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Questions and Answers
What is the primary cause of pityriasis versicolor?
Which treatment options are effective for pityriasis versicolor?
What characteristic pattern is observed in a potassium hydroxide examination of pityriasis versicolor scales?
In which body areas are lesions from pityriasis versicolor most commonly found?
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What is the appearance of pityriasis versicolor lesions?
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What is the primary treatment option for monilial vulvovaginitis?
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Which population is at higher risk for developing oral candidiasis?
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What is a characteristic clinical presentation of candida balanitis?
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How is candidiasis of the skin folds, also known as candida intertrigo, diagnosed?
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What is the recommended treatment for diaper candidiasis?
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What physical environment does candida balanitis thrive in?
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Which antifungal agent is not recommended for treating oral candidiasis in adults?
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What symptoms are associated with angular cheilitis?
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What is considered a common clinical presentation of interdigital tinea pedis?
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Which pathogen is most commonly associated with chronic scaly infection of the plantar surface in tinea pedis?
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What is the treatment protocol for acute vesicular tinea pedis?
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Which of the following differentiates tinea cruris from candidiasis?
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What symptom is most commonly associated with tinea pedis?
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In acute vesicular tinea pedis, what represents an allergic response to the fungus?
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What form of tinea pedis is characterized by the entire sole being infected with silvery white scales?
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Which of the following treatments is effective for moccasin tinea pedis?
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What is a characteristic feature of the infection causing yellowish cup-shaped crusts?
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What is the primary treatment modality for tinea capitis?
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Which medication is NOT recommended for tinea capitis?
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Which condition arises from the inappropriate use of topical steroids in fungal infections?
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What is a common complication if scarring alopecia is not treated promptly?
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What distinguishes tinea barbae from bacterial folliculitis?
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What factors can make candidiasis pathogenic?
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Which of the following treatments is advised for tinea barbae?
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Which treatment is appropriate for tinea cruris?
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What best describes the appearance of tinea corporis?
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What is a common feature of tinea manum?
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Which statement about tinea capitis is true?
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What is the characteristic feature of the non-inflammatory black dot pattern of tinea capitis?
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Which clinical type of tinea capitis leads to scarring alopecia if not treated promptly?
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Which of the following is not a feature of pustular tinea capitis?
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What distinguishes favus from other types of tinea capitis?
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Study Notes
Tinea Pedis (Athlete's Foot)
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Fungal growth is encouraged by warmth and moisture from shoes, commonly affecting men.
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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).
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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.
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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
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Fungal infection of the scalp, mostly in children aged 3-7.
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May present with cervical or occipital lymphadenopathy.
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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.
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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)
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Caused by Candida albicans, part of normal flora but can become pathogenic under certain conditions (e.g., diabetes, antibiotics).
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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.
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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.
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Treatment Options:
- Ketoconazole shampoo, Selenium sulfide suspension, and Itraconazole for recurrences.
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