Dermatophyte infections are common worldwide, and dermatophytes are the prevailing causes of fungal infection of the skin, hair, and nails. These infections lead to a. Clinical recommendation Evidence rating References; Potassium hydroxide testing can be a helpful diagnostic tool to distinguish pityriasis rosea from tinea or other. Tinea capitis is a superficial fungal infection of the scalp skin and hair that may also affect the eyebrows and eyelashes. It is caused by dermatophyte fungi. Find patient medical information for TEA TREE OIL on WebMD including its uses, effectiveness, side effects and safety, interactions, user ratings and products that.
Diflucan is indicated in the following fungal infections (see section 5.1). Diflucan is indicated in adults for the treatment of: • Cryptococcal meningitis (see.
Management of Tinea Pedis - IFD. What is tinea pedis? A fungal infection of the feet, most frequently affecting the spaces between toes (interdigital spaces). It is transmitted by human to human contact in warm humid environments, for example through shared towels and on wet floors in swimming pools, changing rooms and gymnasia. Which population is at risk? Adults almost exclusively, with men being more often affected than women.
What is tinea capitis? Causative organisms: Dermatophyte fungal infection mainly of two genera Microsporum and Trichophyton. The infection is commonly known as scalp.
It is particularly prevalent in hot, tropical, urban environments. Most likely to be seen in those who wear shoes. Heavy industrial or military footwear is particularly associated with this infection. It is common in industry where workers share common shower and changing areas. What are the clinical symptoms? Interdigital. Most common form of tinea pedis.
Scaling, fissured skin in the interdigital spaces, usually the 4th and 5th space. There may be some inflammation. Itch is commonly present. Vesicular patterns.
Usually due to T. Causes vesicles between the toes, on the sides and tops of the feet. These may become larger and form blisters. When the lesions burst they leave scales. It is usually extremely itchy. Dry scaly, hyperkeratotic patterns.
Cover the soles of the feet and extend up around the sides to produce a well demarcated line (moccasin pattern). Small circles of scaling are common.
Usually due to T. Associated nail disease is very common. How is diagnosis confirmed? Diagnosis is confirmed by skin scraping which is then viewed under a microscope in potassium hydroxide, followed by culture.
Generally a clinical diagnosis is sufficient to warrant starting treatment, providing it is recognised that there are other causes of interdigital infection. What might it be confused with? Interdigital fungal infection: Gram negative bacterial infection ( presence of maceration, erosion of the skin, green discolouration and pain rather than itch are all pointers ); interdigital maceration (often present in lymphoedema); soft corns; interdigital erythrasma or Candida infection.
Scytalidium infection - this fungus is common in the tropics, mimics tinea pedis of interdigital and dry scaly types and seldom responds to antifungals. Vesicular pattern: plantar pustular psoriasis or eczema. Hyperkeratotic pattern: psoriasis; eczema, Scytalidium infection ( see above ). What preventive measures should be taken? Preventive approaches are ideal. Patients should be advised. To wash their feet carefully, at least daily, and dry meticulously between the toes.
Avoid having sweaty feet by wearing open toed shoes (sandals or flip flops). Which treatments are most effective?
A number of topical antifungals will be effective if used correctly for the right amount of time. These include azoles (e. All three broad categories of drug are efficacious. Whilst allylamines are slightly more efficacious at resolving infections than azoles they are more expensive. Whitfield’s ointment, comprising benzoic acid and salicylic acid in a white soft paraffin base, is a cheap alternative to the branded antifungal preparations. Treatment is longer ( up to 1 month ).
It is particularly helpful on dry tinea pedis. If nails are involved or there is extensive plantar scaling oral therapy with terbinafine or itraconazole is preferred. Griseofulvin can be used but is less effective. How should the treatments be used? Exact instructions for use will vary depending on the specific product. In general the following guidelines should be followed.
Creams/ointments should always be applied to clean, well dried skin. Enough should be used to cover the area comfortably. The cream/ointment should be rubbed in gently but completely (no white appearance left on the skin). Creams/ointments should be applied for up to two weeks after the symptoms have cleared to reduce the likelihood of a relapse.
What are the common concurrent problems? Interdigital bacterial infection caused by Gram neagtive bacteria. Treatment of one can result in recurrence of the other.
Erythrasma due to Cornyebacterim minutissimum . Early lesions present as asymptomatic areas of interdigital scaling or maceration. Treatment with topical azole antifungals or oral erythromycin is required ; Whitfield’s ointment may also help to resolve these infections. Risk factors are the same as for tinea pedis . It can be differentially diagnosed using a Woods light which will cause bright pink fluorescence.
