Fungal Infections Flashcards
what are fungal infections called
- dermatophytoses
superficial cutaneous fungal infections are limited to the _____
- epidermis
which groups of cutaneous fungi cause superficial infections
- dermatophytes - Malassezia species - Candida species
what is included in Dermatophytes
- Trichophyton species - Microsporum species - Epidermophyton species
dermatophytes infect what kind of tissues
- keratinized tissues
what is the most common fungal infection seen in developed countries
- Tinea pedis
Tinea pedis caused by what fungus
- Trichopyton rubrum
three patterns of Tinea pedis infection
- interdigital - moccasin - vesiculobullous
which the most common patterns of Tinea pedis infection that presents with scaling and redness between the toes and may have associated maceration
- interdigital
what is maceration of the skin
- skin breakdown due to moisture
what patterns of Tinea pedis infection presents with sharply marginated scale, distributed along the lateral borders of feet, heels, and soles
- moccasin type
moccasin patterns of Tinea pedis infection often associated with
- onychomycosis
what is onychomycosis
- nail fungal infection
moccasin type tinea pedis may present as ______ syndrome
- one hand, two feet
what patterns of Tinea pedis infection presents with grouped 2-3 mm vesicles or bullae that are often seen on the arch or instep that may be itchy or painful
- vesiculobullous
vesiculobullous type tenia pedis represents ________ hypersensitivity immune response to a dermatophyte
- delayed
what do you look for on KOH exam
- parallel walls throughout entire length - septated and branching hyphae
how long do you apply topical antifungals for tinea pedis
- until resolution - then continue for two weeks
which antifungals are fungistatic examples
- imidazoles - clotrimazole - miconazole - ketoconazole
which antifungals are fungicidal examples
- allylamines - terbinafine - naftifine
which antifungals are fungicidal and fungistatic examples
- ciclopirox - ciclopirox olamine
complications of tinea pedis
- lower leg cellulitis - tinea corporis
the most common risk for lower leg cellulitis in immunocompetent non diabetics is _______
- tinea pedis
what is a chronic fungal infection of the nailbed
- onychomycosis
how well does onychomycosis respond to topicals
- poorly
first line treatment of onychomycosis
- oral terbinafine or azoles for 3 months
what refers to dermatophytosis of the skin, that usually affects the trunk and limbs
- tinea corporis
tinea corporis most prominent symptom
- itching
what is an annular lesion with central clearing typical of
- tinea corporis
tinea corporis affects what
- body
tinea pedis affects what
- feet
tinea capitis affects what
- scalp
tinea cruris affects what
- groin/folds
tinea manuum affects what
- hands
tinea facei affects what
- face
tinea incognito is caused by what
- tinea obscured by a topical steroid
treatment of tinea corporis
- similar to tinea pedis
- topical antifungals
treatment for severe or widespread cases of tinea corporis
- oral terbinafine - fluconazole
what do you see in a KOH exam with tinea capitis
- arthrospores inside hair shafts
what is another name for arthrospores inside hair shafts
- endothrix
tinea capitis is common in what race and what age
- african american - children (4-8)
tinea capitis spreads through
- direct contact
most common worldwide transmission of tinea capitis is by what organism what kind of transmission
- Microsporum canis - animal to human
most common US transmission of tinea capitis is by what organism what kind of transmission
- Trichophyton tonsurans - human/fomite to human
what are broken hairs a prominent feature of
- tinea capitis
noninflammatory tinea capitis has these features
- black dot - seborrheic
inflammatory tinea capitis has these features
- kerion
what physical exam finding does tinea capitis often present with
- lymphadenopathy (post auricular, posterior cervical, occipital)
what is a painful, boggy inflammatory mass with broken hair follicles that untreated tinea capitis can progress to
- kerion
topical agents are (effective/ineffective) in management of tinea capitis
- ineffective
drug of choice for tinea capitis
- griseofulvin/terbinafine
what is the diagnosis for beefy red confluent erosions and marginal scaling in the area covered by the diaper in an infant
- diaper candidiases
what helps differentiate candidal diaper dermatitis from other eruptions in the diaper area
- satellite papules and pustules
suspect ______ when rash does not improve with application of barrier creams such as zinc oxide paste
- diaper candidiasis
what causes diaper candidiasis
- wet and dirty diapers not changed regularly - due to urease in feces - disruption of epidermal barrier allows entry of Candida in which is present in feces
topical treatment for diaper candidiasis
what about for significant inflammation
- nystatin - imidazole cream or ointment
- 1% hydrocortisone cream or ointment
what helps differentiate diaper candidiasis from irritant diaper dermatitis
- candidiasis is present in the folds - and does not improves with a barrier cream
what is an erythematous dermatitis limited to exposed areas on the diaper
- irritant diaper dermatitis
treatment of irritant diaper dermatitis
- barrier creams - zinc oxide - frequent diaper changes
what is candidiasis of large skin folds
- candidal intertrigo
what does KOH exam of candidal intertrigo reveal
- pseudohyphae
symptoms of candidal intertrigo
- burns more than itches
treatment of candidal intertrigo
- nystatin and imidazoles
what is due to an inflammatory reaction to a normal skin yeast
- seborrheic dermatitis
