Fungal Skin Infections Lecture Powerpoint Flashcards
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Ways to test for fungal infections (3) and which is the gold standard
-KOH prep -culture (gold standard but takes time) -woods lamp
KOH prep
Microscopy technique easiest and most cost effective method to diagnose fungal infections of hair skin and nail, KOH dissolves keratinocytes making it easier to identify the hyphae
Important to not give antifungals before performing a…
…KOH
Fungal culture
Several weeks long test that can identify species of fungus from a sample, useful for narrowing down
Wood’s lamp
small handheld device that uses black light to illuminate areas that causes fluorescence in presence of bacteria or fungi
Cornyebacterium minitussiumm
Causes erythasma, and is NOT a fungus but fluoresces with a woods lamp with a bright coral red color
2 types of fungal skin infections
-Dermatophytes -yeast (candida)
Dermatophytes and 3 most susceptible groups of patients
Groups of fungi that survive on dead keratin, hair and nails and cannot survive on mucus membranes, patients most ssceptible include those with diabetes, immunodeficiency, or atopic individuals
All types of tinea respond to the same oral and topical agents except…
…tinea versicolor
What population is most susceptible to tinea infections
-young adults and most often male patients
Most common population to undergo tinea capitis infection
Children prepubertal and common in those living in crowded conditions
Most common population for tindea pedis infection
Uncommon in women and prepubertal children, most common diagnosed dermatophyte in developed countries,
What presentation of tinea pedis is most common?
Interdigital
“one hand, 2 feet syndrome”
Refers to moccasin type presentation of tinea pedis where an affected hand shows unilateral scalingin creases and indicates to look at feet for tinea pedis
Tinea pedis treatment (2)
-topical antifungals -systemic antifungals in severe cases as long as liver function is okay
Pitted keratolysis and what is the recommended treatment
A bacterial in origin condition often mistaken for tinea pedis or plantar warts that has much lowered severity of itchiness and pain and appears as little pitted spots on soles of feet, treated with drysol (aluminum chloride)
Tinea corporis
Also known as rinworm usually affecting trunk and limbs, often itchy and uncomfortable
Tinea cruris
Jock itch, similar presentation to tinea corporis but slightly different in area of presentation and appearance
Tine corporis treatments (2)
-Topical antifungals for at least 2 weeks (sue even if goes away visually) -oral antifungals if resistant but watch liver function
If dermatitis is treated with topical steroids, it will initially appear ___ and this is called ____
better, tinea incognito
Tinea capitis is most common in this population
School aged children often from fomites
2 presentations of tinea capitis
Noninflammatory - seborrheic and black dot (broken follicles) Inflammatory - Kerion (painful inflammatory boggy mass)
___ agents do not work for tinea capitis
TOPICAL
Inflammatory tinea capitis is a dermotologic emergency because…
…it can lead to permanent balding and scarring
Treatment for inflammatory tinea capitis is….
…referral
Tinea versicolor (pityriasis versicoor)
A yeast infection not a dermatophyte, can cause some itching and can appear very variantly but does not have visible scale until rubbed with finger or scalpal blade (differentiates from tinea corporis)
Tinea versicolor is most often found in this population…
…adolescence and young adults in the tropics
Tinea versicolor has unique presentation on KOH exam called…
…spaghetti and meatball pattern
Tinea versicolor (pityriasis versicolor) treatments (3)
-Topical shampoos (selenium sulfide) -imidazole creams -oral medications such as fluconazole but monitor liver
Seborrheic dermatitis
Also known as dandruff, common inflammatory rxn to eyast that thrives on seborrheic skin and causes inflammation to normal flora, chronic condition that can be controlled but not cured
Seborrheic dermatitis treatments (2)
-Topical shampoos (selenium sulfide) -imidazole creams
Candidiasis risk factors (4)
-broad spectrum antibiotics -hormonal factors -HIV -DM
What confirms visual inspection of yeast infection
Peripheral or “satellite” lesions
Treatments for candidiasis (2)
-topical preparations -fluconazole oral
Diaper candidiasis treatments (1) and what treatment should be avoided
-nystatin cream Combination therapieswith high potency steroids
Candida Intertrigo
Candida infection of large skin folds due to consistent wet and dampness in those areas causing burning
What 2 treatments are not effective for candida yeast?
Allyamines (terbinafine, naftifene)
What condition is this that fluoresces red under the lamp?
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Erythrasma
What condition is this?
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Moccasin tinea pedis
What condition is this?
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Interdigital tinea pedis
What condition is this?
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Vesicular tinea pedis
What condition is this?
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Pitted Keratolysis
What condition is this?
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tinea corporis