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HDID Block 3 > Superficial, cutaneous and subcutaneous mycoses > Flashcards

Superficial, cutaneous and subcutaneous mycoses Flashcards

1
Q

What is the hallmark of superficial mycoses?

A

No inflammation/no elicitation of host immune response

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2
Q

___ is a superficial mycotic infection (of young folks) caused bylipophilic yeast Malassezia spp. (Malassesia furfur), usually involving upper trunk, neck, and arms

A

Tinea versicolor

(I got a real nice versicolor fur coat from Malassezia!!)

Also, versi di colore sauce + that woman’s fur coat

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3
Q

___ also cause pityriasis folliculitis, seborrheic dermatitis (“dandruff”), and atopic dermatitis

A

Malassezia spp

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4
Q

What do Malassezia spp use as their source of lipids and oils?

A

Skin and keratin

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5
Q

The hallmarks of tinea versicolor infection include:

A

Non pruritic, has varying color, hyper and hypo-pigmentation

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6
Q

Which condition is indicated below and which fungal spp causes it?

A

Non pruritic, has varying color, hyper and hypo-pigmentation

Skin scraping: delicate septated hyphae and clusters of yeast (spaghetti and meatballs)

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7
Q

Which superficial mycosis is characterized by a skin scraping with the presence of delicate septated hyphae and clusters of yeast (spaghetti and meatballs)?

A

Tinea versicolor

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8
Q

What is the treatment for tenia versicolor?

A

Ketoconazole 2% shampoo

Selenium sulfide suspension 2.5%

Terbinafine solution 1% (spray bottle)

Systemic Rx: Itraconazole or Terbinafine

Systemic Prx: Itraconazole

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9
Q

How do you Dx Malassezia infection?

A

Olive Oil-Supplemented Sheep Blood Agar

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10
Q

Which bug is this and what infection does it cause?

A

Malassezia spp

They look like a shoe print (think of getting a fancy pair of versicolor shoes from Malassezia)

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11
Q

What are two differences between cutaneous mycoses and superficial mycoses?

A

Superficial: stays on stratum corneum (most superfical layer) and DOES NOT elicit host immune response

Cutaneous: Involves epidermis and dermis and evokes an inflammatory reaction in the host

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12
Q

Name the 3 classes of dermatophytes that cause cutaneous mycoses (hint: MEfT)

A

Microsporum

Epidermophyton floccosum

Trichophyton spp

(Dermatophytes are so MEfT!)

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13
Q

Which fungi are these and what infection do they cause?

A

Microsporum (dermatophytes) - cause cutaneous mycoses

Have big microconidia and septations within them

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14
Q

Which fungus is this?

A

Tricho has tiny canidia that are transmitted from pt to pt

Also septated hyphae

Tricho has Tiny Canidia!!

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15
Q

___ is a dermatophyte infection of the foot

A

Tenia pedis

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16
Q

___ is a dermatophyte infection of the head

Tinea corporis is a dermatophyte infection of the ___

Tinea barbae is a dermatophyte infection of the ___

A

Tinea capitis- dermatophyte infection of the head

Tinea corporis- dermatophyte infection of the body

Tinea barbae- dermatophyte infection of the beard

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17
Q

___ dermatophyte infection of the groin

Tinea unguium- dermatophyte infection of the ___

Tinea ___- dermatophyte infection of the hand

A

Tinea cruris- dermatophyte infection of the groin

Tinea unguium- dermatophyte infection of the nail

Tinea manuum- dermatophyte infection of the hand

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18
Q

What are the characteristic features of dermatophyte infection?

A

Inflammatory, pruritic, hyper-keratosis eruptions (papulo-squamous eruptions)

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19
Q

Patients with what 2 conditions are especially at risk for more severe dermatophyte infections?

What component of the host immune response is responsible for the tissue damage seen in dermatophyte infections?

A

Pts with iron overload and immunocompromised pts have more severe infections

Cell mediated immunity** (neutrophils not so much)

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20
Q

__ is a more severe dermatophyte infection that affects mainly transplant recipients and HIV patients

A

Majocchi’s granuloma

21
Q

What is the difference between an ectothrix and an endothrix invasion of hair caused by dermatophytes?

Which bugs fall into either category?

