Superficial Fungal Infectinos Flashcards
(41 cards)
What are the 4 Superficial Fungal Infections?
● Athlete’s foot (tinea pedis)
● “Jock itch” (tinea cruris)
● Ringworm (tinea corporis)
● Onychomycosis (tinea unguium
● Athlete’s foot (tinea ____)
● “Jock itch” (tinea _____)
● Ringworm (tinea ______)
● Onychomycosis (tinea ______)
● Athlete’s foot (tinea pedis)
● “Jock itch” (tinea cruris) [crude]
● Ringworm (tinea corporis) [corporate RING]
● Onychomycosis (tinea unguium) [ungulate- nail]
Waht are dermatophytes?
a pathogenic fungus that grows on skin, mucous membranes, hair, nails, feathers, and other body surfaces, causing ringworm and related diseases.
How are fungal infection sspread?
Transmission: Direct contact from infected people, fomites, the environment (soil) or
animals
Waht are 3 predisposing host factors?
Predisposing host factors:
● Moisture (occlusive clothing/shoes, warm humid climates)
● Genetic susceptibility
● Impaired immunity (e.g., diabetes, HIV, chemotherapy)
Waht organisms is athletes foot caused by?3
- most commonly fungus/dermatophytes
- but yeast can be involved
- and gram neg bacteria in ulcerative forms.
What are predisopsong host facctors for athletes foot?
- local factors?
Host factors: immunosuppression, poorly controlled diabetes mellitus, obesity,
hyperhidrosis
Local factors: trauma, occluded skin, poor hygiene, moist conditions, contaminated
surface
how athletes food spread?
DIRECTLY via contact with infected person. or INDIRECTLY via contaminated surfaces (swimming pool, changeroom floor).
What is hte most COMMON VARIANT OF ATHLETES FOOD u must know?
- describe presentation.
- usualy foudn btwn which toes?
- _______ ALL OTHER PRESENTATIONS of ahtletes foot.
chronic interdigital infection.
- itching, burning btwn the toes.
- skin appears red scaly and dry that progresses to white fisuses, scaling.
- is stinky.
- btwn 4-5th toes.
- REFER ALL OTHER PRESENTATIONS of ahtletes foot.
otehr variants of athletes foot?
- what are some red flags questions to ask ?
- mocassin typ e–> toenails infected.
- vesicular -> small vesicls appear near instep and plantar surface.
- ulcerative: weeping and inflamted.
__% will acquire Athlete’s foot infection at some point in their lifetime
● athletes foot more common i nwhich gender>
● Prevalence increases with ____
● ____ have 30% prevalence rate
70% will acquire Athlete’s foot infection at some point in their lifetime
● Males are 4 times more likely than females to acquire infection
● Prevalence increases with age
● Marathon runners have 30% prevalence rate
What are some non-pharm tips for ATHLETES FOOT?
● Avoid ______________ in public spaces.
● Manage ______.
● allow shoes to ______.
● avoid ________ shoes
● ______shoes
● Personal ___
● __ and -___ feet thoroughly
● ______ socks daily (choose breathable sock materials, avoid nylon)
● do not share what?
● Avoid going barefoot in public spaces ) -
sandals!
● Manage hyperhidrosis (antiperspirant or absorbent powders - talcum/aluminum
chloride);
● allow shoes to dry thoroughly
● avoid tight-fitting shoes
● Breathable shoes - leather/canvas allow feet to breathe
● Personal hygiene
● wash feet and dry feet thoroughly
● change socks daily (choose breathable sock materials, avoid nylon)
● launder items used by infected person often and DONT SHARE TOWELS. –> Don’t dry off infected part of body then dry other parts of body- can re-inoculate.
Waht is first line therapy for ahtletes foot?
- second line?
1st: topical antigunal.
2nd: systemic antigungal. Terbinafine po - is for more complex presentation (moccasin or vesicular) and are usually referred anyway.
What is the prescription product for athletes foot? (3)
- duration of trx for lamisil?
- what are the other trx for athletes foot?
- duration trx?
- Lamisil (Terbinafine cream, spray):
duration: 1-2 wks if mild; 4 wks if needed.
–> requires APA. - imidazoles.
- duration: all 4 wks.
- Miscellan
- Hydroxypyridones….. see slide
Rx: terbinafine cram, ketoconazole and ciclopirox cream. others otc.
Waht is the most effective drug for athletes foot? con?
TERBINAFINE! CON: REQUIRES APA.
terbinafine>miconazole/clotrimazole>tolnaftate
is tea treee oild effective for Athletes foot?
no!
Educate on how to apply a topical antifungal for athletes foot.
- apply hwere?
- how muhc?
- how often and for how long?
- what about sprays?
● Apply to clean dry area
● Affected area including 2-3 cm beyond the border
● Most products (e.g., creams, lotions etc) apply/massage into area twice
daily for at least 4 weeks (AND CONTINUE USING ~1 week after the
infection has cleared to prevent recurrence).
● Sprays: apply to skin only.
- powders – apply to dry footwear and skin (check directions)
What do you monitor for Athletes foot?
Efficacy:
- most imp tip?
- refer if no improvement after how many wks trx?
Safety:
- common AEs of topical products?
- should they d/c if dvlp rash?
Efficacy:
● Finish recommended course of treatment to prevent reoccurrence, even though symptoms
may resolve before treatment is complete.
● Refer if worsens or no improvement after 2 weeks of treatment or not completely resolved after 6 weeks of treatment
Safety:
Topical products: Local skin irritation or hypersensitivity (burning, erythema, pruritus, rash,
stinging).
–> yes. Rash suggests possible allergy to product - discontinue use and consult HCP
are topical steroids recommended in athletes foot?
NO! do not recommend. Could use in mild cases, but incr cost, more side effects, and can sometimes lead to more growth, so not often used. But just be aware you may see this. When see this, ask whether they really need the steroid.
can athletes foot cause jock itch?
yes!Can be transmitted from underwear sliding up from foot. Be careful when dressing from self-inoculating
Describe the lcoation of jock itch.
- is penis and scrotum involved?
Involves groin - medial and upper parts of the thigh and pubic
area, Occasionally anal cleft
● Unlike candida – penis and scrotum usually spared
● May also involve buttocks
Describe presentation of jock itch.
- symmetry?
- appearance?
● Often Bilateral/symmetrical due to inner thigh contact’’
● Round, well-defined bordered lesions (red-brown) with a raised
erythematous margin (ring like)
● Patches may be less erythematous and more hyperpigmented on
darker skin compared to lighter skin
● Dry scaling is frequent
● Can be asymptomatic or pruritic
● May become macerated and infected,
although rare
Waht are some differntial dx of jock ithc?
Candidiasis (very red with poorly defined borders), seborrheic dermatitis
(usually also involves scalp, face etc), psoriasis (symmetrical erythematous
plaques) or bacterial infections
what are some non pharm recommendations for jock itch?
- avoid what kind of clothes?
- how should they dry off?
- launder?
- are dyring powders recommended?
Avoid tight fitting clothes to reduce moisture at the affected area.
Wear clothes made out of breathable fibers (cotton).
Dry all areas completely (use separate towel to dry groin area).
Laundering of contaminated clothing separately.
Drying powders?? NO! can actually incr fungal growth.
