Fungal Skin Infections Lecture Powerpoint

Question 1

Ways to test for fungal infections (3) and which is the gold standard

Answer 1

-KOH prep -culture (gold standard but takes time) -woods lamp

Question 2

KOH prep

Answer 2

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

Question 3

Important to not give antifungals before performing a…

Answer 3

…KOH

Question 4

Fungal culture

Answer 4

Several weeks long test that can identify species of fungus from a sample, useful for narrowing down

Question 5

Wood’s lamp

Answer 5

small handheld device that uses black light to illuminate areas that causes fluorescence in presence of bacteria or fungi

Question 6

Cornyebacterium minitussiumm

Answer 6

Causes erythasma, and is NOT a fungus but fluoresces with a woods lamp with a bright coral red color

Question 7

2 types of fungal skin infections

Answer 7

-Dermatophytes -yeast (candida)

Question 8

Dermatophytes and 3 most susceptible groups of patients

Answer 8

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

Question 9

All types of tinea respond to the same oral and topical agents except…

Answer 9

…tinea versicolor

Question 10

What population is most susceptible to tinea infections

Answer 10

-young adults and most often male patients

Question 11

Most common population to undergo tinea capitis infection

Answer 11

Children prepubertal and common in those living in crowded conditions

Question 12

Most common population for tindea pedis infection

Answer 12

Uncommon in women and prepubertal children, most common diagnosed dermatophyte in developed countries,

Question 13

What presentation of tinea pedis is most common?

Answer 13

Interdigital

Question 14

“one hand, 2 feet syndrome”

Answer 14

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

Question 15

Tinea pedis treatment (2)

Answer 15

-topical antifungals -systemic antifungals in severe cases as long as liver function is okay

Question 16

Pitted keratolysis and what is the recommended treatment

Answer 16

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)

Question 17

Tinea corporis

Answer 17

Also known as rinworm usually affecting trunk and limbs, often itchy and uncomfortable

Question 18

Tinea cruris

Answer 18

Jock itch, similar presentation to tinea corporis but slightly different in area of presentation and appearance

Question 19

Tine corporis treatments (2)

Answer 19

-Topical antifungals for at least 2 weeks (sue even if goes away visually) -oral antifungals if resistant but watch liver function

Question 20

If dermatitis is treated with topical steroids, it will initially appear ___ and this is called ____

Answer 20

better, tinea incognito

Question 21

Tinea capitis is most common in this population

Answer 21

School aged children often from fomites

Question 22

2 presentations of tinea capitis

Answer 22

Noninflammatory - seborrheic and black dot (broken follicles) Inflammatory - Kerion (painful inflammatory boggy mass)

Question 23

___ agents do not work for tinea capitis

Answer 23

TOPICAL

Question 24

Inflammatory tinea capitis is a dermotologic emergency because…

Answer 24

…it can lead to permanent balding and scarring

Question 25

Treatment for inflammatory tinea capitis is….

Answer 25

…referral

Question 26

Tinea versicolor (pityriasis versicoor)

Answer 26

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)

Question 27

Tinea versicolor is most often found in this population…

Answer 27

…adolescence and young adults in the tropics

Question 28

Tinea versicolor has unique presentation on KOH exam called…

Answer 28

…spaghetti and meatball pattern

Question 29

Tinea versicolor (pityriasis versicolor) treatments (3)

Answer 29

-Topical shampoos (selenium sulfide) -imidazole creams -oral medications such as fluconazole but monitor liver

Question 30

Seborrheic dermatitis

Answer 30

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

Question 31

Seborrheic dermatitis treatments (2)

Answer 31

-Topical shampoos (selenium sulfide) -imidazole creams

Question 32

Candidiasis risk factors (4)

Answer 32

-broad spectrum antibiotics -hormonal factors -HIV -DM

Question 33

What confirms visual inspection of yeast infection

Answer 33

Peripheral or “satellite” lesions

Question 34

Treatments for candidiasis (2)

Answer 34

-topical preparations -fluconazole oral

Question 35

Diaper candidiasis treatments (1) and what treatment should be avoided

Answer 35

-nystatin cream Combination therapieswith high potency steroids

Question 36

Candida Intertrigo

Answer 36

Candida infection of large skin folds due to consistent wet and dampness in those areas causing burning

Question 37

What 2 treatments are not effective for candida yeast?

Answer 37

Allyamines (terbinafine, naftifene)

Question 38

What condition is this that fluoresces red under the lamp?

Answer 38

Erythrasma

Question 39

What condition is this?

Answer 39

Moccasin tinea pedis

Question 40

What condition is this?

Answer 40

Interdigital tinea pedis

Question 41

What condition is this?

Answer 41

Vesicular tinea pedis

Question 42

What condition is this?

Answer 42

Pitted Keratolysis

Question 43

What condition is this?

Answer 43

tinea corporis