Fungal Skin Infections Flashcards
What are all the skin infections?
tinea capitis (ringworm of the scalp) tinea corporis (ringworm of glabrous skin) tinea cruris (ringworm of the groin) tinea unguium or onychomycosis (ringworm of the nail) tinea pedis (ringworm of the feet) tinea barbae (ringworm of the beard) tinea manuum (ringworm of the hand) tinea versicolor Candidiasis
What is ringworm of scalp?
tinea capitis
What is ringworm of glabrous skin?
tinea corporis
What is ringworm in groin?
tinea cruris
What is ringworm of nail?
tinea unguium or onychomycosis
What is ringworm of the feet?
tinea pedis
What is ringworm of the beard?
tinea barbae
What is ringworm of the hand?
tinea manuum
What is Superficial fungal infection of the skin of the scalp, eyebrows, and eyelashes, with a propensity for attacking hair shafts and follicles?
tinea capitus
What causes this?
dermatophytes
What are the three genres?
microsporum, trichophyton, epidermophyton
What is the dx for dermatophytes?
KOH mount, see branching hyphae
What else can you use to dx dermatophytes?
cultures - take long time
wood’s lamps
Where do dermatophytes survive?
keratin, hair, nails
Who gets tinea capitus?
children 3-10 yo
What is the cause of tinea capitus?
trichophyton tonsurans
How do you get tinea capitus?
person to person contact, orangism is viable on contaminated brushes, combs, sheets
What is the presentation of tinea capitus?
non-inflammatory- patches of alopecia, scaling
Inflammatory - granulomatus, boggy mass
How does tinea capitus progress?
red papules –> grayish ring –> pustules –> debris –> alopecia
How do you dx tinea capitus?
KOH mount, wood lamp (the most common does not fluorescence), cultures (2 wk to identify)
What is the tx for tinea capitus?
Griseofluvin 20-25 mg/kg/d for 6-8 wks
Itraconazole 3-5 mg/kg/d with a full meal for 4-6 wks
terbinafine 3-6 mg/kg/d for approximately 2-4 weeks
Selenium sulfide shampoo
How does selenium sulfide shampoo help with tinea capitus?
reduces viable spores, reduce spreading
What does tinea corporis look like?
annular lesions, scaly ring like, advances elevated borders, central clearing, deep inflammatory lesion
What causes tinea corporis?
zoophilic or geophilic dermatophytes
What is trichophyton rubum cause?
infection of hair, hair follicles, surrounding dermis, perifollicular granulomatous nodules
How do you dx tinea corporis?
KOH test, skin scrapings, fungal cultures
What is the treatment for tinea corporis?
topical agents
Naftifine 1% cream/gel (Naftin) x 4 weeks
Terbinafine topical (Lamisil)
Ketoconazole topical (Nizoral)
Clotrimazole 1% cream (Mycelex, Lotrimin)
Oxiconazole 1% cream (Oxistat)
How should the topical be applied in tinea corporis?
at least 2 cm beyond area once or twice a day for at least 2 weeks
What are the systemic agents of tinea corporis?
for extensive infection, immunosuppression, resistance to topicals, or comorbid tineas
GRISEOFULVIN 10mg/kg/d for 4 weeks
FLUCONAZOLE 50-100mg/d or 150mg once weekly for 2-4 weeks
ITRACONAZOLE 200mg/d x 1 week, or 100mg/d x 2 weeks
What is tinea cruris called?
jock itch
What is Pruritic, superficial fungal infection of the groin and adjacent skin?
tinea cruris
What are risk factors for tinea cruris?
wearing tight-fitting or wet clothing or undergarments or auto-inoculation from other site
What does 50% of tinea cruris pts have?
tinea pedis
What causes tinea cruris?
Trichophyton rubrum and Epidermophyton floccosum
How do you dx tinea cruris?
KOH
What is the treatment for tinea cruris?
Naftifine 1% cream/gel (Naftin) Terbinafine topical (Lamisil) Ketoconazole topical (Nizoral) Clotrimazole 1% cream (Mycelex, Lotrimin) Oxiconazole 1% cream (Oxistat)
What are key things in tinea cruris?
symmetric erythematous rashsymmetric erythematous rash
central clearing
What is term is tinea pedis?
athlete’s foot
What is Dermatophyte infection of the soles of the feet and the interdigital spaces?
tinea pedis
What are risk factors for tinea pedis?
hyperhidrosis, prolonged exposure to occlusive footwear, hot/humid/tropical environments, swimming
What causes tinea pedis?
Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum
What is the presentation of tinea pedis?
Pruritic, scaly soles and, often, painful fissures between the toes – Rarely vesicular or ulcerative lesion
What is the treatment for athlete’s foot?
Naftifine 1% cream/gel (Naftin) BID x 4 weeks
Terbinafine topical 1% (Lamisil) x 2-3 weeks
Clotrimazole 1% cream (Mycelex, Lotrimin)
Oxiconazole 1% cream (Oxistat)
Luliconazole, topical cream, is applied once daily for 2 weeks
How long do you treat tinea pedis?
1-6 weeks
What does tinea versicolor look like?
HYPO/HYPERPIGMENTED SCALY MACULES
CONFLUENT PATCHES
UPPER TRUNK
What are risk factors for tinea versicolor?
genetic predisposition; warm, humid environments; immunosuppression; malnutrition; application of oily preparations; corticosteroid usage; Cushing disease
What is the cause of tinea versicolor?
Malassezia furfur or Pityrosporum orbiculare
What is the dx of tinea versicolor?
KOH -clusters of spores and SHORT hyphae
SPAGGETTI WITH MEATBALLS
What will tinea versicolor look like on a wood lamp?
yellow to coppery-orange
What is there with tinea versicolor?
scaling
When do skin color alteration resolve within?
1-2 months after treatment
What is the treatment for tinea versicolor??
SELENIUM SULFIDE 2.5% LOTION OR SHAMPOO, applied daily (for 10 minutes then rinse) x 2weeks
KETACONAZOLE SHAMPOO or TOPICAL FOAM
Fluconazole 300mg PO weekly for 2 weeks
Itraconazole 200mg PO daily for 5-7 days
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