Tinea

Question 1

Types

Answer 1

Tinea pedis (feet)
Inflammatory/vesicular tinea pedis (soles)
Ulcerative tinea pedis
Ringworm
Tinea unguium (nail)
Tinea cruris (groin)
Tinea Capitis (scalp, eyebrow/lash)
Tinea Manuum (hand)
Tinea incognito (when infection is treat with corticosteroids)

Question 2

symptoms

Answer 2

itchy, scaling, red inflammations (common) will need to refer to table 4.38 in APF

Question 3

Medical causes

Answer 3

diabetes
immunosuppression
obesity
hot humid environment
hyperhidrosis
using communal areas
skin-to-skin contact with infected person
tight and occlusive clothing/footwear
household pets
contaminated bedding or clothing

Question 4

When to refer

Answer 4

Extensive, severe or persistent infection
Infection of scalp, bread, or nail matrix
Lack of response to therapy
Prior treatment with a topical steroid
Signs of secondary bacterial infection
Patients with diabetes or immune deficiency.

Question 5

Azoles

Answer 5

Can be used in combination with corticosteroid for 1 week for severe skin inflammation, afterwards treatment with just an antifungal product.
Pregnancy: some are safe
Breastfeeding: safe, just remove from nipple area before feeding.

Question 6

nail infection treatment

Answer 6

amorolfine, ciclopirox

Question 7

non-pharmacological

Answer 7

Wash daily with soap and water, dry skin thoroughly, especially between toes and skin folds
Avoid sharing bedding, towels, shoes, clothing
Wear sandals in communal areas
Wear cotton socks and change frequently
If family have signs of tinea treat aswell.

Question 8

creams

Answer 8

preferred for scaling and non-oozing lesions

Question 9

Ointments

Answer 9

Soften lesions that are thickened and hyperkeratotic

Question 10

Lotion

Answer 10

Prevent maceration in intertriginous and hairy areas, can be used on moist, oozing or weeping lesions

Question 11

Liquids/sprays

Answer 11

Applied to larger/hairy area

Question 12

Powder

Answer 12

Groin, feet and other intertriginous areas such as inside socks and shoes

Question 13

Lamisil cream

Answer 13

Terbinafine - fungistatic
Apply to clean infected area sparingly and gently once daily. Continue using for 1 week without stopping even if the skin looks clear.
Breastfeeding - safe
Pregnant - safe
Other formulations: spray, liquid solution and gel

Question 14

Canesten cream

Answer 14

Clotrimazole - bacteriostatic
Clean thoroughly and apply to the affected area and gentle and repeat 2-3 times daily
Breastfeeding - safe
pregnant- safe
If super itchy use cancesten extra (has corticosteroid in it)

Question 15

Rejuvenail

Answer 15

Apply to entire surface of affected nails, 5mm of surrounding skin and under the free edge of nails. Allow to dry and leave for 6 hours before washing off.
For age 12+
Safe for preg and breastfeeding