A

Ectothrix (M canis):

Causes tenia capitis

Bug cuts hair down and leaves an intact bulb but destroys external surface of hair shaft

Endothrix infection

T tonsurans – anthropophilic so its adapted to host response (host response becomes limited) and don’t clip the hair shaft externally but instead destroy the bulb of the hair (note that this is a disease in kids) – causes permanent alopechia

(most common cause in urban settings of tenia capitis)

22
Q

Which dermatophyte infections are caused by Trichophyton spp (tonsurans)? Microsporum? (canus)

A

Trichophyton spp: Tinea capitis, tinea barbae, tinea corporis, tinea cruris, tinea pedis, and tinea unguium

Microsporum spp: tinea capitis, tinea corporis, tinea cruris, and tinea pedis, but not tinea unguium

23
Q

What infection is caused by Epidermophyton floccosum?

A

Tinea cruris

24
Q

___ is the most common dermatophytosis, affecting mainly adults and is most commonly caused by Trichophyton rubrum

Which dermatophytosis is mainly seen in children?

A

Tinea pedis

Tinea capitis - c is for kids

25
Q

Which infection is shown below? Which fungus mainly causes it?

A

Tinea corporis

Mainly Trichophyton spp

26
Q

There are 3 forms of tinea pedis, namely __

A

Interdigital (just pronounce it fancy)

Moccasin (like drinking anything mocca is sin)

Vesiculobulluous

**may also present with onychomycosis**

27
Q

What infection is this?

Which dermatophyte infection is characterized by “black dot” alopechia and formation of a kerion?

A

Tinea capitis

Also tinea capitis

28
Q

How dp you Dx tinea capitis?

A

KOH prep

Culture on Sabouraud dextrose agar with cycloheximide

Wood’s light examination (M canis = blue green)

29
Q

What is the Rx for tenia capitis?

A

terbinafine (systemic)

azoles

griseofulvin

Ketoconazole (topical to reduce fungal shedding)

30
Q

What is the Rx for the following infections?

Tinea pedis, tinea corporis, tinea cruris, tinea manuum

A

Topical rx most common: miconazole and clotrimazole; can use oral therapy if most of trunk is covered (terbinafine)

31
Q

___ is an infection of the nail plate and/or nail bed that interferes with normal nail function

A

Onychomycosis

32
Q

The main causes (fungi) of onychomycosis are __

A

T. rubrum and T. mentagrophytes var. interdigitale

(rubrum is almost like rubio as in the politician marco rubio)

33
Q

There are 3 forms of onychomycosis, namely__

A

proximal subungual (PSO),

distal subungual (DSO)

white superficial (WSO)

(Onychomycosis is PDW!)

34
Q

Of the forms of onychomycosis, which is the most common and what is the mechanism of infection?

A

DSO most common ( T rubrum)

fungi enter distally >> spread proximally >> eat nail bed + plate >> subungual hyperkeratosis, paronychia, onycholysis

35
Q

Which type of onychomycosis is this?

A

DSO

36
Q

Which type of onychomycosis occurs in imunocompromised hosts and is thought to be an early indicator of HIV infection or other severe impairment of cell mediated immunity?

A

PSO via T rubrum

37
Q

What is the mechanism of invasion in PSO?

A

Fungi enter proximally @ cuticle>> eat nail bed >> spread distally>> if left un-Rx, will eventually eat nail plate

38
Q

Which type of onychomycosis is this?

A

PSO; Cuticle damaged, base of nail bed also damaged

39
Q

Which type of onychomycosis involves extensive exposure to water and results in attack of the dorsal surface of the nail plate and minimal inflammation?

A

WSO

Caused by T. mentagrophytes.

40
Q

How do you Dx onychomycosis?

A

Dx: KOH prep + culture of nail

41
Q

What is the Rx for onychomycosis?

A

Rx: systemic (terbinafine or itraconazole)

42
Q

An example of subcutaneous mycosis is __ (disease)

A

Lymphocutaneous sporotrichosis or fixed sporotrichosis

43
Q

Lymphocutaneous sporotrichosis typically results from ___

A

Introduction of spores via trauma from wooded plants (or exposure to thorn, like when gardening)

44
Q

Which infection is this?

A

Fixed cutaneous sporotrichosis

45
Q

Which infection is this?

A

Lymphocutaneous sporotrichiosis

46
Q

How do you Dx sporotrichosis?

A

Biopsy

Culture

47
Q

How do you treat sporotrichosis?

A

Itraconazole

Terbinafine

48
Q

Which subcutaneous mycosis is characterized by plaque-like, papular, and verrucous lesions, and muriform cells?

A

Chromoblastomycosis

**Typically in agricultural workers**

49
Q

Which subcutaneous mycosis is characterized by the invasion of muscle, tendon and bone with draining sinus tracks (its like actinomycosis with sulfure granules except caused by fungi)?

A

Mycetoma

(caused by Pseudallescheria)

HDID Block 3 (19 decks)

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