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Flashcards in Fungal Skin Infections Deck (53)
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1

What are all the skin infections?

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

2

What is ringworm of scalp?

tinea capitis

3

What is ringworm of glabrous skin?

tinea corporis

4

What is ringworm in groin?

tinea cruris

5

What is ringworm of nail?

tinea unguium or onychomycosis

6

What is ringworm of the feet?

tinea pedis

7

What is ringworm of the beard?

tinea barbae

8

What is ringworm of the hand?

tinea manuum

9

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

tinea capitus

10

What causes this?

dermatophytes

11

What are the three genres?

microsporum, trichophyton, epidermophyton

12

What is the dx for dermatophytes?

KOH mount, see branching hyphae

13

What else can you use to dx dermatophytes?

cultures - take long time
wood's lamps

14

Where do dermatophytes survive?

keratin, hair, nails

15

Who gets tinea capitus?

children 3-10 yo

16

What is the cause of tinea capitus?

trichophyton tonsurans

17

How do you get tinea capitus?

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

18

What is the presentation of tinea capitus?

non-inflammatory- patches of alopecia, scaling
Inflammatory - granulomatus, boggy mass

19

How does tinea capitus progress?

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

20

How do you dx tinea capitus?

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

21

What is the tx for tinea capitus?

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

22

How does selenium sulfide shampoo help with tinea capitus?

reduces viable spores, reduce spreading

23

What does tinea corporis look like?

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

24

What causes tinea corporis?

zoophilic or geophilic dermatophytes

25

What is trichophyton rubum cause?

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

26

How do you dx tinea corporis?

KOH test, skin scrapings, fungal cultures

27

What is the treatment for tinea corporis?

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)

28

How should the topical be applied in tinea corporis?

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

29

What are the systemic agents of tinea corporis?

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

30

What is tinea cruris called?

jock itch

31

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

tinea cruris

32

What are risk factors for tinea cruris?

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

33

What does 50% of tinea cruris pts have?

tinea pedis

34

What causes tinea cruris?

Trichophyton rubrum and Epidermophyton floccosum

35

How do you dx tinea cruris?

KOH

36

What is the treatment for tinea cruris?

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

37

What are key things in tinea cruris?

symmetric erythematous rashsymmetric erythematous rash
central clearing

38

What is term is tinea pedis?

athlete's foot

39

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

tinea pedis

40

What are risk factors for tinea pedis?

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

41

What causes tinea pedis?

Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum

42

What is the presentation of tinea pedis?

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

43

What is the treatment for athlete's foot?

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

44

How long do you treat tinea pedis?

1-6 weeks

45

What does tinea versicolor look like?

HYPO/HYPERPIGMENTED SCALY MACULES
CONFLUENT PATCHES
UPPER TRUNK

46

What are risk factors for tinea versicolor?

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

47

What is the cause of tinea versicolor?

Malassezia furfur or Pityrosporum orbiculare

48

What is the dx of tinea versicolor?

KOH -clusters of spores and SHORT hyphae
SPAGGETTI WITH MEATBALLS

49

What will tinea versicolor look like on a wood lamp?

yellow to coppery-orange

50

What is there with tinea versicolor?

scaling

51

When do skin color alteration resolve within?

1-2 months after treatment

52

What is the treatment for tinea versicolor??

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

53

KNOW FIRST LINE AGENTS AND CAUSATIVE ORGANISMS

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