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Dermatology > Fungi and infestations > Flashcards

Fungi and infestations Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the 3 categories of fungal infections?

A

Superficial - epidermis

Deeper infections - dermis + subcutaneous tissue

Systemic infections

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2
Q

What are the most common causative fungi seen in dermatology?

A

Dermatophytes

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3
Q

What are the three genera of dermatophytes?

A

microsporum

trichophyton (most common)

epidermophyton

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4
Q

Through what do dermatophytes invade and live in?

A

Keratinised stratified squamous epithelium

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5
Q

What are potential reservoirs of dermatophytes?

A

humans

animals

soil

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6
Q

What are the lay and medical terms for dermatophyte infection?

A

Lay - ringworm

Medical - tinea

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7
Q

What types of tinea infection are there?

A

tinea corporis (tinea of the hairless skin)

tinea cruris (groin)

tinea manuum (hand)

tinea pedis (foot)

onychomycosis (tinea of the nails, a.k.a. tinea unguium)

tinea capitis (head)

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8
Q

What is the most common type of tinea infection?

A

tinea pedis

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9
Q

Which demographic is tinea capitis most common in?

A

Afro-Caribbeans due to increased genetic risk

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10
Q

List diseases than can be confused with tinea?

A

Psoriasis

Nummular dermatitis

Erythrasma

Candidiasis

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11
Q

How can psoriasis be differentiated from tinea?

A

In tinea there will NOT be nail pitting.

although onycholysis can occur in both

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12
Q

Which areas are at risk of candida infection?

A

Mouth

Genitals

Around nails

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13
Q

Which groups are particularly at risk of candida infection?

A

Young / Old

Immunosuppressed

Diabetics

On antibiotics / steroids

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14
Q

What is the Ix of choice for suspected fungal skin infections?

A

Skin scraping (essentially any infested part of skin which can the be MC+S)

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15
Q

What are the indications for systemic anti-fungals?

A

If nail,

scalp or

hair are infected

if a widespread skin infection

if immunocompromised

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16
Q

What is the most effective agent for tinea (dermatophyte infection)?

A

Terbinafine

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17
Q

Through what route are azoles metabolised?

A

Via the liver

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18
Q

In which patients must you be careful prescribing systemic azoles to?

A

Those with poor liver function as the azole will thus be metabolised slower

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19
Q

Which azole can be used as a shampoo?

A

Fluconazole

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20
Q

Why is ketoconazole generally not used systemically?

A

As it inhibits androgen synthesis leading to gynaecomastia

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21
Q

Why is griseofulvin rarely used anymore?

A

As it is more fungistatic than cidal

22
Q

For what is griseofulvin licensed for?

A

Orally treat Tinea

23
Q

What are the two adverse affects of griseofulvin?

A

Can induce a photosensative rash

Can cause drug interactions as is metabolised by the liver

24
Q

Is griseofulvin oral or topical?

A

Oral. It is ineffective topically

25
Q

What are the treatments for candidiasis?

A

Systemic –> Polyenes: Nystatin or Amphotericin B

Topical –> Azoles: Clotrimazole or fluconazole

26
Q

What are malassezia furfur?

A

Commensal fungi (yeasts)

27
Q

What are the two cutaneous manifestations of malassezia furfur?

A

pityriasis vesicolor

seborrhoeic dermatitis

28
Q

Who is pityriasis vesicolor commonly seen in the UK?

A

People coming home from holiday

29
Q

How common is relapse in pityriasis vesicolor?

A

Common to relapse

30
Q

How is Pityriasis vesicolor treated?

A

Topical antifungals

Selenium shampoo

Intraconzole

31
Q

How common is Seborrhoeic dermatitis?

A

Fairly common

32
Q

What is the typical distribution of seborrhoeic dermatitis?

A

Symmetrical on the face

Scalp - cradle cap (in young children), dandruff (adults)

Flexures

33
Q

What is the treatment for seborrhoeic dermatitis?

A

Topical azoles

Low potency topical corticosteroids

34
Q

How does scabies spread?

A

Human to human contact

not via clothing or dirty toilet seats

35
Q

What is the severe form of scabies known as? (who is it seen in)

A

crusted scabies

(seen in immuno-compromised or elderly patients)

has a high mite load

36
Q

What are the signs of scabies infection?

A

Itchy papules (often excoriated)

Burrows

37
Q

What is the inflammation in scabies caused by?

A

Mite faeces

38
Q

What is a unique physical sign of scabies in children? (and what causes it)

A

blistering of the palms and soles

due to stong host response to the infestation

39
Q

What is the treatment for scabies?

A

Permethrin for 12hrs

or

Malathion for 12hrs

wash clothes and linen

treat all contacts simultaneously (including health care workers)

40
Q

What is an adverse outcome post-scabies treatment? (how is it treated?

A

post-scabies eczema

this is treated as per normal eczema

41
Q

What causes head lice?

A

pediculosis capitis

42
Q

What do pediculosis capitis feed on?

A

Feed on blood in the scalp

43
Q

What can pediculosis capitis transmit?

A

Transmit staph aureus &

strep pyogenes

44
Q

How is pediculosis capitis transmited?

A

Human to human contact

45
Q

What are the signs of head lice?

A

pruritis

eggs (nits) or live lice seen on hair

erythema

papules

excoriations

46
Q

What is the treatment for pediculosis capitis?

A

Removal (hair conditioner, fine comb)

Pediculicides (malathion) - this is not that effective

47
Q

How is tinea investigated?

A

Skin scraping
Nail clippings/subungul debrisd
Hair pluckings
Wood’s light (emits UV-A)

48
Q

What are the systemic antifungals?

A

Terbinafine
Azoles (Itraconazole)
Griseofulvin

49
Q

What are the topical antifungals?

A

Terbinafine
Azoles (Ketoconazole)
Polyenes (Nystatin)

50
Q

What are the sigde effects of terbinafine?

A

There arn’t any common ones

51
Q

What are the signs of pityriasis vesicolor?

A

Hypo- or hyper-pigmented patches
Mild scaling
Mostly on the trunk

Dermatology (11 decks)

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