different kind of yeast infections
Pityriasis versicolour
Oral candidiasis
Vaginal candidiasis
Napkin candidiasis
How does pityriasis versicolour appear on different skin tones?
Fair skin = lesions are light-brown
Pigmented skin = patchy hypopigmentation
Caused by a yeast
How does pityriasis versicolour appearance differ in areas of high/low sun exposure?
Area unexposed to light = red-brownish circular lesion often joining up together
Areas exposed to light = infected lesions do not tan
What are the signs and symptoms of pityriasis versicolour (sx, location)
Location = upper trunk
Characteristics = discoloured skin patches, light scaling if skin is scratched, asymptomatic may itch
Not infectious but may itch
What are the signs and symptoms of oral candidiasis? (sx, location)
Location = mouth, tongue, cheeks
Characteristics = white, creamy patches in mouth (easily wipes off), may be red and painful, red sore splits in corner of mouth
Infants = may not feed well, uncomfortable sucking
Adults = taste disturbances
What are the signs and symptoms of vaginal candidiasis? (sx, location)
Location = vagina or vulva
Characteristics = thick, white discharge w/ non offensive odour, may itch/be sore, external dysuria
Sex may be painful
What are the signs and symptoms of napkin candidiasis? (sx, location)
Location = usually skin folds
Characteristics = clusters of red papules and plaques, well demarcated, painful red rash
Small satellite lesions may be present
How does Pityrosporum orbiculara/versicolour change skin colour?
Multiplies in superficial layers or stratum corneum on trunk and upper limbs –> mild inflammation –> carboxylic acid production –? inhibits melanin production
What are some differential diagnoses to tinea corporis?
Dermatitis = will go away with corticosteroid treatment whilst fungal will not
Discoid eczema = arms and legs, whole lesion is red and not just border
Psoriasis = patient will have fam hx, lesions are red and fully scaly
What are some differential diagnoses to tinea unguium?
Trauma = identifiable event that affected nails
Eczema = ridges in nail, skin near/around feet affected
Psoriasis = will see nail pitting, less yellow discolouration seen
What are some differential diagnoses to tinea capitis?
Alopecia = not associated with scales, not common
Seborrhoeic dermatitis = should not have hair loss
Psoriasis = has thicker scales
What are some differential diagnoses to tinea manuum?
Pompholyx = often bilateral or symmetrical
Psoriasis = often bilateral or symmetrical
List the topical drugs used to treat fungal infections
Imidazoles = clotrimazole, miconazole, ketoconazole, bifonazole, econazole
Terbinafine (lamisil)
Tolnaftate = not super effective
What is the efficacy, duration, and considerations for topical imidazoles?
(Fungal infections)
Req freq application
Apply for 14 days after sx resolve
What is the efficacy, duration, and considerations for topical terbinafine?
Rapid response, once daily application
short duration of use ~ 1 week
Continue use for 2-3 days after sx resolve
Summarise the specific treatments for tinea unguium
Amorolfine nail lacquer = 1-2/week for 6 months (fingernails)/ 9-12 months (toenails)
- use until nail is completely cured/regrown
Bifonazole and Urea (mild-moderate infections) = used in phases
- Phase 1 (wk 1-3) = Urea ketatinolytic agent that softens infected nail only --> apply 1/day for 2-3 wks, soak in warm water + scrape to remove infected nail - Phase 2 (wk 4-7) = bifonazole Treats the infection, 1/day for 28 days
List the systemic treatments for tinea
Oral terbinafine
Fluconazole
Itraconazole
Griseofulvin
