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Peds Skin: Fungal infections
Terms in this set (17)
What do fungal infections typically look like and where do they occur?
Dermatophytes become attached to the superficial layer of the epidermis, nails, and hair, where they proliferate. Fungal infection should be suspected with any red and scaly lesion.
Thickened, broken-off hairs with erythema and scaling of underlying scalp are the distinguishing features of what fungal infections?
Hairs are broken off at the surface of the scalp, leaving a "black dot" appearance. Diffuse scaling of the scalp and pustules are also seen.
What lab tests should you use to diagnose Tinea Capitis?
What fungal skin infection presents either as annular marginated plaques with a thin scale and clear center or as an annular confluent dermatitis?
Besides clinical appearance how would you diagnose Tinea Corporis?
diagnosis is made by scraping thin scales from the border of the lesion, dissolving them in 20% potassium hydroxide (KOH), and examining for hyphae.
Symmetrical, sharply marginated lesions in inguinal areas is the characteristic presentation of what fungal infection?
Presentation of this fungal infection is with red scaly soles, blisters on the instep of the foot, or fissuring between the toes. Most commonly seen in postpubertal males.
What is the first sign of fungal infection of the nails?
Loosening of the nail plate from the nail bed (onycholysis), giving a yellow discoloration.
(Thickening of the distal nail plate then occurs, followed by scaling and a crumbly appearance of the entire nail plate surface)
How do you confirm a diagnosis of TINEA UNGUIUM (ONYCHOMYCOSIS)?
diagnosis is confirmed by KOH examination and fungal culture
Does Tinea unguium effect all the nails at once?
Usually only one or two nails are involved. If every nail is involved, psoriasis, lichen planus, or idiopathic trachyonychia is a more likely diagnosis than fungal infection.
How do you treat these dermatophytosises?
If hair is involved, systemic therapy is necessary (Griseofulvin and terbinafine are both effective). Topical antifungal agents do not enter hair or nails in sufficient concentration to clear the infection. With hair infections, cultures should be done every 4 weeks, and treatment should be continued for 4 weeks following a negative culture result.
Tinea corporis, tinea pedis, and tinea cruris can be treated effectively with topical medication after careful inspection to make certain that the hair and nails are not involved. Treatment with any of the imidazoles, allylamines, benzylamines, or ciclopirox applied twice daily for 3-4 weeks is recommended.
What superficial infection caused by Malassezia globosa (a yeastlike fungus), characteristically causes polycyclic connected hypopigmented macules and very fine scales in areas of sun-induced pigmentation, that in winter, the polycyclic macules appear reddish brown?
How do you treat Tinea Versicolor?
Treatment consists of application of selenium sulfide (Selsun), 2.5% suspension, zinc pyrithione shampoo, or topical antifungals. Selenium sulfide and zinc pyrithione shampoo should be applied to the whole body and left on overnight. Treatment can be repeated again in 1 week and then monthly thereafter. It tends to be somewhat irritating, and the patient should be warned about this difficulty. Topical antifungals are applied twice a day for 1-2 weeks. Fluconazole 400 mg single dose may also be used.
This fungal infection presents in many ways including: diaper dermatitis; thick, white patches on the oral mucosa (thrush); fissures at the angles of the mouth (perleche); and periungual erythema and nail plate abnormalities (chronic paronychia).
Candida albicans Infections
Candida dermatitis is characterized by sharply defined erythematous patches, sometimes with eroded areas. Pustules, vesicles, or papules may be present as satellite lesions. Where on the body do you usually find these infections?
moist areas, such as the axillae and neck folds
Is there anything that contributes to the development of Candida albicans?
Pt's who recently received antibiotics and diabetics
How is candida albicans treated?
-A topical imidazole cream is the drug of first choice for C albicans infections.
-In oral thrush, nystatin suspension should be applied directly to the mucosa with the parent's finger or a cotton-tipped applicator.
- In candidal paronychia, the antifungal agent is applied over the area, covered with occlusive plastic wrapping, and left on overnight after the application is made airtight.
- Refractory candidiasis will respond to a brief course of oral fluconazole.
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