Fungal Skin Infections

Question 1

What are all the skin infections?

Answer 1

tinea capitis (ringworm of the scalp)
tinea corporis (ringworm of glabrous skin)
tinea cruris (ringworm of the groin)
tinea unguium or onychomycosis (ringworm of the nail)
tinea pedis (ringworm of the feet)
tinea barbae (ringworm of the beard)
tinea manuum (ringworm of the hand)
tinea versicolor 
Candidiasis

Question 2

What is ringworm of scalp?

Answer 2

tinea capitis

Question 3

What is ringworm of glabrous skin?

Answer 3

tinea corporis

Question 4

What is ringworm in groin?

Answer 4

tinea cruris

Question 5

What is ringworm of nail?

Answer 5

tinea unguium or onychomycosis

Question 6

What is ringworm of the feet?

Answer 6

tinea pedis

Question 7

What is ringworm of the beard?

Answer 7

tinea barbae

Question 8

What is ringworm of the hand?

Answer 8

tinea manuum

Question 9

What is Superficial fungal infection of the skin of the scalp, eyebrows, and eyelashes, with a propensity for attacking hair shafts and follicles?

Answer 9

tinea capitus

Question 10

What causes this?

Answer 10

dermatophytes

Question 11

What are the three genres?

Answer 11

microsporum, trichophyton, epidermophyton

Question 12

What is the dx for dermatophytes?

Answer 12

KOH mount, see branching hyphae

Question 13

What else can you use to dx dermatophytes?

Answer 13

cultures - take long time

wood’s lamps

Question 14

Where do dermatophytes survive?

Answer 14

keratin, hair, nails

Question 15

Who gets tinea capitus?

Answer 15

children 3-10 yo

Question 16

What is the cause of tinea capitus?

Answer 16

trichophyton tonsurans

Question 17

How do you get tinea capitus?

Answer 17

person to person contact, orangism is viable on contaminated brushes, combs, sheets

Question 18

What is the presentation of tinea capitus?

Answer 18

non-inflammatory- patches of alopecia, scaling

Inflammatory - granulomatus, boggy mass

Question 19

How does tinea capitus progress?

Answer 19

red papules –> grayish ring –> pustules –> debris –> alopecia

Question 20

How do you dx tinea capitus?

Answer 20

KOH mount, wood lamp (the most common does not fluorescence), cultures (2 wk to identify)

Question 21

What is the tx for tinea capitus?

Answer 21

Griseofluvin 20-25 mg/kg/d for 6-8 wks
Itraconazole 3-5 mg/kg/d with a full meal for 4-6 wks
terbinafine 3-6 mg/kg/d for approximately 2-4 weeks
Selenium sulfide shampoo

Question 22

How does selenium sulfide shampoo help with tinea capitus?

Answer 22

reduces viable spores, reduce spreading

Question 23

What does tinea corporis look like?

Answer 23

annular lesions, scaly ring like, advances elevated borders, central clearing, deep inflammatory lesion

Question 24

What causes tinea corporis?

Answer 24

zoophilic or geophilic dermatophytes

Question 25

What is trichophyton rubum cause?

Answer 25

infection of hair, hair follicles, surrounding dermis, perifollicular granulomatous nodules

Question 26

How do you dx tinea corporis?

Answer 26

KOH test, skin scrapings, fungal cultures

Question 27

What is the treatment for tinea corporis?

Answer 27

topical agents Naftifine 1% cream/gel (Naftin) x 4 weeks Terbinafine topical (Lamisil) Ketoconazole topical (Nizoral) Clotrimazole 1% cream (Mycelex, Lotrimin) Oxiconazole 1% cream (Oxistat)

Question 28

How should the topical be applied in tinea corporis?

Answer 28

at least 2 cm beyond area once or twice a day for at least 2 weeks

Question 29

What are the systemic agents of tinea corporis?

Answer 29

for extensive infection, immunosuppression, resistance to topicals, or comorbid tineas GRISEOFULVIN 10mg/kg/d for 4 weeks FLUCONAZOLE 50-100mg/d or 150mg once weekly for 2-4 weeks ITRACONAZOLE 200mg/d x 1 week, or 100mg/d x 2 weeks

Question 30

What is tinea cruris called?

Answer 30

jock itch

Question 31

What is Pruritic, superficial fungal infection of the groin and adjacent skin?

Answer 31

tinea cruris

Question 32

What are risk factors for tinea cruris?

Answer 32

wearing tight-fitting or wet clothing or undergarments or auto-inoculation from other site

Question 33

What does 50% of tinea cruris pts have?

Answer 33

tinea pedis

Question 34

What causes tinea cruris?

Answer 34

Trichophyton rubrum and Epidermophyton floccosum

Question 35

How do you dx tinea cruris?

Answer 35

KOH

Question 36

What is the treatment for tinea cruris?

Answer 36

``` Naftifine 1% cream/gel (Naftin) Terbinafine topical (Lamisil) Ketoconazole topical (Nizoral) Clotrimazole 1% cream (Mycelex, Lotrimin) Oxiconazole 1% cream (Oxistat) ```

Question 37

What are key things in tinea cruris?

Answer 37

symmetric erythematous rashsymmetric erythematous rash | central clearing

Question 38

What is term is tinea pedis?

Answer 38

athlete's foot

Question 39

What is Dermatophyte infection of the soles of the feet and the interdigital spaces?

Answer 39

tinea pedis

Question 40

What are risk factors for tinea pedis?

Answer 40

hyperhidrosis, prolonged exposure to occlusive footwear, hot/humid/tropical environments, swimming

Question 41

What causes tinea pedis?

Answer 41

Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum

Question 42

What is the presentation of tinea pedis?

Answer 42

Pruritic, scaly soles and, often, painful fissures between the toes – Rarely vesicular or ulcerative lesion

Question 43

What is the treatment for athlete's foot?

Answer 43

Naftifine 1% cream/gel (Naftin) BID x 4 weeks Terbinafine topical 1% (Lamisil) x 2-3 weeks Clotrimazole 1% cream (Mycelex, Lotrimin) Oxiconazole 1% cream (Oxistat) Luliconazole, topical cream, is applied once daily for 2 weeks

Question 44

How long do you treat tinea pedis?

Answer 44

1-6 weeks

Question 45

What does tinea versicolor look like?

Answer 45

HYPO/HYPERPIGMENTED SCALY MACULES CONFLUENT PATCHES UPPER TRUNK

Question 46

What are risk factors for tinea versicolor?

Answer 46

genetic predisposition; warm, humid environments; immunosuppression; malnutrition; application of oily preparations; corticosteroid usage; Cushing disease

Question 47

What is the cause of tinea versicolor?

Answer 47

Malassezia furfur or Pityrosporum orbiculare

Question 48

What is the dx of tinea versicolor?

Answer 48

KOH -clusters of spores and SHORT hyphae | SPAGGETTI WITH MEATBALLS

Question 49

What will tinea versicolor look like on a wood lamp?

Answer 49

yellow to coppery-orange

Question 50

What is there with tinea versicolor?

Answer 50

scaling

Question 51

When do skin color alteration resolve within?

Answer 51

1-2 months after treatment

Question 52

What is the treatment for tinea versicolor??

Answer 52

SELENIUM SULFIDE 2.5% LOTION OR SHAMPOO, applied daily (for 10 minutes then rinse) x 2weeks KETACONAZOLE SHAMPOO or TOPICAL FOAM Fluconazole 300mg PO weekly for 2 weeks Itraconazole 200mg PO daily for 5-7 days

Question 53

KNOW FIRST LINE AGENTS AND CAUSATIVE ORGANISMS

Answer 53

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