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X Clin Med Exam 1 > L3 Tinea Scabies > Flashcards

L3 Tinea Scabies Flashcards

1
Q

Dermatophyte infections

A

Tinea Capitis
Tinea Corporis
Tinea Cruris
Tinea Pedis

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2
Q

Tinea capitis

A

fungal infection
common in children, african-americans, decreased hygiene, etc
acquired via direct contact with individual or object
scaly patches w/ alopecia
black dots, widespread, kerion, favus

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3
Q

Kerion

A

boggy edematous painful plaque

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4
Q

favus

A

multiple cup-shaped yellow crusts (scutula) “honeycomb”

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5
Q

assoc signs of tinea capitis

A

cervical adenopatchy
erthema nodosum
dermatophytid rxn: eczema like often after anti fungal therapy

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6
Q

Dx of tinea capitis

A 
physical exam
KOH prep
Dermoscope (see cork-screw hairs)
culture: slow
wood's lamp: meh
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7
Q

tx of tinea capitis

A

Griseofulvin, systemic anti fungal for 6-12 weeks

topicals do not penetrate the hair follicle enough

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8
Q

Tinea corporis

A

common in caregivers of children with t. capitis
athletes with skin to skin contact, t. corporis gladiatorum
immunocompromised
pruritic annular erythematous plaque
central clearing, raised border

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9
Q

Dx of t. corporis

A

H&P
KOH prep
culture

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10
Q

tx of t. corporis

A

topical antifungal
Clotrimazole at least 2 weeks
in special circumstances could use systemic anti fungal
itraconazole

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11
Q

clomitrazole

A

topical antifungal

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12
Q

itraconazole

A

systemic antifungal

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13
Q

tinea incognito

A

tinea infection that is made worse b/c of topical steroid use. can cause local immune suppression allowing the fungus to proliferate

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14
Q

majocchi’s granuloma

A

follicular and perifollicular dermatophyte infection of the deep dermis, and may be found in immunocompetent and immunocompromised people
aka using steroid cream

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15
Q

tinea cruris

A 
"jock itch"
begins in inguinal fold
contributing factors:
sweat/humidity
males
obesity
athlete's foot
occlusive clothes
well-marginated, scaly, annular plaque with raised border
scrotum is spared usually
pruritic and painful
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16
Q

Dx of t. cruris

A

H&P
KOH prep
Culture

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17
Q

tx of t. cruris

A

topical anti fungal
clotrimazole
resistant cases:
oral itraconazole

drying talcum powder
avoid tight clothes

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18
Q

tinea pedis

A

most common dermatophytosis in the world
caused by occlusive footwear and communal showers
Acute and chronic forms

19
Q

acute t. pedis

A

itchy/painful vesicles/bulla following sweating
secondary staph infections can occur
usually self-limited, intermittent, and recurrent

20
Q

chronic t. pedis

A

slowly progressive infection that persists indefinitely
erosion/scales and fissures b/w toes
“moccasin ringworm”
tinea manuum

21
Q

moccasin ringworm

A

sharp demarcation with accumulated scale in skin creases

22
Q

tinea manuum

A

“vacuum for man”
jkjkjk
two feet & 1 hand infected

23
Q

dx of tinea pedis

A

H&P
KOH prep
Cuture
Gram stain if suspected bacterial infection

24
Q

tx of t. pedis

A 
topical antifungal
clotrimazole x 4 weeks
oral anti fungal for chronic/extensive disease
itraconazole
burrow's wet dressings
treat secondary infections
25
Q

onychomycosis

A

infection of nail by fungus, yeast, or non-dermatophyte molds
primarily cosmetic
can be painful
increases risk of concurrent infection
distal, proximal, & white superficial subtypes,

26
Q

distal subungal onychomycosis

A 
most common subtype
usually toenails 
starts with big toe
white/brown/yellow starting at distal corner and spreads toward cuticle
nail breaks, exposing nail bed
27
Q

proximal subungual onychomycosis

A

starts near cuticle and progresses distally
usually toenails
uncommon
immunocompromised (AIDS)

28
Q

white superficial onychomycosis

A

starts with dull white spots on nail plate
usually toenails
spreads centrifugally
can be scraped for lab sample

29
Q

yeast onychomycosis

A

thickening of nail with yellow/brown discoloration
usually fingernails
may cause paronychia

30
Q

dx of onychomycosis

A 
difficult to distinguish clinically
KOH prep of nail scrapings
culture
histopathology (bx)
most of the time fingernails carry yeast
toenails carry dermatophytes
31
Q

tx of oncyhomycosis

A

not obligatory

topical medications are usually ineffective

oral terbinafine if dermophyte infection 6 weeks on fingernails
12 weeks on toenails

oral itraconazole if non-dermatophyte infection 6 weeks for fingernails
12 weeks for toenails

32
Q

intertrigo

A

any infectious or non-infectious inflammatory condition of two closely opposed skin surfaces

33
Q

candidal intertrigo

A

risk factors: moisture, skin friction, immunocomp
typically involves areas of the groin, mammary/abd folds, web spaces, and axilla
erythematous, macerated (soggy) plaques and erosions
satellite papules/putules
fine peripheral scaling

34
Q

dx of c. intertrigo

A

H&P
KOH prep
Culture

35
Q

tx of c. intertrigo

A

topical medication
nystatin cream
systemic medication in severe cases
itraconazole

36
Q

tinea versicolor

A 
fungal infection of the normal skin flora that converts into mycelia form
common in humid climates
hyperhidrosis
immunosuppressed
NOT CONTAGIOUS
macules, patches, plaques on trunk and upper extremity
typically asymptomatic
mildly pruritic
variety of colors
hypo/hyper/erythematous
37
Q

dx of t. versicolor

A

H&P
KOH
Wood’s lamp

38
Q

tx of t. versicolor

A 
topical anti fungal medications 
clotrimazole
selenium sulfide (lotion/shampoo/foam)
Zinc pyrithione (shampoo)
systemic medications for extensive disease or failed topical treatment
itraconazole
pigment changes can last months after tx
39
Q

scabies

A 
parasitic infection
mite buries herself in the stratum corneum and lays 2-3 eggs/day x ~30days
eggs hatch in 10 days
can live without host for 3 days
transmission through direct contact
initial erythematous macule/papule
burrow line is pathognomonic 
back and head are often spared of infestation
severe pruritus, worse at night
40
Q

crusted scabies

norwegian scabies

A

presentation in immunocompromised pts
fissures=avenue for bacteria, can lead to sepsis
requires oral medications

41
Q

dx scabies

A

visualization of burrow
microscopic identification of mites/eggs/feces
dermatoscopy

42
Q

scabies tx

A

permethrin 5% cream initial dose followed by 2nd dose 10-14 days later
oral ivermectin initial dose followed by 2nd dose 14 days later

2nd dose is necessary to kill any eggs that have hatched

tx of pruritus with antihistamines and emoillants

43
Q

pubic lice

A

cause by crab louse
can be seen with the naked eye
most commonly affect teens and young adults via sexual contact
pt presents with itching in the groin/axilla

44
Q

dx and tx of pubic lice

A

microscopy
permethrin 1% cream, recheck/repeat in 10 days
treat sexual partners
30% of pts will have a concurrent STI

X Clin Med Exam 1 (7 decks)

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