Superficial Mycoses -Pham

Question 1

What are the topical treatments for Dermatophytosis? Which treatment is ok in pregnant women and children?

Answer 1

Imidazoles creams:

• Spectazole (econazole nitrate)
• Oxistat (oxiconazole) *Pregnancy category B/children

Allylamines:
-Naftin cream or gel (Naftifine)

Benzylamines:
-Metax cream (butenafine)

Loprox (Ciclopirox olamine)

Question 2

What are the oral medications for Dermatophytosis? Which one should be given if the pt has an allergy to penicillin?

Answer 2

• Griseofulvin p.o.

- Lamisil (Terbinafine) p.o. (*give this if pt has a PCN allergy)

Question 3

Which oral medication treats both dermatophytes and yeasts?

Answer 3

Sporanox (itraconazole)

Question 4

Which topical treatments cover both dermatophytes and yeasts?

Answer 4

• Loprox
• Oxistat lotion/cream
• Spectazole cream

Question 5

What 2 things should be used to treat a Tinea Faciei infection?

Answer 5

• PO either Griseofulvin or Lamisil

- Cream (Imidazole or Naftin)

Question 6

What medication might be needed to treat Tinea Barbae?

Answer 6

Prednisone

-very inflammatory. Scarring with permanent alopecia can occur in severe cases

Question 7

Does the scrotum normally affect Tinea Cruris?

Answer 7

NO!

dermatophytes do not infect the scrotum. ONLY yeast

Question 8

What is Onychomycosis? What are the oral treatment options? The topical treatment options?

Answer 8

-lifting of the nail plate from the nail bed

oral:

• Lamisil
• Sporanox

Topical:

• Loprox gel
• Naftin
• Ciclopirox nail solution*

Question 9

Should dermatophytes (fungi) be treated with steroid creams (Lotrisone)?

Answer 9

NO!

it will cause the rash to spread and worsen

Question 10

What is the most common form of onychomycosis? What does this look like?

Answer 10

Onycholysis

-Yellowing, crumbling, thickening, nail dystrophy, subungual hyperkeratosis

Question 11

What should be suspected if proximal sublingual onchomycosis is found?

Answer 11

HIV

only found in immunocompromised pts

Question 12

How long does it take the big toe nail to grow out?

Answer 12

6-9 months

Question 13

What is Kerion? How should this be treated?

Answer 13

• inflammatory Tinea Capitis
• inflammatory lesion due to delayed hypersensitivity reaction to fungal elements

Tx:

• prednisone
• anti-dermatophyte medication
• Antifungal shampoo (Loprox or Nizoral shampoo)–> remove scales and spores

Question 14

How are tinea infections diagnosed?

Answer 14

skin (punch) biopsy with PAS stain at the advancing margin