Fungal Skin Infections Flashcards

(68 cards)

1
Q

With superficial mycoses, infections are limited to the outermost layers of skin and hair. What part of the skin and hair?

A

Skin - stratum corneum

Hair - cuticle

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2
Q

What are the superficial mycoses? x4

A
  1. Pityriasis Vesicolor
  2. Tinea Nigra
  3. Black Piedra
  4. White Piedra
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3
Q

What is Pityriases Vesicolor caused by?

A

Malassezia furfur

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4
Q

What are the characteristics of Malassezia furfur?

A

Dimorphic
Part of normal flora
Lipophilic - found in area of body rich in sebaceous glands

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5
Q

Clinical disease of Pitryriasis Versicolor occurs when environmental factors promote growth in hyphal phase like ________ and _______

A

Increased lipid production
Moist heat

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6
Q

Where is Pityriasis Versicolor more common?

A

Tropics

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7
Q

What is the presentation of Pityriasis Versicolor (Tinea Versicolor)?

A

Numerous irregularly shaped scaly patches

Yellow-brown to dark brown in color

Hyper or hypopigmentation

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8
Q

How do you diagnose Pityriasis Versicolor?

A

Observation of skin scarping - looks like spaghetti and meatballs with KOH

Cultivation not typical - may require lipid rich overlay

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9
Q

How do you treat Pityriasis versicolor?

A

Topical treatment

Relapse common

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10
Q

What is tinea nigra?

A

Superficial skin infection caused by Exophiala werneckii

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11
Q

What are the characteristics of Exophiala weneckii?

A

Dimorphic fungus

Common in tropics

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12
Q

Tinea nigra is thought to arise following ________ of organism such as contamination with soil, sewage, wood, or compost.

A

Traumatic (superficial abrasions)

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13
Q

What are the presentations of Tinea Nigra?

A

Distinct oval-shaped lesions on hands and feet

Light brown to black in color

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14
Q

How is Tinea Nigra diagnosed?

A

Skin scrapings (KOH) reveal 2 celled yeast forms containing dark pigment

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15
Q

What is black and white piedra?

A

Hard or gritty granules on hair shaft

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16
Q

What organism causes Black Piedra? Where is it common?

A

Piedra hortae

Tropics

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17
Q

What organism causes White Piedra? Where is it common?

A

Trichosporon beigelii

Temperature and semi tropical areas like South US

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18
Q

Both Piedra Hortae and Trichosporon beigelii can be isolated from ______ and ______

A

Soil
Compost

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19
Q

_________ forms nodules composed of asci and ascospores

A

Black Piedra

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20
Q

________ forms mycelium and arthrocondinia forming a collar around the hair shaft.

A

White Piedra

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21
Q

Black Piedra presents with __________ on hair, primarily the ______, and _______ are firmly attached.

A

Hard, gritty nodules

scalp

nodules

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22
Q

White Piedra presents with ______ nodules (white/light brown), usually on ______ or axillary hair, beards, eyebrows. Nodules are _________ attached

A

Soft

Pubic

Loosely

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23
Q

How do you diagnose black and white piedra?

A

Microscopix examination of infected hairs

Lab cultivation - rare

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24
Q

How do we treat black and white piedra?

