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OTC > Fungal infections and warts > Flashcards

Fungal infections and warts Flashcards

1
Q

tinea refers to

A

dermatophyte infections

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2
Q

____ of the US population suffer from a tinea infection at any one time

A

10-20%

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3
Q

what increases risks of fungal infections

A

trauma to the skin; esp. if it produces blisters

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4
Q

transmission of fungal infections

A

through contact with infected people. animals, soils, or fomites

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5
Q

inoculation of fungus

A

penetration of fungus into the skin

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6
Q

incubation of fungus

A

growth of infection inside stratum corneum

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7
Q

fungal growth rate must be

A

greater than two times epidermal turnover rate or the fungus will be shed quickly

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8
Q

involution of fungus

A

resolution of infection after an adequate immune response

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9
Q

signs and symptoms of fungal infection

A
  • mild itching and scaling
  • denudation: losing outside layer of skin
  • fissuring: break in skin
  • crusting
  • discoloration
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10
Q

risk factors for fungal infections

A
  • age (more common in children)
  • contact sports
  • restrictive clothing and shoes
  • weak immune system (diabetes, HIV)
  • sex (more often in men)
  • race (AA female children)
  • poor hygiene
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11
Q

tenia pedis location and characteristics

A
  • location: feet

- Characteristics: chronic intertriginous

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12
Q

chronic intertriginous

A

toe webs, scaling, fissures, maceration of interdigital spaces, malodor, pruritus, and stinging sensation

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13
Q

tinea corporis location and characteristics

A
  • location: any smooth and bare skin
  • characteristics: start as small circular, erythematous, scaly areas; spread peripherally, borders may contain vesicles or pustules
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14
Q

tinea cruris location

A

medial and upper parts of thigh and pubic area (more common in males)

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15
Q

tinea cruris characteristics

A

bilateral, pruritic, scaly lesions
acute lesions: bright red
chronic lesions: hyperpigmented appearance
pain may occur with sweating

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16
Q

tinea capitis location

A

scalp

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17
Q

4 kinds of tinea capitis

A
  1. non-inflammatory
  2. inflammatory
  3. black dot
  4. favus variant
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18
Q

non-inflammatory tinea capitis

A
  • small papules
  • spread centrifugally
  • some scaling
  • hair in lesions (dull gray color)
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19
Q

inflammatory tinea capitis

A
  • pustules or kerion (weeping lesions)
  • pruritis
  • fever
  • pain
  • regional lymph node enlargement
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20
Q

black dot tinea capitis

A
  • broken hair shaft (hair loss) –> black dots
  • inflammation
  • scaling
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21
Q

favus variant tinea capitis

A
  • patchy hair loss
  • scutula (yellow crust and scales)
  • lesions can merge
  • can lead to secondary bacterial infections
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22
Q

tinea unguium location and characteristics

A

location: nails
characteristics: opaque, thick, rough, yellow and friable nails (may separate from nail bed if infection progresses)

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23
Q

treatment goals for fungal infxn

A
  1. symptomatic relief
  2. eradicate infection
  3. prevent future infections
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24
Q

tinea types for self-treatment

A

tinea pedis, tinea corporis, tinea cruris

25
Q

fungal nail revitalizer

A

(for unguium, WILL NOT TREAT)

  • reduces discoloration and smooths out nail
  • contains calcium carbonate and urea
  • apply over infected nail and scrub with nail brush for 1 min, wash and dry (daily for three weeks)
26
Q

exclusions for self treatment of fungal infxn

A
  1. causative factor unclear
  2. unsuccessful initial treatment or worsening of condition
  3. nails or scalp involved
  4. face, mucous membranes, or genitalia involved
  5. signs of possible bacterial infection
  6. excessive and continuous oozing
  7. condition extensive, seriously inflamed, or debilitating
  8. diabetes, systemic infection, immune deficiency
  9. fever and/or malaise
27
Q

non pharm treatment of fungal infxn

A
  • keep skin clean and dry
  • avoid sharing personal articles
  • wash contaminated towels
  • do not wear clothing or shoes that causes skin to stay wet
  • dust shoes with foot powder to keep them dry
  • avoid contact with people who have infection
28
Q

topical antifungals

A
  • clotrimazole
  • miconazole nitrate
  • terbinafine HCl
  • butenafine HCl
  • tolnaftate (prevention too)
  • undecylenic acid, clioquinol
29
Q

considerations when using topical antifungals

A
  • creams or solutions are most effective
  • sprays and powders more prophylactic
  • symptom relief within 1 week but complete therapy
  • recommended treatment for at least 1-4 weeks
30
Q

duration of tx for tinea pedis and tinea corporis

A

4 weeks

31
Q

duration of tx for tinea cruris

A

2 weeks

32
Q

application of topical antifungal

A

mostly twice daily (except butenafine and terbinafine)

