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Cuntaneous Fungal Infections Flashcards

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1
Q

objectives of self treatment of fungal infections

A

provide symptomatic relief
eradicate existin infection
prevent future recurrent infections
refer if infection widespread, systemic, recurrent, or persistent

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2
Q

activity of clotrimazole or miconazole what they are used for

A

fungistatic with broad spectrum of activity to treat dermatophyte and yeast infections

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3
Q

application of clotrimazole or miconazole

A

thin layer morning and evening

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4
Q

adverse effects of clot and micon

A

local skin irritation

hypersensitivity

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5
Q

preparations of imadazole or azoles available in canada

A

clotrimazole- cream

miconazole- cream, spray, powder

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6
Q

activity of tolnaftate and uses

A

narrow spectrum antifungal

only for dermatophyte infectiosn

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7
Q

application of tolnaftate

A

apply mornign and evenign

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8
Q

adverse effects of tolnaftate

A

local skin irritation

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9
Q

activity and uses of undecylenic acid

A

unknown

used for dermatophyte infections

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10
Q

application adn adverse effects of undecylenic acid

A

twice daily

itching, burning, stinging

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11
Q

activity of nystatin and uses

A

fungistatic or cidal

only for candidal infections

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12
Q

application and adverse effects of nystatin

A

2-3 times daily

rarely irritation

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13
Q

activity of ciclopirox

A

antimycotic agent

effective against dermatophytes, yeast, and some bacteria

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14
Q

application and adverse effects of topical ciclopirox

A

itch, burn, red

apply twice daily for 4 weeks

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15
Q

time of effects for topical ciclopirox

A

first week relief of itchign and other symptoms

reevalute if not improvement after 2 weeks

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16
Q

two types of ciclopirox

A

loprox- 1%cream/lotion

stieprox 1.5% shampoo 2-3 times per week for seborrheic dermatitis

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17
Q

activity of terbinafine

A

fungicidal to dermatophytes

fungistatic to candida

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18
Q

application adn adverse effects of topical terbinafine

A

once daily for one week

itch, burn, rash, dryness

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19
Q

uses of oral terbinafine

A

fungal nail infections

severe tinea skin infections failed with topical

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20
Q

adverse effects of oral terbinafine

A

interfere with cytp450 so hepatic failure, gi disturbances, rash, headache

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21
Q

ketaconazole activity

A

broad spectrum

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22
Q

oral ketoconazole adverse effects

A

fatal liver toxicity so only for life threatening infections

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23
Q

why are dermatophytes restricted to scalp, nails, and superficial skin

A

requires keratin for growth/proliferation

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24
Q

how are dermatophytes spread

A

contact with infected person, soil, animal, indirectly from fomites

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25
most common dermatophytes in skin infection
trichophyton microsporum epidermophyton
26
risk factors of tinea corporis
children in daycare/school exposure to contaminated soils, peoples, animals warm moist environment shared towels or clothing
27
signs and symptoms of tinea corporis
``` oval ring red scaly patches reddened edges with sharp margins inner area clear sometimes itching ```
28
when to refer tinea cirporis
younger than 2 immunocomprimised large part of body ...... reading
29
treatment of tinea corporis and cruris
imidaxole twice daily for 4 weeks | apply to normal skin 2 cm around infected to prevent spread
30
what areas are affected by tinea cruris
bilateral thighs inguinal folds butt anal cleft
31
risk factors for tinea cruris
``` wam and humid multiple layers of clothing immunicompromised obesity men ```
32
sign and symptoms of tinea cruris
``` well marginated red half moon plaque small vesicles itchy bright red lesion chronic more hyperpigmented ```
33
when do you refer tinea cruris
reading.....
34
risk factors for tinea pedis
``` hot and damp occlusive footwear public bathing facilities high impact sports sharing footwear prolonged steroid application sweat ```
35
signs of tinea pedis
``` toe webs interdigital maceration fissuring and scaling itching or stinging malodour ```
36
refer tinea pedis
risk of delayed wound healing less than 12 lesion inflamed oozing painful - may be bacterial toenail affected
37
chronic interdigital tinea pedis
fissures scaling maceration | between 3rd/4th or 4/5 toes
38
vesicular type
itchy vesicles on instep of feet
39
moccasin tinea pedis
off white scaling | red lesions on soles and side of feet
40
acute ulcerative tinea pedis
macerated weepy lesions on soles of feet
41
non pharms for tinea pedis
proper footcare/hygiene avoid occlusive footweat changes to dry socks dry between toes bid and affter showering
42
products pharmacists can prescribe for tinea pedis
topical ciclopirox twice daily for 4 weeks | topical terbinafine once daily for a week
43
why is important to promptly treat tinea pedis
prevent development of tinea unguium or infections of toenails
44
how do you treat onychomycosis
``` oral terbinafine tonail 12-16 weeks fingernail 6 weeks risk of liver injury so closely monitored ciclopirox nail lacquer takes 48 weeks ```
45
tinea capitis
hair follicles visible black dots often in children
46
tinea manuum
one hand two feet
47
tinea unguium
nails brittle opaque yellow thick
48
tinea incognito
suppresion of inflammatory response
49
cause of pityriasis versicolor
infection of stratum corneum by malassezia
50
highest risk of pityriassis versicolor
tropical environments | adolescents and young adults
51
signs and symptoms of pityriassi versicolor
change in cutaneous pigementation- hyper/hypopigmented lesions on back, chest, upper arms, coalesce to for large patches fine scale present cosmetic issue no itching
52
piityriasis versicolor treatment
selenium sulfide 2.5% shampoo- apply 10 min and wash off once daily for 1-2 weeks topical azole cream bid for 2 week ketaconazole 2% shampoo- leave on for 5 minutes and wash off one time
53
risk factors of candida intertrigo
``` diabetes mellitus immunosuppression tropical environment poor hygiene psoriasis contact dermatitis obesity hands in water lots overuse of cornstarch ```
54
areas that can be affected by candida intertrigo
``` groin armpit gluteal region under breasts skin folds hand ```
55
signs of candid intertrigo
bright red moist skin surface scaling border and satellit papules
56
when to refer candida intertrigo
``` unsuccessful treatment worsens unknown cause extensively seriouslt inflamed systemic or recurrent secondary bacterial infection - discharge immunocompromised under 2 ```
57
treatment of cutaneous candidiasis
keep dry with non medicated powder imidazole or nystatin bid 2-3 weeks sever combinaton of topical antifungal and topical corticosteroid
58
tea tree oil as complimentary treatment
must be used bid for 6 months and not guaranteed
59
which products can be used in pregnancy/breast feeding
clotrimazole miconazole nystatin
60
general non pharms
use separate wash cloth/towel for area hair dryer to dry area towel cant socks on before underwear launder contaminated towel and clothing separate in hot water cleanse skin daily with soap and water and pat dry avoid clothing that keep skin wet - wool allow shoes to dry before using again protective footwear in public showers and pools
61
how long should treatment continue and why
1-2 weeks after symptoms resolution to ensure full eradication and prevent relapse
62
monitoring parameters
relief of symptoms in 1-2 weeks monitor daily for infection no improvement or worsens refer lesions should resolve within treatment timeframe

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