A13. Fungal diseases of the skin and its appendages

From greek.doctor
  • Diagnosis of fungal infections
    • KOH preparation -> hyphae/yeasts visible under microscope
      • KOH dissolves keratin
    • Culture
    • Wood-light – green fluorescence UV lamp
  • Treatment of fungal infections
    • Terbinafine – for dermatophytoses
    • Fluconasol – for candida
    • Itraconazole – for candida, dermatophytoses
    • Ketoconazole – for Malassezia (pityrasis versicolor)
  • Epidermomycoses
    • By dermatophytes
    • Risk factors
      • Children
      • Immunocompromised
      • Diabetes
    • Clinical features
      • Pruritus
      • Scaling
      • Erythema
    • Treatment
      • Topical antifungals
        • Terbinafine
        • Azoles
      • Oral antifungals
        • For immunocompromised persons
        • Terbinafine
        • Itraconazole
    • Tinea facialis – face
    • Tinea corporis – body
    • Tinea cruris – inguinal area
    • Tinea manuum – hands
      • Usually affects two feet and one hand (syndrome)
      • Because the person scratches the feet with the dominant hand
    • Tinea pedis – feet
  • Onychomycoses
    • Discoloured and brittle nails
    • Candida
    • Tinea unguium
    • Treatment
      • Terbinafine
      • Itraconazole
  • Trichomycosis
    • Tinea capitis – scalp
      • Dandruff
      • Smooth areas of hair loss
    • Kerion – very inflamed abscess-like mass
    • Favus – yellow crust
  • Candida
    • Albicans most common
    • Risk factors
      • Immunosuppression
      • Diabetes
      • Antibiotic therapy
    • Skin infections
      • Oral candidiasis
      • Angular cheilitis
      • Vulvovaginal candidiasis
      • Balanitis
      • Intertrigo – infection of the skin folds
      • Interdigital candidiasis
      • Diaper rash
      • Chronic mucocutaneous candidiasis
        • Congenital impaired T-cell function
    • Clinical features
      • Pruritic erythematous plaque
      • White layer – on mucous membranes, genital organs
    • Systemic
      • Candida sepsis
        • Fever that doesn’t improve with antibiotics
      • Invasive candidiasis
  • Pityriasis versicolor
    • Risk factors
      • Hot, humid environment
      • Excessive sweat
    • Clinical features
      • Hypomelanotic macules
    • Treatment
      • Topical ketoconazole cream
      • Ketoconazole shampoo
  • Cryptococcosis
    • Immunocompromised patients
    • Cutaneous cryptococcosis
      • Molluscum contagiosum-like papules
    • Can also cause pneumonia and meningitis
    • Cryptococcal meningitis
    • Treatment
      • Fluconazole
      • Amphotericin
      • Flucytosine
  • Aspergillosis
    • Immunocompromised patients
    • Necrotizing nodules
    • Abscess