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Fungal Infections. Reena Doshi. Two major groups. Candida Dermatophyte. Candidiasis : Genital. Women > Men Itchy, sore vulvovaginitis White plagues on mucous membranes White ‘cheesy’ discharge. Candidiasis : Genital. Candidiasis: Intertrigo. Red, moist, glazed, itchy

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Presentation Transcript
two major groups
Two major groups
  • Candida
  • Dermatophyte
candidiasis genital
Candidiasis : Genital
  • Women > Men
  • Itchy, sore vulvovaginitis
  • White plagues on mucous membranes
  • White ‘cheesy’ discharge
candidiasis intertrigo
Candidiasis: Intertrigo
  • Red, moist, glazed, itchy
  • Submammary, inguinal, axillary folds
  • Occasionally between digits
candidiasis oral
Candidiasis: Oral
  • Babies, pts with poor oral hygiene, elderly with false teeth
  • Sore mouth
  • Poor feeding
  • White plaques on buccal mucosa – wipe off
  • Angular stomatitis
candidiasis nappy
Candidiasis: Nappy
  • Babies
  • Nappy area
candidiasis chronic paronychia
Candidiasis: Chronic paronychia
  • Wet workers
  • Chronic nail bed inflammation
candidiasis systemic
Candidiasis: Systemic
  • Immunosupressed pts

esp. HIV,malignancy

  • Red skin nodules
tinea infections

Tinea infections…

Obtain scrapings/clippings before starting treatment

tinea corporis ringworm
Tinea Corporis: Ringworm
  • Trunk/limbs
  • Plaques with scaling and erythema – esp. at edges
  • Lesions enlarge slowly and clear centrally
tinea cruris
Tinea Cruris
  • Groin, upper thigh (scrotum)
  • Common in athletes
  • Men > Women
  • Red plaque with scaling esp. at the edge – central clearing with active edge
  • Assoc. with tinea pedis
tinea pedis athletes foot
Tinea Pedis: Athletes Foot
  • Feet
  • Young > Old
  • Men > Women
  • Itchy maceration between toes esp. 4th/5th
  • RFs:
    • Swimming
    • Occlusive footwear
    • Hot weather
    • Communal showers
tinea capitis
Tinea Capitis
  • Hair and scalp
  • Defined inflammed scaly areas
  • May have alopecia with broken hair shafts
tinea unguium
Tinea Unguium
  • Nails
  • Old > Young
  • Toenails > Fingernails
  • Distal to proximal spread
  • Thickening, yellowing and crumbling of nail plate
  • Assoc with tinea pedis
management topical
Management: Topical
  • Genital
    • Imidazole cream, pessaries
  • Nail
    • If 1-2 nails only: lacquer or paint (1-2x/week)
  • Skin
    • Imidazole cream , spray, powder
    • Terbinafine cream
  • Mouth
    • Tongue deposits-brush bd
    • Oral pastilles, suspensions, gels eg nystatin, miconazole
management systemic
Management: Systemic
  • Recurrent, systemic, extensive or resistant infection
  • Genital candida: 200mg fluconazole stat
  • Oral/mucocutaneous/systemic candida:

Eg. Oral fluconazole (1-2/52)

management systemic26
Management: Systemic
  • Dermatophyte –
    • Oral terbinafine or itraconazole daily
      • Skin: 2-4/52
      • Nails: 3/12