Interdigital cracks of whatever cause create entry lesions for other bacterial infections which can lead to cellulitis/erysipelas and “acute febrile attacks” particularly in people with lymphoedema. What are the uncommon concurrent problems? Multiple itchy vesicles sometimes develop most commonly on sides of fingers, palms and soles, worse closer to the primary infection. This is known as an ‘id’ reaction probably an immunological reaction to the dermatophyte. Treatment should be continued. What are the commonly held misconceptions about the disease?
That all interdigital lesions on the feet are always fungal.
Diflucan 1. 50 Capsules - - (e. MC)This information is intended for use by health professionals. Diflucan 1. 50 mg hard Capsules. Each hard capsule contains fluconazole 1. Excipient(s) of known effects: each hard capsule also contains 1. For the full list of excipients, see section 6. Hard capsule. The 1.
Pfizer” and the code “FLU- 1. The capsule size is no. Diflucan is indicated in the following fungal infections (see section 5. Diflucan is indicated in adults for the treatment of. Cryptococcal meningitis (see section 4. Coccidioidomycosis (see section 4.
Invasive candidiasis. Mucosal candidiasis including oropharyngeal, oesophageal candidiasis, candiduria and chronic mucocutaneous candidiasis. Chronic oral atrophic candidiasis (denture sore mouth) if dental hygiene or topical treatment are insufficient. Vaginal candidiasis, acute or recurrent; when local therapy is not appropriate. Candidal balanitis when local therapy is not appropriate.
Dermatomycosis including tinea pedis, tinea corporis, tinea cruris, tinea versicolor and dermal candida infections when systemic therapy is indicated. Tinea unguinium (onychomycosis) when other agents are not considered appropriate. Diflucan is indicated in adults for the prophylaxis of. Relapse of cryptococcal meningitis in patients with high risk of recurrence. Impetigo In Adults Causes on this page. Relapse of oropharyngeal or oesophageal candidiasis in patients infected with HIV who are at high risk of experiencing relapse.
To reduce the incidence of recurrent vaginal candidiasis (4 or more episodes a year). Prophylaxis of candidal infections in patients with prolonged neutropenia (such as patients with haematological malignancies receiving chemotherapy or patients receiving Hematopoietic Stem Cell Transplantation (see section 5. Diflucan is indicated in term newborn infants, infants, toddlers, children, and adolescents aged from 0 to 1. Diflucan is used for the treatment of mucosal candidiasis (oropharyngeal, oesophageal), invasive candidiasis, cryptococcal meningitis and the prophylaxis of candidal infections in immunocompromised patients. Diflucan can be used as maintenance therapy to prevent relapse of cryptococcal meningitis in children with high risk of reoccurrence (see section 4.
Therapy may be instituted before the results of the cultures and other laboratory studies are known; however, once these results become available, anti- infective therapy should be adjusted accordingly. Consideration should be given to official guidance on the appropriate use of antifungals. Posology. The dose should be based on the nature and severity of the fungal infection. Treatment of infections requiring multiple dosing should be continued until clinical parameters or laboratory tests indicate that active fungal infection has subsided.
An inadequate period of treatment may lead to recurrence of active infection. Adults. Indications. Posology. Duration of treatment. Cryptococcosis- Treatment of cryptococcal meningitis. Loading dose: 4. 00 mg on Day 1. Subsequent dose: 2.
Usually at least 6 to 8 weeks. In life threatening infections the daily dose can be increased to 8. Maintenance therapy to prevent relapse of cryptococcal meningitis in patients with high risk of recurrence. Indefinitely at a daily dose of 2. Coccidioidomycosis 2. Invasive candidiasis Loading dose: 8. Day 1. Subsequent dose: 4.
In general, the recommended duration of therapy for candidemia is for 2 weeks after first negative blood culture result and resolution of signs and symptoms attributable to candidemia. Treatment of mucosal candidiasis- Oropharyngeal candidiasis. Loading dose: 2. 00 mg to 4. Day 1. Subsequent dose: 1. Longer periods may be used in patients with severely compromised immune function- Oesophageal candidiasis. Loading dose: 2. 00 mg to 4. Day 1. Subsequent dose: 1.
Longer periods may be used in patients with severely compromised immune function- Candiduria. Longer periods may be used in patients with severely compromised immune function.- Chronic atrophic candidiasis. Chronic mucocutaneous candidiasis.
Up to 2. 8 days. Longer periods depending on both the severity of infection or underlying immune compromisation and infection. Prevention of relapse of mucosal candidiasis in patients infected with HIV who are at high risk of experiencing relapse- Oropharyngeal candidiasis. An indefinite period for patients with chronic immune suppression - Oesophageal candidiasis. An indefinite period for patients with chronic immune suppression. Genital candidiasis- Acute vaginal candidiasis- Candidal balanitis.
Single dose- Treatment and prophylaxis of recurrent vaginal candidiasis (4 or more episodes a year). Maintenance dose: 6 months.
