Fungal Skin Infection Flashcards
Describe the two types of fungal skin infections
- Tinea corporis (ringworm) (all over skin)
- Tinea cruris (groin, perineum, perianal)
What are risk factors for fungal skin infections?
- Hot humid climates
- Wearing tight fitting clothing
- Obesity
- Hyperhidrosis
- Immunocompromised states
What are complications of fungal skin infections?
- Secondary bacterial infection
- Tinea incognito (inappropriate use of topical steroids can lead to extensive spread of fungal infection)
Describe fungal rashes on the skin
- Single or multiple red or pink, flat or slightly raised annular patches of varying size
- They enlarge outwards
- Lesions have an active, red, scaly advancing edge and a clear central area. Scaly edge may be lost in moist flexures
- Asymmetrical in distribution
- Coalescence of lesions
What investigations would you undertake?
- Usually a clinical diagnosis
Skin sampling for microscopy and culture if:
- Severe and extensive disease in adults
- Diagnosis is uncertain and there is an atypical appearance
What self care management strategies can you advise?
- Loose fitting clothing made of cotton/moisture away from the skin material
- Good hygiene measures
- Dry thoroughly after washing
- Don’t scratch affected skin
- Do not share towels, and wash them frequently
- Wash clothes and bed linen to eradicate fungal spores
- Don’t exclude from school/nursery
What is the management for fungal skin infections?
- Terbinafine cream
- Imidazole cream (clotrimazole, miconazole)
- Mildly potent topical corticosteroid (hydrocortisone 1% for max 7 days)
- If severe, oral antifungals but needs skin sample testing
What advise should you give about topical corticsteroids?
- Apply a thin layer one or twice daily for max 7 days
- Rare to get side effects if used appropriately
- Seek GP advice if thin skin, striae or acne
- Keep away from fire or naked flames
What type of foot infections can be caused by fungus?
- Interdigital type (white or red, fissured, scaling skin)
- Dry type (diffuse scaling, erythema and hyperkeratosis of the sole and lateral aspect of the foot)
- Vesicobullous (inflammatory variant of vesicles on an erythematous base, mainly on arches and soles of the feet)
What symptoms suggest a fungal scalp infection?
- Scaling and itching of the scalp, may be generalised and diffuse
- Single or multiple circular patches of alopecia which is asymmetrical
- Inflammation - erythema, scattered pustules, crusting, thick crust
What is the self management advice for fungal scalp?
- Soften surface crusts with moistened dressings then tease away
- Discard or wash any hats, pillows etc
- Do not share towels
- Assess and treat household pets
What is the treatment for fungal scalp?
- Ketonazole shampoo twice weekly for 2-4 weeks
- Oral antifungal agents (oral terbinafine)
What are symptoms of fungal nail infections (onychomycosis)?
- Discoloured nail
- Single or rarely all the nails are affected
- Superficial white (small flaky white patches and pits on the nail plate)
- Associated with paroncyhia
What investigations would you undertake?
- Nail clippings or scrapings for fungal microscopy and culture
What is the self management advice for fungal nail infections?
- Keep nails trimmed short and filed down
- Well fitted non occlusive shoes
- Wear cotton absorbent socks
- Maintain good foot hygiene
- Wear protective footwear in communal bathing spaces
