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1

What products to use for PREGNANCY

in treating vulvovaginal candidiasis

Butoconazole / Clotrimazole / Miconazole

BCM

Try to withold treatment during the 1st trimester

SELF TREATMENT IS NOT APPROPRIATE

 

breastfeeding, is okay with ANY PRODUCT

2

Treatment Approach for

VULVOVAGINAL CANDIDIASIS

Reestablish normal Vaginal Floral

Self-treatment is appropriate for uncomplicated disease
w/ infrequent episodes + mild/moderate symptoms

 

3

What NON-RX Antifungal medication?

Imidazole derivative, ​inhibits biosynthesis of sterols

Fungistatic / FungiCIDAL

Pedis / Crusis / Corpsis

BID Q4WEEKS

2+ y/o

MICONAZOLE 2%

FEET / GROIN / BODY

BID F4WEEKS

AE = skin irritation / burning / stinging

 

SAME AS CLOTRIMAZOLE 1%

4

What BODY PARTS does this genera of pathogenic fungi affect?

Epidermophyton

Same as Micro but adding the FEET/ Pedis

 

Pedis / Crusis / Corposis

Feet + Groin + Scalp

5

Fungal infection of what affected area of the body?

Tinea Crusis

GROIN

 

cursed groin

6

What NON-RX Antifungal medication?

Pedis / Cruris / Corporis

BID F4WEEKS

2+ y/o

CLOTRIMAZOLE 1%

SAME AS MICONAZOLE 2%

BID 4WEEKS

2+

7

What type of Fungal Infection?

seen as hypo or HYPER - PIGMENTED lesions

Patients are often ASYMPTOMATIC

primaryly found on the TRUNK of body

warm climate

Tinea VERSICOLOR

 

Pityrosporum Orbiculare

Clotrimazole 1% + Miconazole 2% + Tolnaftate 1%
QD for 14 days

Selenium Sulfide
Lathe for 5 min, rinse -> Repeat QD f2weeks then taper use

8

OTC Treatment of

VULVOVAGINAL CANDIDIASIS​

1 / 3 / 7 Day treatments

Usually only Miconazole 2% / Clotrimazole 1%

RX = Butoconazole / 2%/4% Ticonazole

ONLY USE OTC if condition has been DIAGNOSED in the PAST

9

Non pharmacologic Therapy for

VULVOVAGINAL CANDIDIASIS

Decreased consumption of Sucrose / Refined Carbs

 

Consume YOGURT

 

D/C meds that are known to INCREASE susceptibility

10

EX-ST of FUNGAL INFECTIONS

NAILS / SCALP INVOLVED = Unguium / Capitis

Face / mucous membranes / genitalia involved

unclear factor / unsuccessful treatment / WORSENING

Signs of possible Secondary Bacterial Infection = OOZING
excessive exudation (oozing)

Diabetes / Systemic Infection / Immune Deficiency

Fever / Malaise

11

What NON-RX Antifungal medication?

FungiSTATIC

PEDIS
BID

Cruris / Corporis
QD

 

 

UNDECYLENIC ACID

DIFFERENT DOSE FOR PEDIS = BID

 

Corposis / Cruris = QD

 

mild irritation / burning

12

Which Fungal infections can NOT be treated with OTC topical therapy?

Tinea UNGUIUM = Onychomycosis

 

Tinea CAPTIS = sCalp

13

Contributing Factors of

Fungal Infections

 

Poor Hygiene 

TROPICAL climate

Immunocompromised / Impaired Circulation

CONTACT w/ infected person / animal

TRAUMA to skin

poor nutrition

14

What type of Fungal Infection?

Most common fungal infection

PRURITIS = most common symptom

may become inflammatory / pustular + sting

From: public pools / bathing 

Sports / tight socks/shoes / hyperhidrosis

Tinea PEDIS = ATHLETE'S FOOT

 

Trichophyton or Epidermophyton

15

What NON-RX Antifungal medication?