33
Q

butenafine application

A

tinea pedis: BID for 1 week or 1 QD for 4 weeks

tinea cruris/corporis: 1 qd for 2 weeks

34
Q

terbinafine application

A

1 qd for 1 week

35
Q

potential adverse effects of topical antifungals

A

mild skin irritation, redness, itching, burning/stinging

36
Q

active ingredient

  1. lotrimin AF cream and solution
  2. lotrimin spray and powder
  3. lotrimin ultra
A
  1. clotrimazole 1%
  2. miconazole nitrate 2%
  3. butenafine HCl
37
Q

salts of aluminum useful when

A

in combo with topical antifungals for wet, soggy tinea pedis lesions or inflammatory type

38
Q

salts of aluminum serves two purposes

A

astringent action and antibacterial activity to prevent secondary bacterial infections (at concentrations > 20%)

39
Q

apply salts of aluminum before or after antifungal?

A

before and can be used up to 1 week

40
Q

if no fissures then use

A
  • aluminum acetate solution
  • 20-30% aluminum chloride solution
    apply bid until odor or wetness goes away then 1 qd for 1 week
41
Q

if deep fissures are present then use

A

lower concentration 10% aluminum acetate or chloride

apply bid until fissures heal; then higher concentrations

42
Q

______ percent of general population have warts

A

7-10

43
Q

peak incidence of warts

A

12-16 years old

44
Q

percentage of warts that clear in

  1. two months
  2. three months
  3. two years
A
  1. 23%
  2. 30%
  3. 65-78%
45
Q

warts are caused by

A

HPV, type of HPV dictates type of wart and location

46
Q

infection of wart occurs

A

through person to person contact, autoinoculation, or fomites

47
Q

common wart type

verruca vulgaris

A

found on hands. typically skin or brown colored; dome shaped papules with a rough cauliflower-like appearance and painless. common in children

48
Q

plantar warts

verruca plantaris

A

found on feet. skin colored, flat, callous-like papules; may be painful, esp. if in a weight-bearing location; common in adolescents and young adults
May be difficult to distinguish from calluses or malignant growth
If multiple closely grouped – considered “mosaic” type

49
Q

flat warts

verruca plana

A

found on face. smooth, flat-topped, yellow-brown papules; common in children

50
Q

periungal warts

A

found on nails; thickened, fissured, cauliflower-likes skin around nail plate

51
Q

filiform warts

A

found on face; rapidly growing, thread-like projections

52
Q

goals of treatment for warts

A

eliminate signs and symptoms, remove wart without scarring, prevent recurrence, and prevent spread of HPV

53
Q

exclusions for self treatments of warts

A
  1. less than 4 y/o
  2. pregnancy or breast-feeding
  3. conditions that affect blood circulation to hands or feet
  4. large or multiple warts located on one area of the body
  5. painful plantar warts
  6. warts on face, breasts, armpits, fingernails, toenails, anus, genitalia, or mucus membranes
54
Q

to avoid spread of warts

A
  1. avoid cutting, shaving or picking at warts
  2. wash hands before and after touching warts
  3. keep feet clean and dry
  4. use specific towel to dry area
  5. avoid sharing items (towels, razors..)
  6. avoid walking barefoot
55
Q

self-treatment options of warts

A

salicylic acid and cryotherapy

56
Q

salicylic acid products for warts

A
  • salicylic acid 40% in plasters/pads/strips
  • salicylic acid 17% liquid/gel
  • salicylic acid 15% patch in karaya gum vehicle
57
Q

cryotherapy

A

pressurized spray can or foam applicator

58
Q

cryotherapy ingredients

A

dimethyl ether and propane

59
Q

other wart therapies

A

duct tape occlusion, vitamin a, dietary zinc, garlic, essential oils

OTC (22 decks)

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