Dermatomycosis- tinea pedis,- tinea corporis,- tinea cruris,- candida infections. Treatment should be continued until infected nail is replaced (uninfected nail grows in).
Regrowth of fingernails and toenails normally requires 3 to 6 months and 6 to 1. However, growth rates may vary widely in individuals, and by age.
Nevus - Wikipedia. Nevus is a nonspecific medical term for a visible, circumscribed, chroniclesion of the skin or mucosa. The term originates from nævus, which is Latin for "birthmark," however, a nevus can be either congenital (present at birth) or acquired. Common terms, including mole, birthmark, and beauty mark, are used to describe nevi, but these terms do not distinguish specific types of nevi from one another.
ClassificationThe term nevus is applied to a number of conditions caused by neoplasias and hyperplasias of melanocytes, as well as a number of pigmentation disorders, both hypermelanotic (containing increased melanin, the pigment responsible for skin color) and hypomelanotic (containing decreased melanin).Increased melaninAcquiredCongenitalCongenital melanocytic nevus. These nevi are often categorized based on size, however, the lesions usually grow in proportion to the body over time, so the category may change over an individual's life. This categorization is important because large congenital melanocytic nevi are associated with an increased risk of melanoma, a serious type of skin cancer.Small: < 1. Medium: 1. 5 - 1. Large: ≥ 2. 0 cmNevus of Ito. Nevus of Ota. Conjunctival nevus of a 3.
Acquired melanocytic nevi. Atypical nevus. Becker's nevus.
Blue nevus. Spitz nevus. Congenital melanocytic nevus. Nevus of Ota. Decreased melaninAcquiredCongenitalNevus anemicus.
Nevus depigmentosus. Additional types of nevi do not involve disorders of pigmentation or melanocytes. These additional nevi represent hamartomatous proliferations of the epithelium, connective tissue, and vascular malformations.Epidermal neviThese nevi represent excess growth of specific cells types found in the skin, including those that make up oil and sweat glands.These nevi represent abnormalities of collagen in the dermis, the deep layer of the skin.Vascular neviThese nevi represent excess growth of blood vessels, including capillaries.[1. Nevus sebaceous. Nevus flammeus nuchae. DiagnosisNevi are typically diagnosed clinically with the naked eye or using dermatoscopy.
More advanced imaging tests are available for distinguishing melanocytic nevi from melanoma, including computerized dermoscopy and image analysis.[1. The management of nevi depends on the type of nevus and the degree of diagnostic uncertainty. Some nevi are known to be benign, and may simply be monitored over time. Others may warrant more thorough examination and biopsy for histopathological examination (looking at a sample of skin under a microscope to detect unique cellular features). For example, a clinician may want to determine whether a pigmented nevus is a type of melanocytic nevus, dysplastic nevus, or melanoma as some of these skin lesions pose a risk for malignancy.
The ABCDE criteria (asymmetry, border irregularity, color variegation, diameter > 6 mm, and evolution) are often used to distinguish nevi from melanomas in adults, while modified criteria (amelanosis, bleeding or bumps, uniform color, small diameter or de novo, and evolution) can be used when evaluating suspicious lesions in children.[1. In addition to histopathological examination, some lesions may also warrant additional tests to aid in diagnosis, including special stains, immunohistochemistry, and electron microscopy.[1. Typically; the nevi which exist since childhood are harmless. A modern polarized dermatoscope. A dermatoscope. Differential diagnosesHypermelanotic nevi must be differentiated from other types of pigmented skin lesions, including: Cafe au lait. Mongolian spot. ManagementThe management of a nevus depends on the specific diagnosis, however, the options for treatment generally include the following modalities: ObservationDestructionSurgeryThe decision to observe or treat a nevus may depend on a number of factors, including cosmetic concerns, irritative symptoms (e. SyndromesThe term nevus is included in the names of multiple dermatologic syndromes: EtymologyA nevus may also be spelled naevus.
The plural is nevi or naevi. The word is from nævus, Latin for "birthmark". References^Happle, Rudolf (1. What is a nevus? A proposed definition of a common medical term". Dermatology. 1. 91 (1): 1–5.
PMID 8. 58. 94. 75. ^ abcdefgh"Chapter 1. Benign Neoplasias and Hyperplasias of Melanocytes". Fitzpatrick's Dermatology in General Medicine. The Mc. Graw- Hill Companies, Inc. ISBN 9. 78- 0- 0. Chapter 7. 5. Hypomelanoses and Hypermelanoses".
Fitzpatrick's Dermatology in General Medicine. The Mc. Graw Hill Companies, Inc. ISBN 9. 78- 0- 0.
Dysplastic (Atypical) Nevi". Melanocytic Lesions - Springer. Dermal melanocytosis". Melanocytic Lesions - Springer.