Fungal cell death

PEDIS
BID F1Week or QD F4weeks

ONE OF 2 THAT CAN BE EFFECTIVE IN 1 WEEK​

CRURIS / UNGUIUM
QD F2 Weeks

12+ y/o

BUTENAFINE 1%
ONE OF 2 THAT CAN BE EFFECTIVE IN 1 WEEK​

FEET + GROIN + UNGUIUM

unguim = QD f2weeks

16

Counseling / Directions for treatment of

VULVOVAGINAL CANDIDIASIS

only use OTC if been diagnosed

Start treatment AT NIGHT b4 bed

May use PAD, to prevent leakage
DO NOT USE TAMPON

Complete FULL COURSE CONSECUTIVELY
even during MENSTRUAL FLOW!

AVOID SEXUAL CONTACT USE PROTECTION

 

17

Fungal infection of what affected area of the body?

Tinea Corposis

BODY

 

BODY = CORPSE

18

Fungal infection of what affected area of the body?

Tinea Captis

SCALP

 

sCalp = CAPTIS

19

What type of Fungal Infection?

Occurs most often in AA Female Children

spread by direct contact or contact with fomites

Can NOT be managed with OTC PRODUCTS
OTC can not penetrate hair follicles

requires systemic RX therapy

 

Tinea CAPTIS 

sCalp

4 varients:
non-inflammatory / inflammatory / BLACK DOT / Favus

 

20

What type of Fungal Infection?

Pruritus + Erthematous Eruptions

typically seen in males

small vesicles / scaling / pruritus / pain

lesions w/ demarcated margins

Factors: Wet clothing / heat / friction / obesity

Tinea CRUSIS = JOCK ITCH

Groin

Trichophyton + Epidermophyton

21

Fungal infection of what affected area of the body?

Tinea Pedis / Unguim

FEET / FOOT = Pedis

 

NAILS = UNGUIM

22

What type of Fungal Infection?

Children are HIGHLY susceptible

Factors: contact sports / warm / humid / stress / obesity

Tinea CORPORIS = RINGWORM

 

Trichophyton / Microsporum / Epidermophyton

ALL 3 INCLUDE CORPORIS

23

What type of Fungal Infection?

WHITE vaginal discharge + Pruritus

High incidence in women of childbearing age

Predisposing factors:

tight clothing / medications / diabetes / obesity

sexual activity / pregnancy

VULVOVAGINITIS

candida albicans, not tinea

24

Clinical Presentation = S/Sx

of Fungal infections

 

Mild Itching

SCALING

 

Exudative inflammatory process:
denudation / fissuring / crusting / discoloration

25

Treatment for Tinea VERSICOLOR

Clotrimazole 1% + Miconazole 2% + Tolnaftate 1%
QD for 14 days

 

Selenium Sulfide
Lathe for 5 min, rinse -> Repeat QD f2weeks then taper use

26

When to CONTACT MD

in Fungal Infections

No clearing of infection after >4 Weeks
normally use BID for 3-4 weeks

DIABETES

TOENAILS

painful + foul smelling

INFLAMMED / SWOLLEN

27

What type of Fungal Infection?

Seen as erythematous pustules found in interiginous areas

Increased incidence in immunosuppressed / DIABETICS / <6M/O

Predisposed factors:
MOIST macerations / OCCLUDED macerations

CANDIDIASIS

Candida albicans, different type of fungus

28

What NON-RX Antifungal medication?

does NOT have any DIRECT ANTIFUNGAL ACTIVITY

approved for relief of Inflammatory Conditions

ASTRINGENT / ANtibacterial

BID

SALTS OF ALUMINUM

BID

not an antifungal, just for inflammatory

29

Complementary Therapies for 

FUNGAL INFECTIONS

BITTER ORANGE

 

TEA TREE OIL

 

GARLIC

30

What type of Fungal Infection?

Lesions begin as small / circular / scaly lesions

Pruritus

 

Tinea CORPORIS

can occur on any part of the body

 

Zoophilic = EXPOSED Skin

Anthropophilic = Occluded areas