Tinea infections Flashcards
List the two main groups of fungi that infect humans:
Candida yeasts and the dermatophytes
Dermatophyte skin infections are classed by?
Anatomical location
ringworm of the body is called
tinea corporis
Ringworm of the scalp is called
Tinea capitis
Ringworm of the beard is called
Tinea barbae
Ringworm of the nails is called
Tinea unguium
Ringworm of the face is called?
Tinea faciei
Ringworm of the groin is called
tinea cruris
Ringworm of the hand
Tinea manus
ringworm of the foot is called
Tinea pedis ( athlete foot)
—- is the most common fungal infection
Tinea pedis
State the epidemiology of Tinea infections
More prevalent in tropical and subtropical areas because fungal organisms prefer high temperature and high humidity
State the aetiology of Tinea infection
Contagious and transmitted directly from one host to another
Invade the stratum corneum, hair and nail but do not generally infiltrate living tissue
Fungus then begins to grow and proliferate in the non-living cornified layer of keratinised tissue of the epidermis
List the signs and symptoms of tinea pedis
Itching
Flaking and fissuring of the skin
Skin appears white and ‘soggy’ due to maceration of the skin
Feet often smell
Usual site is in the toe webs, especially the fourth web space
Infection can spread to the sole and instep of the foot
Nail involvement may be present
State the specific questions to ask a patient suffering from a tinea infection
Age & Sex of patient
Presence of itch
Associated symptoms
Previous history
Most prevalent in young adults, especially men. Nail involvement usually occurs in older patient
Fungal infections usually have itch, irritation or burning sensation
Flaky, smelly, nail involvement
Usually have acute onset with no previous episodes, although athletes foot may be recurrent.
what is the first line treatment for Tinea pedis
Imidiazoles for candidiasis;
e.g. Clotrimazole 1%, Miconazole, Ketoconazole, Bifonazole
New ONCE daily Canesten Bifonazole cream
In the case of Miconazole – this should be continued for 10 days to prevent re-lapse
Consider co-products with Hydrocortisone. – Only licensed for over 10 years old.
Canesten HC applied BD. Only licensed for 7 days use and for 10yrs and over. Limits the usefulness as the fungal infection takes longer to treat. So best to continue with non_HC product after
List the side effects of Imidazoles
Side effects: occasional local irritation, burning sensation and itching
To prevent re-infection, imidazole should continued to be used after the lesions have healed.
State the treatment used for dermatophyte
. Terbinafine for dermatophytes (LAMISIL range)
Recent POM to P switch
Better efficacy than imidiazoles, good for resistant cases
Reserve for treatment failure
All products (cream, gel & spray) licensed for 16 years and over except Lamisil ONCE >18 years old.
State other products used to treat dermatophyte infections
Tolfinate Undecenoic acid (mycota)
Benzoic acid
State the side effects of terbinafine
Redness and itching
State the self advice to give to a patient suffering from tinea pedis
Dry the skin thoroughly after showering or bathing
Keep personal towel and do not share it
Wear cotton socks and change them at least once a day
Avoid use of occlusive non-breathable shoes
Dusts shoes and socks with antifungal powder
Avoid scratching infected skin
Use flip-flops when using communal changing rooms
When to refer a patient suffering from Tinea pedis
OTC treatment failure
Nail involvement (if more than 2 nails refer. If diabetic refer)
Suspected facial or scalp involvement
Onychomycosis means?
Infection develops slowly and causes the nail to become discolored (may turn white, black, yellow or green) , thickened and distorted. (becomes unusual shape and difficult to trim)
Can cause pain and discomfort particularly when pressure is applied
Can become brittle or crumbly where piece break off.
Toenails are more frequently affected than fingernails
State the product used in treating onchomycosis
Curanil(amorolfine)
Curanail can be used for up to 2 nails. Otherwise tablets need to be taken .
Affects major skin surfaces that do not involve ———
A face, hands, feet, groin or scalp.
Signs and symptoms of Tinea corporis(Ringworm)
Itchy pink or red scaly slightly raised patches with WELL DEFINED INFLAMED BORDER
Over time the lesions show ‘central clearing’
List the conditions to eliminate when suffering from Ringworm
Psoriasis and Dermatitis/eczema
State how to differentiate ringworm from eczema and psoriasis
Central area is resistant to colonization
Lesions can occur singly, be numerous or overlap to produce a large lesion
Psoriasis – take family history. Lesions tend not to itch, and exhibit more scaling and do not show central clearing
Eczema/dermatitis- take family history. Very itchy, particularly affects arms and legs- can be difficult to differentially diagnose.
Same treatment
When to refer to Ringworm infection?
Refer if large areas become involved, otc failure, facial/scalp involvement, signs of secondary bacterial infection (puss, redness or inflammation)
