Fungal/Infestation Flashcards
fungal infections
moulds
yeast
dimorphic
supf
subcut
deep/systemic
dermatophytes
unilateral, annular, circ’d, central clearing, red concentric border, scaling, infectious
corporis: body
cruris: groin (creases)
manuum: proximal from wrist, asymmetical
pedis: pustules and erythema on sole, white maceration between toe webs
capitis: Afro-C; genetics; Kerion swelling (persistent infection)
unguium: white discolouration, onycholysis, plate loss, hyperkeratosis
investigations
skin scrapings (Scale)
nail clippings/subungal debris
plucked hairs
UV/wood’s light
treatment - overview
topical: localised; azoles, terbinafine
systemic: widespread, hair/scalp/nails,immo; terbinafine, itra/fluconazole, griseofulvin (kids)
differentials
psoriasis: nail pitting, no central clearing
candida: moist, itchy, peeling, papules/pustules
dermatitis: scaling throughout, no clearing
erythrasma: fluoro
pityriasis rosea: herald
pityriasis versicolor: pigmentation, variable colour
erythrasma
bacterial (ABx -erythromycin)
erythema, fine scaling
defined patch/plaque
coral pink fluoro
candidiasis
very common
erythema extending from skin folds
satellite lesions and pustules at edges
moist and itchy
Rx: polyenes (nystatin/amphoB) or clotrimazole (top) or fluconazole (PO)
pityriasis versicolor (malassezia)
yellow/brown/variable/hypopigmented macules
usually truncal
fine scaling
Rx: topical miconazole/itraconazole
seborrhoeic dermatitis (malessezia)
sweaty areas: upper back, face, scalp, flexure
symmetrical
salmon-pink scaly plaques, ill-defined sun helps (worse in winter)
Rx: azoles (top) steroids, ‘limus’ (top immomod)
scabies
pruritus + excoriation (mite faeces)
trunk, digit webs, wrist
burrow marks
blistering hands/soles in kids
headlice
eggs/nits and live lice in hair
erythema, papules, excoriations
