Fungal skin infections

Question 1

What is Ringworm

Answer 1

Fungal infection of the skin

Question 2

Causative organism for Ringworm

Answer 2

Most common type of fungus is trichophyton.

Spread through contact with infected individuals, animals or soils.

Question 3

Name for Ringworm affecting scalp

Answer 3

Tinea capitis

Question 4

Name for Ringworm affecting feet

Answer 4

Tinea pedis - AKA athletes foot

Question 5

Name for Ringworm affecting groin

Answer 5

Tinea cruris

Question 6

Name for Ringworm affecting body

Answer 6

Tinea corporis

Question 7

Name for fungal nail infection

Answer 7

Tinea Unguium - AKA Onychomycosis

Question 8

Athlete’s foot presentation

Answer 8

Teenagers and young adults.

White or red flaky, cracked, itchy patches between the toes. Skin may be split and bleed.

Question 9

Athlete’s foot cause

Answer 9

Often sharing changing rooms with someone with athlete’s foot.
Sweaty and damp feet for prolonged periods of time

Question 10

Ringworm presentation

Answer 10

Itchy rash that is erythematous, scaly and well demarcated. Often one of several rings or circular areas. Edge is more prominent and red than the area in the centre.

Question 11

Tinea capitis presentation

Answer 11

More common in children
Well demarcated hair loss
Itching, dryness and erythema of the scalp

Question 12

Tinea cruris presentation

Answer 12

Typically young men
Itchy, scaly rash on groin, typically bilateral
Usually overweight pt

Question 13

Onychomycosis presentation

Answer 13

>60yrs
White/yellow discolouration of nail
Thickened nail
More common on toenails
Caused by dermatophytes (require keratin for growth)

Question 14

Onychomycosis complications

Answer 14

Fungal infection spreads to other body parts

Painful walking

Question 15

Fungal skin infection complications

Answer 15

Secondary bacterial infection

Cellulitis

Question 16

Fungal infection investigations

Answer 16

Can scrape scales off and send them for microscopy and culture - usually only if severe symptoms or unsure of diagnosis
Nail clippings for onychomycosis - send for microbiology

Question 17

Onychomycosis management

Answer 17

5% Amorolfine nail lacquer (antifungal) for 6-12 months
If severe, resistant or trouble walking may need oral terbinafine 250mg once daily for 6 weeks - 3 months (monitor LFT’s)
Wear comfy shoes

Question 18

Fungal skin infection management

Answer 18

Antifungal cream e.g. clotrimazole or miconazole twice daily for a month
Keep dry and wear loose breathable clothing. Avoid sharing towels, clothes and bedding
Foot hygiene for tinea pedis
Antifungal shampoo e.g. ketoconazole for tinea capitis
Mild topical steroid to settle inflammation and itching - Daktacort cream (miconazole 2% and hydrocortisone 1%)

Question 19

What is tinea incognito

Answer 19

More extensive fungal skin infection that results from the use of steroids to treat an initial fungal infection
E.g. ringworm misdiagnosed as dermatitis and topical steroid prescribed. Improves inflammation and itching but accelerated growth of fungus due to dampening of immune system. Steroid stopped and itchy rash returns but more extensive and less recognisable as ringworm.