Fungal infections of skin and soft tissue Flashcards

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1
Q

What are the superficial mycoses?

A

Pityriasis versicolor, tinea nigra, black piedra, white piedra

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2
Q

What is the cause of pityriasis versicolor?

A

Malassezia furfur

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3
Q

Where is pityriasis versicolor normally found?

A

Areas of the body rich in sebaceous glands (head, trunk, upper back)

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4
Q

What are the clinical symptoms of pityriasis versicolor?

A

Numerous irregularly shaped yelllow / brown scaly patches; failure to tan

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5
Q

What is the diagnosis for pityriasis versicolor?

A

Direct observation - KOH prep (“spaghetti and meatballs”)

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6
Q

What is the cause of tinea nigra?

A

Exophiala werneckii

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7
Q

How is tinea nigra transmitted?

A

Traumatic inoculation / contamination with soil, sewage, wood, compost

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8
Q

What is the clinical presentation of tinea nigra?

A

Distinct oval-shaped brown/black lesions on hands and feet

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9
Q

How is tinea nigra diagnosed?

A

KOH prep on skin scrapings reveal two-celled yeast forms containing dark pigment

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10
Q

Where is black piedra most common? White piedra?

A
  1. Black - tropics 2. White - southern US
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11
Q

What are the clinical symptoms of black piedra?

A

Hard, firmly attached gritty nodules on hair, primarily scalp

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12
Q

What are the clinical symptoms of white piedra?

A

Soft, loosely attached white / light brown nodules usually on pubic or axillary hair, beards, eyebrows

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13
Q

What is the cause of cutaneous mycoses?

A

Dermatophytes

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14
Q

What are the three most clinically relevant dermatophytes?

A

Microsporum, trichophyton, epidermophyton

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15
Q

What do the dermatophytes use as a nutrient source?

A

Keratin

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16
Q

What is used to treat tinea capitis?

A

Griseofulvin

17
Q

Candida exists in which form in normal flora?

A

Yeast

18
Q

Candida exists in which form in tissues?

A

Hyphal

19
Q

What is the recommended treatment for disseminated candidiasis?

A

IV amphotericin B with or without fluconazole

20
Q

What are the subcutaneous mycoses?

A

Sporotrichosis, chromoblastomycosis, mycetoma

21
Q

How is sporotrichosis transmitted?

A

Traumatic inoculation via rose thorns, wood splinters, sphagnum moss

22
Q

What are the clinical symptoms of sporotrichosis?

A

Inflammation at site of inoculation followed by development of painless granulomatous lesion which eventually ulcerates to create an open sore

23
Q

How is sporotrichosis diagnosed?

A

Cultivation from tissue or pus - mold converts to yeast form at 37 C

24
Q

How is sporotrichosis treated?

A

Oral potassium iodide, oral azoles (sever)

25
Q

How is chromoblastomycosis transmitted?

A

Traumatic inoculation of darkly pigmented soil fungi

26
Q

What is the clinical symptoms of chromoblastomycosis?

A

Initially presents as a wart like lesion and slowly develops to red/gray cauliflower like lesion (painless)

27
Q

What are Medlar bodies?

A

Copper colored spherical cells seen in tissues during chromoblastomycosis infection

28
Q

What is the diagnosis for chromoblastomycosis?

A

Brown pigmented hyphae in skin scrapings and presence of Medlar bodies

29
Q

What is the replicating form of chromoblastomycosis?

A

Medlar bodies

30
Q

What is the treatment for chromoblastomycosis?

A

Surgical removal, 5-fluorocytosine

31
Q

How is mycetoma transmitted?

A

Traumatic inoculation of soil-inhabiting fungi

32
Q

What is the clinical syndrome associated with mycetoma?

A

Slow growing papule at site of infection that ulcerates to release pus and blood - underlying bone becomes involved to create pitted lesions

33
Q

What is the diagnosis for mycetoma?

A

Direct observation of colored “grains” in pus, tissue, or discharge - compacted hyphae and conidia