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Fungal infections and warts Flashcards

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1
Q

tinea refers to

A

dermatophyte infections

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2
Q

____ of the US population suffer from a tinea infection at any one time

A

10-20%

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3
Q

what increases risks of fungal infections

A

trauma to the skin; esp. if it produces blisters

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4
Q

transmission of fungal infections

A

through contact with infected people. animals, soils, or fomites

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5
Q

inoculation of fungus

A

penetration of fungus into the skin

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6
Q

incubation of fungus

A

growth of infection inside stratum corneum

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7
Q

fungal growth rate must be

A

greater than two times epidermal turnover rate or the fungus will be shed quickly

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8
Q

involution of fungus

A

resolution of infection after an adequate immune response

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9
Q

signs and symptoms of fungal infection

A
  • mild itching and scaling
  • denudation: losing outside layer of skin
  • fissuring: break in skin
  • crusting
  • discoloration
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10
Q

risk factors for fungal infections

A
  • age (more common in children)
  • contact sports
  • restrictive clothing and shoes
  • weak immune system (diabetes, HIV)
  • sex (more often in men)
  • race (AA female children)
  • poor hygiene
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11
Q

tenia pedis location and characteristics

A
  • location: feet

- Characteristics: chronic intertriginous

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12
Q

chronic intertriginous

A

toe webs, scaling, fissures, maceration of interdigital spaces, malodor, pruritus, and stinging sensation

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13
Q

tinea corporis location and characteristics

A
  • location: any smooth and bare skin
  • characteristics: start as small circular, erythematous, scaly areas; spread peripherally, borders may contain vesicles or pustules
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14
Q

tinea cruris location

A

medial and upper parts of thigh and pubic area (more common in males)

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15
Q

tinea cruris characteristics

A

bilateral, pruritic, scaly lesions
acute lesions: bright red
chronic lesions: hyperpigmented appearance
pain may occur with sweating

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16
Q

tinea capitis location

A

scalp

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17
Q

4 kinds of tinea capitis

A
  1. non-inflammatory
  2. inflammatory
  3. black dot
  4. favus variant
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18
Q

non-inflammatory tinea capitis

A
  • small papules
  • spread centrifugally
  • some scaling
  • hair in lesions (dull gray color)
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19
Q

inflammatory tinea capitis

A
  • pustules or kerion (weeping lesions)
  • pruritis
  • fever
  • pain
  • regional lymph node enlargement
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20
Q

black dot tinea capitis

A
  • broken hair shaft (hair loss) –> black dots
  • inflammation
  • scaling
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21
Q

favus variant tinea capitis

A
  • patchy hair loss
  • scutula (yellow crust and scales)
  • lesions can merge
  • can lead to secondary bacterial infections
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22
Q

tinea unguium location and characteristics

A

location: nails
characteristics: opaque, thick, rough, yellow and friable nails (may separate from nail bed if infection progresses)

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23
Q

treatment goals for fungal infxn

A
  1. symptomatic relief
  2. eradicate infection
  3. prevent future infections
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24
Q

