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Derm Fungal & Viral
Fungal and Viral Infections of the skin
| Question | Answer |
|---|---|
| what classifies fungal infections | depth of penetration |
| ____ are the most common fungal infections of the skin | dermatophytic infections. |
| 3 genera of fungi responsible for dermatophytic infections | microsporum, trichophyton, epidermophyton |
| Three routes to acquire a dermatophytic infections | person to person, animal to human, environmental |
| Predisposing factors to Tinea | atopy, steroid use, dry skin, occlusion, high humidity |
| Scales are usually suggestive of | fungal etiology |
| Dermatophytic infection of the feet characterized by erythema, scaling, vesicles and maceration | Tinea pedis. Bacterial secondary infection is common. Predisposing factors: hot/humid weather, sweating, occlusion (by shoes), contaminated floors. Involvement of toe nails is common |
| Tinea pedis is most common in which population? | males |
| Types of Tinea Pedis | Interdigital, Moccasin, Inflammatory/bullous (fluid filled that burst) |
| Tx for Tinea Pedis | Topical: imidazole (1%), allylamines (lamasil). Oral: for severe refractory cases, imidazole, allylamines, long tx? monitor LFTs (at least baseline). Treat any secondary infection |
| Jock itch is AKA | tinea cruris. Sub-acute or chronic infection of the groin/medial thighs. well-demarcated line between involved and uninvolved |
| If scrotum and inner thigh is involved, consider | candida. Also may see satellite lesions and less scales. |
| how should ointment be applied | make sure to also apply ointment wider than the borders of the lesion |
| Central clearing is typical of | tinea lesions |
| Population in which tinea capitus is most common | Most common in children, espeicially AA boys, ages 6-10 years; rare in adults |
| Only tinea infection that must be treated systemically | tinea capitus. Needs oral tx. Griseofulvin, Imidazoles, Lamisil. therapy for 6-12 weeks. For kerion, secondary infection abx must be added to regimen |
| infection accompanied by swollen, painful nodules associated with tinea capitus | kerion |
| If you see something like tinea capitus that is erythematous and oozing, think | impetigo |
| Candidiasis forms | cutaneous (intertrigo), mucocutaneous (oropharyngeal, genital), nail, systemic |
| Tx for intertriginous candidiasis | nystatin, imidazoles, glucocorticoids used sparingly to calm inflammatory response. Patients may c/o of itchy and PAIN (tx w/steroid) |
| Intertrigionous candidiasis at mouth corners is called | angular cheilitis |
| Lamisil works only on | dermatophytes. NOT ON YEAST |
| Nystatin works only | yeast. NOT ON DERMATOPHYTES |
| Imidazoles work on | yeast AND dermatophytes |
| Candidiasis features | satellite regions, burns, stings. no odor |
| What helps Tinea Versicolor grow? | oil. Etiologic agent: Malasezzia furfu |
| Common sites of Tinea Versicolor | upper trunk, axillae, groin, thighs, applications of oils/grease: face, neck & scalp |
| Spaghetti and meatballs | Tinea Versicolor. |
| Patient information in treating Tinea Versicolor? | Only works on symptoms, not the appearance. |
| Think about ________ in patients who have dirty wounds that aren't getting better | Subcutaneous fungal infections |
| Viral Exanthems presentation | Generalized skin eruption secondary to systemic infection. Prodrome present. Ask if they were sick before the rash. Common in children and adolescents |
| Viral exanthems can be accompanied by | oral lesions (enathems) |
| Most common viral exanthems in childhood | rubeola (measles), rubella, varcella, roseola, erythema infectiousum (fifth's dz) |
| Generalized Erythema with sandpaper feel, but no discrete lesions suggests | Scarlatiniform viral exanthem |
| You should see all stages of lesions in which disease? | chicken pox |
| Etiology of Hand-Foot-Mouth dz | Coxsackie virus. epidemic outbreaks q3 years. Lesions on hands and feet don't usually hurt much, but the ones in the mouth are painful |
| Grouped vesicles on erythamtous base | Herpes simplex |
| tx for herpes simplex | penciclovir (topical), acyclovir (cream and ointment), valacyclovir |
| Herpes lesions near fingernails | herpetic whitlow |
| Any time you see a large, single ulcer think | herpes and do a culture |
| In teenages, make sure they have had what vaccination or illness? | Chicken pox; can be life-threatening |
| Most worrisome complication of Shingles | Post-herpetic Neuralgia; oral steroids may prevent |
| Shingles | eruptions along a single dermatome, not itchy, painful |
| Tx for Shingles | High dose acyclovir for 7 days. Ideally start within 72 hours of eruption of lesions. Offer prednisone to patients 50 years and older to reduced likelihood of PHN |
| Vaccine newly approved for preventing shingles | Zosatvax; live vaccine. Medicare Part D covers. Anyone over 60, this is considered health maintenance |
| Viral skin infection caused by pox virusDistinct flesh colored or “pearly white”papules (1-2 mm) with umbilicated centers | molluscum contagiosum. Very common in children, sexually active adults. Transmission in skin to skin contact. Resolves spontaneously, but may take months. May be itchy and can autoinnoculate |
Created by:
ltm12