Lentigo, Other Melanosis, and the Acquired Nevus". Melanocytic Lesions - Springer. Chapter 1. 18. Benign Epithelial Tumors, Hamartomas, and Hyperplasias.". Fitzpatrick's Dermatology in General Medicine. The Mc. Graw- Hill Companies, Inc.
Dermatophyte (tinea) infections. Literature review current through. This topic last updated. May 0. 5, 2. 01. 7. INTRODUCTION — Dermatophyte infections are common worldwide, and dermatophytes are the prevailing causes of fungal infection of the skin, hair, and nails [1- 3].
These infections lead to a variety of clinical manifestations, such as tinea pedis, tinea corporis, tinea cruris, Majocchi's granuloma, tinea capitis, and tinea unguium (dermatophyte onychomycosis). The clinical features, diagnosis, and treatment of dermatophyte infections of the skin will be reviewed here. Dermatophyte infections of scalp hair (tinea capitis), beard hair (tinea barbae), and nails (tinea unguium) are discussed in detail separately. See "Tinea capitis" and "Infectious folliculitis", section on 'Fungal folliculitis' and "Onychomycosis: Epidemiology, clinical features, and diagnosis".)GENERAL PRINCIPLES — Dermatophytes are filamentous fungi in the genera Trichophyton, Microsporum,and Epidermophyton. Dermatophytes metabolize and subsist upon keratin in the skin, hair, and nails.
The major clinical subtypes of dermatophyte infections are: ●Tinea corporis – Infection of body surfaces other than the feet, groin, face, scalp hair, or beard hair●Tinea pedis – Infection of the foot●Tinea cruris – Infection of the groin●Tinea capitis – Infection of scalp hair●Tinea unguium (dermatophyte onychomycosis) – Infection of the nail. Additional terms used to describe less common presentations are tinea faciei (infection of the face), tinea manuum (infection of the hand), and tinea barbae (infection of beard hair).
See 'Other clinical variants' below.)Tinea corporis, tinea pedis, tinea cruris, tinea faciei, and tinea manuum infections are typically superficial, involving only the epidermis. Occasionally, dermatophyte infections penetrate the hair follicle and dermis causing a condition called Majocchi's granuloma. Tinea capitis and tinea barbae are characterized by infection of terminal hairs. A diagnosis of a cutaneous dermatophyte infection may be strongly suspected based upon the clinical findings. However, testing to confirm the diagnosis is recommended because a variety of cutaneous disorders may present with similar features. A potassium hydroxide (KOH) preparation is a rapid method to confirm the diagnosis.
Dermatophyte test medium or a fungal culture may also be used to confirm the diagnosis. See "Office- based dermatologic diagnostic procedures", section on 'Potassium hydroxide preparation'.)If a cutaneous dermatophyte infection is misdiagnosed and initially treated with a topical corticosteroid, the appearance of the infection may be altered, making diagnosis more difficult (ie, tinea incognito). Patients can develop diminished erythema and scale, loss of a well- defined border, exacerbation of disease, or a deep- seated folliculitis (Majocchi's granuloma). See 'Majocchi's granuloma' below.)The simultaneous presence of more than one type of dermatophyte infection is common (eg, tinea pedis and tinea cruris or tinea pedis and tinea unguium). Performance of a full skin examination including the skin, hair, and nails aids in the detection of additional sites of infection. Occasionally, patients develop a dermatophytid reaction, a secondary dermatitic reaction at a distant site that may reflect an immunologic reaction to the infection.
See 'Dermatophytid (id) reactions' below.)Topical or systemic antifungal drugs with antidermatophyte activity are effective therapies. Most superficial cutaneous dermatophyte infections can be managed with topical therapy with agents such as azoles, allylamines, butenafine, ciclopirox, and tolnaftate (table 1). Nystatin, an effective treatment for Candida infections, is not effective for dermatophytes. Oral treatment with agents such as terbinafine, itraconazole, fluconazole, and griseofulvin is used for extensive or refractory cutaneous infections and infections extending into follicles or the dermis (eg, Majocchi's granuloma) or involving nails.
Patients should not be treated with oral ketoconazole because of risk for severe liver injury, adrenal insufficiency, and drug interactions. Although they can be effective and may accelerate resolution of the clinical manifestations of superficial dermatophyte infections , use of combination antifungal and corticosteroid products that include medium- or high- potency corticosteroids (eg, clotrimazole. Treatment failures have also been reported [5- 7]. Immunosuppression may increase risk for dermatophyte infection and may contribute to the development of extensive or persistent disease. The possibility of an underlying immune disorder should be considered in patients with particularly severe or treatment- refractory disease. TINEA PEDIS — Tinea pedis (also known as athlete's foot) is the most common dermatophyte infection.
Tinea pedis may manifest as an interdigital, hyperkeratotic, or vesiculobullous eruption, and rarely as an ulcerative skin disorder.