tinea types for self-treatment

Study These Flashcards
A

tinea pedis, tinea corporis, tinea cruris

25
fungal nail revitalizer
(for unguium, WILL NOT TREAT) - reduces discoloration and smooths out nail - contains calcium carbonate and urea - apply over infected nail and scrub with nail brush for 1 min, wash and dry (daily for three weeks)
26
exclusions for self treatment of fungal infxn
1. causative factor unclear 2. unsuccessful initial treatment or worsening of condition 3. nails or scalp involved 4. face, mucous membranes, or genitalia involved 5. signs of possible bacterial infection 6. excessive and continuous oozing 7. condition extensive, seriously inflamed, or debilitating 8. diabetes, systemic infection, immune deficiency 9. fever and/or malaise
27
non pharm treatment of fungal infxn
- keep skin clean and dry - avoid sharing personal articles - wash contaminated towels - do not wear clothing or shoes that causes skin to stay wet - dust shoes with foot powder to keep them dry - avoid contact with people who have infection
28
topical antifungals
- clotrimazole - miconazole nitrate - terbinafine HCl - butenafine HCl - tolnaftate (prevention too) - undecylenic acid, clioquinol
29
considerations when using topical antifungals
- creams or solutions are most effective - sprays and powders more prophylactic - symptom relief within 1 week but complete therapy - recommended treatment for at least 1-4 weeks
30
duration of tx for tinea pedis and tinea corporis
4 weeks
31
duration of tx for tinea cruris
2 weeks
32
application of topical antifungal
mostly twice daily (except butenafine and terbinafine)
33
butenafine application
tinea pedis: BID for 1 week or 1 QD for 4 weeks | tinea cruris/corporis: 1 qd for 2 weeks
34
terbinafine application
1 qd for 1 week
35
potential adverse effects of topical antifungals
mild skin irritation, redness, itching, burning/stinging
36
active ingredient 1. lotrimin AF cream and solution 2. lotrimin spray and powder 3. lotrimin ultra
1. clotrimazole 1% 2. miconazole nitrate 2% 3. butenafine HCl
37
salts of aluminum useful when
in combo with topical antifungals for wet, soggy tinea pedis lesions or inflammatory type
38
salts of aluminum serves two purposes
astringent action and antibacterial activity to prevent secondary bacterial infections (at concentrations > 20%)
39
apply salts of aluminum before or after antifungal?
before and can be used up to 1 week
40
if no fissures then use
- aluminum acetate solution - 20-30% aluminum chloride solution apply bid until odor or wetness goes away then 1 qd for 1 week
41
if deep fissures are present then use
lower concentration 10% aluminum acetate or chloride | apply bid until fissures heal; then higher concentrations
42
______ percent of general population have warts
7-10
43
peak incidence of warts
12-16 years old
44
percentage of warts that clear in 1. two months 2. three months 3. two years
1. 23% 2. 30% 3. 65-78%
45
warts are caused by
HPV, type of HPV dictates type of wart and location
46
infection of wart occurs
through person to person contact, autoinoculation, or fomites
47
common wart type | verruca vulgaris
found on hands. typically skin or brown colored; dome shaped papules with a rough cauliflower-like appearance and painless. common in children
48
plantar warts | verruca plantaris
found on feet. skin colored, flat, callous-like papules; may be painful, esp. if in a weight-bearing location; common in adolescents and young adults May be difficult to distinguish from calluses or malignant growth If multiple closely grouped – considered “mosaic” type
49
flat warts | verruca plana
found on face. smooth, flat-topped, yellow-brown papules; common in children
50
periungal warts
found on nails; thickened, fissured, cauliflower-likes skin around nail plate
51
filiform warts
found on face; rapidly growing, thread-like projections
52
goals of treatment for warts
eliminate signs and symptoms, remove wart without scarring, prevent recurrence, and prevent spread of HPV
53
exclusions for self treatments of warts
1. less than 4 y/o 2. pregnancy or breast-feeding 3. conditions that affect blood circulation to hands or feet 4. large or multiple warts located on one area of the body 5. painful plantar warts 6. warts on face, breasts, armpits, fingernails, toenails, anus, genitalia, or mucus membranes
54
to avoid spread of warts
1. avoid cutting, shaving or picking at warts 2. wash hands before and after touching warts 3. keep feet clean and dry 4. use specific towel to dry area 5. avoid sharing items (towels, razors..) 6. avoid walking barefoot
55
self-treatment options of warts
salicylic acid and cryotherapy
56
salicylic acid products for warts
- salicylic acid 40% in plasters/pads/strips - salicylic acid 17% liquid/gel - salicylic acid 15% patch in karaya gum vehicle
57
cryotherapy
pressurized spray can or foam applicator
58
cryotherapy ingredients
dimethyl ether and propane
59
other wart therapies
duct tape occlusion, vitamin a, dietary zinc, garlic, essential oils

OTC (22 decks)

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