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Fungal Infections

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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Fungal Infections

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  1. Fungal Infections Reena Doshi

  2. Two major groups • Candida • Dermatophyte

  3. Candidiasis : Genital • Women > Men • Itchy, sore vulvovaginitis • White plagues on mucous membranes • White ‘cheesy’ discharge

  4. Candidiasis : Genital

  5. Candidiasis: Intertrigo • Red, moist, glazed, itchy • Submammary, inguinal, axillary folds • Occasionally between digits

  6. Candidiasis: Intertrigo

  7. 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

  8. Candidiasis: Oral

  9. Candidiasis: Nappy • Babies • Nappy area

  10. Candidiasis: Chronic paronychia • Wet workers • Chronic nail bed inflammation

  11. Candidiasis: Systemic • Immunosupressed pts esp. HIV,malignancy • Red skin nodules

  12. Candidiasis: Systemic

  13. Tinea infections… Obtain scrapings/clippings before starting treatment

  14. Tinea Corporis: Ringworm • Trunk/limbs • Plaques with scaling and erythema – esp. at edges • Lesions enlarge slowly and clear centrally

  15. Tinea Corporis: Ringworm

  16. 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

  17. Tinea Cruris

  18. Tinea Pedis: Athletes Foot • Feet • Young > Old • Men > Women • Itchy maceration between toes esp. 4th/5th • RFs: • Swimming • Occlusive footwear • Hot weather • Communal showers

  19. Tineqa Pedis

  20. Tinea Capitis • Hair and scalp • Defined inflammed scaly areas • May have alopecia with broken hair shafts

  21. Tinea Capitis

  22. Tinea Unguium • Nails • Old > Young • Toenails > Fingernails • Distal to proximal spread • Thickening, yellowing and crumbling of nail plate • Assoc with tinea pedis

  23. Tinea Unguium

  24. 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

  25. Management: Systemic • Recurrent, systemic, extensive or resistant infection • Genital candida: 200mg fluconazole stat • Oral/mucocutaneous/systemic candida: Eg. Oral fluconazole (1-2/52)

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

  27. Thank You!

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