1 / 35

Management of Common Fungal & Bacterial Skin Infections

Management of Common Fungal & Bacterial Skin Infections. Dr. Sandra McLeod Consultant Dermatologist Skin Clinic KPH/NCH. Superficial Fungal Infections. DERMATOPHYTES. aka Tinea YEASTS - Pityrosporum. -Candida sp. TINEA Infections. T.Corporis - ringworm of body

harken
Download Presentation

Management of Common Fungal & Bacterial Skin Infections

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Management of Common Fungal & Bacterial Skin Infections Dr. Sandra McLeod Consultant Dermatologist Skin Clinic KPH/NCH Downloded from www.pharmacy123.blogfa.com

  2. Superficial Fungal Infections • DERMATOPHYTES.akaTinea • YEASTS -Pityrosporum. -Candida sp. Downloded from www.pharmacy123.blogfa.com

  3. TINEA Infections • T.Corporis- ringworm of body • T.Cruris- groin • T.Pedis- foot • T.Unguium- nail • T.Capitis scalp Downloded from www.pharmacy123.blogfa.com

  4. T.Corporis • Itchy • Annular patch • Well defined edge • Scaling more obvious at edges(central clearing) Downloded from www.pharmacy123.blogfa.com

  5. T.Pedis Downloded from www.pharmacy123.blogfa.com

  6. Downloded from www.pharmacy123.blogfa.com

  7. Downloded from www.pharmacy123.blogfa.com

  8. Downloded from www.pharmacy123.blogfa.com

  9. TINEA CRURIS • Often assoc with T.pedis • “Jock itch” • Tight hot sweaty groin eg athletes, obese,in lycra Downloded from www.pharmacy123.blogfa.com

  10. Downloded from www.pharmacy123.blogfa.com

  11. Onycholysis • Subungual hyperkeratosis • Dystrophy/ pigmentary changes Downloded from www.pharmacy123.blogfa.com

  12. TINEA CAPITIS - KERION Downloded from www.pharmacy123.blogfa.com

  13. TINEA CAPITIS – Black dot Downloded from www.pharmacy123.blogfa.com

  14. Management • General Measures • Non-specific- • Keratolytics -eg Whitfield’s ointment -Irritant Downloded from www.pharmacy123.blogfa.com

  15. Specific Antifungal Rx • Griseofulvin • Azoles- -Imidazole eg ketoconazole (^ liver toxicity, oral prep) topical preps -Triazole eg itraconazole,fluconazole • Allylamines eg terbinafine, naftifine • Ciclopiroxolamine Downloded from www.pharmacy123.blogfa.com

  16. TOPICAL Rx • Localized disease of skin • extend rx for 3-5/7 after apparent cure • 1% clotrimazole less effective • Sprays & solutions • tinea pedis /hairy areas • Limited nail disease • Batrafen nail lacquer Downloded from www.pharmacy123.blogfa.com

  17. ORAL Rx • Extensive disease • Nail disease • Tinea Capitis Downloded from www.pharmacy123.blogfa.com

  18. Regimes-Tinea Unguium • TERBINAFINE • Terbinafine250mg od • ITRACONAZOLE • Pulse rx Itraconazole - 1wk/mth 200mg bid • Itraconazole 200mg od • FLUCANAZOLE • Fluconazole 150mg once weekly Downloded from www.pharmacy123.blogfa.com

  19. Rx-Tinea Capitis • MUST use oral Rx- prolonged course • Griseofulvin-20mg/kg/od x 6-8/52 Terbinafine-62.5mg-250mg od x 4/52 • Flucanazole-50mg-150mg/wk x 4-6/52 Downloded from www.pharmacy123.blogfa.com

  20. Rx-Tinea CapitisAdjunctive Measures • Shampoo- antifungal/ antiseptic/antidandruff • Antibiotics • NO STEROIDS Downloded from www.pharmacy123.blogfa.com

  21. Yeasts • Pityrosporum. • Candida. • Ordinarily commensals. • Can become pathogens under favourable conditions. Downloded from www.pharmacy123.blogfa.com

  22. Pityriasis Versicolor hypopigmented • Ppted by heat, sweat, steroids • Asymptomatic scaly macules • Chest, back, face Downloded from www.pharmacy123.blogfa.com

  23. P.Versicolor • Hyperpigmented Downloded from www.pharmacy123.blogfa.com

  24. Management • Many Rx • No Rx eradicates yeast permanently • NONSPECIFIC • Keratolytics • whitfield ung, sulphur • Antiseptics • selenium sulphide, Na thiosulphate • CHEAP, smelly, messy, irritant, slower Downloded from www.pharmacy123.blogfa.com

  25. Antifungal Rx Azoles-oral/topical • Ketoconazole 200mg od x7 • Itraconazole 200mg od x 7 • Fluconazole 300mg-400mg stat • FORGET terbinafine tabs for P.V Downloded from www.pharmacy123.blogfa.com

  26. P.V-tougher than you think! High recurrence Hypopigmentation post-rx –UVB helpful Prophylaxis Downloded from www.pharmacy123.blogfa.com

  27. Candidiasis • Candida sp- commensal of GIT • Precipitating Factors • Endocrinopathy • Immunosuppression • Fe/Zn deficiency • Oral antibiotic Rx • Oropharyngeal candidiasis is marker for AIDS Downloded from www.pharmacy123.blogfa.com

  28. Candidiasis • Oropharnygeal • Candidal intertrigo-breasts, groin, web spaces • Chronic Paronychia - nail fold infection • Vaginitis/balanitis Downloded from www.pharmacy123.blogfa.com

  29. Candidal Intertrigo • Moist folds • Erythematous patch with satellite lesions Downloded from www.pharmacy123.blogfa.com

  30. Management • Rx underlying disorder • Reduce moisture- • Wt loss, cotton underwear • Absorbent/antifungal powder eg Zeasorb AF • Rx partner in recurrent genital candidiasis • Rx-Nystatin Azoles Downloded from www.pharmacy123.blogfa.com

  31. Chronic Paronychia • Infection of nail fold • Wet alkaline work Excess manicuring • Damage to cuticle • Swelling of nail fold (bolstering) • Nail dystrophy Downloded from www.pharmacy123.blogfa.com

  32. Chronic Paronychia • Keep hands dry /Wear gloves • Long term Rx • Oral Azoles • Antifungal solution-(high alcohol content) • +/-Broad spectrum antibiotics-cover staph/GNB Downloded from www.pharmacy123.blogfa.com

  33. Bacterial Infections • Impetigo • Folliculitis- furuncles ,carbuncles • Cellulitis • Erythrasma- • Secondarily infected skin disorders Downloded from www.pharmacy123.blogfa.com

  34. Folliculitis Downloded from www.pharmacy123.blogfa.com

  35. Erythrasma • Obese • Diabetic • Erythromycin 250 mg qid x 2 weeks • Azoles less effective Downloded from www.pharmacy123.blogfa.com

More Related