A

Shave off hair and practice good hygiene

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25
Cutaneous mycoses are infections of skin, nails, and hair. Generally limited to ______, epidermis, and dermis.
Keratinized layers
26
What group of organisms cause cutaneous mycoses?
Dermatophytes
27
What are the 3 genera of dermatophytes to know that cause cutaneous mycoses?
1. Microsporum 2. Trichophyton 3. Epidermophyton
28
What are the clinical manifestations of infestation by dermatophytes?
Inflammatory reaction involving underlying and surrounding tissue Circular lesions common - ring worm Infections characterized by itching and scaling of skin.
29
Clinical manifestations of dermatophyte infections are often referred to as _____
Tinea
30
What is the clinical term to describe infection of scalp, eyebrows, and lashes?
Tinea Capitis
31
What is the clinical term to describe infection of beard?
Tinea barbae
32
What is the clinical term to describe infection of torso, arms, and legs?
Tinea corporis
33
What is the clinical term to describe infection of hands?
Tinea manus
34
What is the clinical term to describe infection of nails?
Tinea unguium
35
What is the clinical term to describe infection of groin?
Tinea cruris
36
What is the clinical term to describe infection of feet?
Tinea pedis
37
Athlete's Foot is also called ______
Tinea pedis
38
Athlete's Foot is generally a _______ infection. Classic presentation occurs in ________, may involve heels and sides of foot, and may spread to nails.
chronic toe webs
39
________ classically presents with red, round, scaly patch with raised border. Inflamed periphery with pustules and can occur anywhere, but typically on trunk.
Ring Worm
40
What is the presentation of Tinea capitis or a scalp infection?
Distinct scaly lesion Patches of hair loss Involve entire scalp
41
Fungal elements of dermatophytes can surround the hair shaft (______) or be present within the hair shaft (______). Either way, hyphae usually _______ the hair shaft, causing damage.
Ectothrix Endothrix Invade
42
_______ is infection of the nail plate and nail bed. Presents with hyperkeratosis and discoloration
Tinea unguium - onychomycosis
43
If Tinea unguium is caused by dermatophytes you should see _______ and if caused by Candida albicans, you should se ______
Hyphae Yeast
44
What groups of people commonly get Tinea unguium?
Diabetic and AIDS patients
45
How do you diagnose dermatophytic infections? x4
1. Determine source 2. Confirm differential (KOH prep) - differentiate from Candida, viral, or bacterial etiology 3. Anticipate response to therapy 4. Woods lamp
46
What is woods lamp?
Used to diagnose dermatophytic infections. It examines lesions on scalp or beard and many fungi will fluoresce - fluorescent hairs may be plucked for cultivation or microscopic examination
47
What causes Candidiasis?
Candida albicans
48
Candida can exist in yeast, pseudohyphal, and hyphal forms. Yeast = _______. Hyphal forms = _______.
Normal flora Tissue
49
Candida albicans can form ________
germ tubes
50
Cutaneous Candidiasis includes skin and nail infections. May present as _________ or confluent plaques. Need to differentiate from dermatophytes.
papules
51
Chronic Mucocutaneous Candidiasis involves _______ infections at several anatomical sites.
superficial
52
Chronic Mucocutaneous Candidiasis is often associated with particular _______ deficits and _____ disorders. ________ response to infection.
T-cell endocrine Granulomatous
53
What are factors that contribute to disseminated candidiasis?
Increase in colonization Breakdown of normal physical barriers Immune suppression
54
_________ are fungal infections of the dermis, subcutaneous tissue, and bone. Acquired through _______
Subcutaneous mycoses trauma
55
What are 3 examples of subcutaneous mycoses?
1. Sporotrichosis 2. Chromoblastomycosis 3. Mycetoma
56
________ is infection of the cutaneous, subcutaneous tissue, and lymphatics.
Sporotrichosis
57
What causes Sporotrichosis?
Sporothrix schenckii
58
What are the characteristics of Sporothrix schenckii?
Dimorphic fungus found in soil, compost, and on plants. Mold in nature, yeast in tissues
59
Sporothrix schenckii is introduced through _________ like rose thorns, wood splinters, and sphagnum moss.
traumatic inoculation
60
What are the presentations of Sporotrichosis?
Inflammation at site on inoculation followed by development of a painless granulomatous lesion Lesions ulcerates to sore Secondary lesions develops along draining lymphatic tract
61
How do you diagnose Sporotrichosis?
Mold converts to yeast form at 37 degrees celcius if cultivated in tissue
62
Chromoblastomycosis is a disease of the ______. Involved traumatic inoculation of ______ fungi
tropics soil
63
Chromoblastomycosis presents as a _______ lesion and slowly develops to red/gray cauliflower like lesions. Painless
wart-like
64
What do you see when diagnosing Chromoblastomycosis?
Infected tissues may reveal copper-colored spherical cells called Medlar bodies
65
What is Fungal Mycetoma or Madura Foot? Involves traumatic inoculation of ________
Chronic, subcutaneous infection typically affecting the foot. Soil-inhabiting fungi
66
What is the presentation of madura foot?
Slow growing papule Lesions ulcerates, releasing blood and pus Draining tracts or sinuses develop releasing discharge from lesion
67
How do you diagnose Madura foot?
Observe colored grains in pus, tissue, or discharge
68
How do you treat Madura foot?
Surgery and antifungal drugs