Untitled Quiz

Tinea Pedis (Athlete's Foot)

• Fungal growth is encouraged by warmth and moisture from shoes, commonly affecting men.

• Types of Clinical Presentations:

  • Classical ringworm: Occurs on the dorsum of the foot.
  • Interdigital tinea: Commonly affects the fourth toe web, which appears dry, scaly, fissured, or soggy with itching.
  • Chronic scaly infection: Involves the entire sole, showing fine silvery white scales with tenderness; Trichophyton rubrum is the main pathogen.
  • Acute vesicular tinea: Characterized by inflamed vesicles that can fuse and may appear as allergic reactions (dermatophytid).

• Treatment Options:

  • Terbinafine 1% cream applied twice daily for one week.
  • Oral medications: Fluconazole (50 mg once weekly for 4 weeks) or Itraconazole (200 mg twice daily for one week) for moccasin-type infections.
  • Antibiotics for secondary infections and topical steroids for id reaction.

Tinea Cruris (Jock Itch)

• Affects the groin area, common in men, rare in children.
• Presents as a half-moon shaped red-brown plaque with a scaling border.
• Scrotal involvement is atypical, differentiating it from candidiasis.
• Treatment Options:
  • Terbinafine 1% cream, applied twice daily for one week.
  • Oral medications include Fluconazole (150 mg once weekly for 2-4 weeks) and Itraconazole.

Tinea Corporis

• Affects trunk, limbs, and face (excluding beard/mustache areas).
• Presents as round annular lesions with well-demarcated erythematous patches and clear centers.
• Treatment: Similar to tinea cruris.

Tinea Manuum

• Tinea of the hands, dorsal aspect resembles tinea corporis.
• Palmar surface appears similar to hyperkeratotic sole tinea.
• Often associated with tinea pedis and nail infections.
• Treatment: Same as tinea cruris.

Tinea Capitis

• Fungal infection of the scalp, mostly in children aged 3-7.

• May present with cervical or occipital lymphadenopathy.

• Clinical Types:

  • Non-inflammatory (black dot pattern): Hair loss with broken hairs resembling black dots.
  • Inflammatory (kerion): Multiple tender areas with potential for scarring.
  • Seborrheic dermatitis-like: Fine white scales on the scalp.
  • Favus: Scutula formation around hair with potential scarring.

• Treatment Options:

  • Systemic treatment required; Griseofulvin is well-absorbed with fatty meals.
  • Alternatives include Fluconazole and Terbinafine.

Tinea Barbae

• Fungal infection of beard/mustache areas, beginning with follicular pustules.
• Can become confluent with inflammatory masses (kerion).
• Treatment: Similar to tinea capitis.

Tinea Incognito

• Results from improper treatment with topical steroids, masking symptoms but allowing fungal growth.
• Symptoms reappear post-steroid withdrawal, often more extensive.

Candidiasis (Moniliasis)

• Caused by Candida albicans, part of normal flora but can become pathogenic under certain conditions (e.g., diabetes, antibiotics).

• Clinical Presentations:

  • Monilial vulvovaginitis: Presents with vaginal itching and white discharge.
  • Oral candidiasis: White plaques in infants and adults, often associated with immunosuppression.
  • Candida balanitis: Red papules and pustules on the glans in uncircumcised men.

• Treatment Options:

  • Antifungal creams (Miconazole, Clotrimazole) for local infections, with oral Fluconazole for systemic infections.

Candidiasis of Skin Folds

• Occurs in warm, moist areas like under breasts or in groin; presents as macerated pustules with moist scaling.
• Treatment: Maintain dryness and apply topical antifungal creams.

Pityriasis Versicolor

• Caused by Malassezia yeast, presenting as asymptomatic macules/patches on the trunk and limbs.
• Confirmation via potassium hydroxide examination shows hyphae and spores in a "spaghetti-and-meatballs" pattern.
• Treatment Options:
  • Ketoconazole shampoo, Selenium sulfide suspension, and Itraconazole for recurrences.