Phar 362 - Dermatophyte Infections

Front 1

What are three genera of Tinea infections?

Back 1

1) Epidermophyton

2) Microsporum

3) Trichopyton

Front 2

How are Tinea classified by location? (7)

Back 2

1) Scalp: Tinea capitis

2) Body: Tinea corporis

3) Nails: Tinea unguium

4) Feet: Tinea pedis

5) Beard & Chin: Tinea barbae

6) Hands: Tinea manuum

7) Groin: Tinea cruris

Front 3

What is the method of confirmation of Tinea Infections?

Back 3

Confirmation can be achieved by Microscopy & Culture

Front 4

"Tinea cultures can take as long as 4 weeks to develop" True or False?

Back 4

TRUE

Front 5

What are the goals of therapy for Tinea Infections? (4)

Back 5

1) Relieve Symptoms

2) Prevent Recurrence

3) Cure Infection

4) Prevent Transmission

Front 6

What are the general risk factors of Tinea Infections? (3)

Back 6

1) Increased Moisture

2) Genetic Predisposition

3) Impaired Immunity: Medical Conditions, Medications

Front 7

What are some of the differntial diagnosis of Tinea Infections? (7)

Back 7

1) Dermatitis

2) Bacterial Infections (e.g. Impetigo)

3) Foot: Soft Corn (pale and white)

4) Yeast Infection

5) Lupus erythematous

6) Lyme disease

7) Pityriasis rosea

Front 8

What are the alternate names for Tinea Pedis?

Back 8

"Athletes Foot" or "Ringworm Foot"

Front 9

What is the prevelance of Tinea Pedis?

Back 9

Affects up to 70% of population

Front 10

What are the common organisms of Tinea Pedis?

Back 10

1) Interdigital: T.Mentagrophytes

2) Moccasin: T.Rubrum

3) Vesicular: T.Mentagrophytes

Front 11

What is the method of transmission of Tinea Pedis?

Back 11

Via Direct or Indirect Contact (walking along pool deck, showering in public showers)

Front 12

What are the risk factors of Tinea Pedis? (8)

Back 12

1) Poor foot hygiene

2) Tight fitting and/or non breathable footwear 3) Hot, humid weather

4) Hyperhidrosis (excessive sweat)

5) Elderly, teenagers and males

6) Diabetics (due to impaired circulation)

7) Immunocompromised patients

8) Patients with peripheral vascular disease

Front 13

What are the symptoms of Interdigital Tinea Pedis? (5)

Back 13

1) Intense itching and bad smell

2) Can be unilateral or bilateral

3) Moist, pale white -> Scaly, white macerated

4) Fissures: watch for 2nd bacterial infection

5) Starts with 4th and 5th toe webs

Front 14

What are the symptoms of Moccasin Tinea Pedis? (4)

Back 14

1) Fine scales

2) Diffuse Erythema

3) Generally bilateral and affects toe nails

4) Occurs along soles of feet, but can involve palms of hands become thickened [2:1 rule]

Front 15

What are the symptoms of Vesicular Tinea Pedis? (6)

Back 15

1) Patches of Erythema

2) Scaling

3) Painful Vesicles

4) Bad odour

5) Sudden onset of symptoms

6) Usually at instep but may affect toe webs, soles and dorsa of feet

Front 16

"Pustules usually indicate ______"

Back 16

Bacterial Infection

Front 17

What are the alternate names for Tinea Corporis?

Back 17

"Ringworm Body"

Front 18

What is the prevelance of Tinea Corporis?

Back 18

Affects 10-20% of population, Men> Women

Front 19

What is the method of transmission of Tinea Corporis?

Back 19

1) Person-Person (athletes, caregivers)

2) Contaminated Surfaces

3) Animals (humans, dogs, horses)

Front 20

What are the risk factors of Tinea Corporis? (3)

Back 20

1) Increased moisture

2) Genetic Predisposition

3) Immunocompromised

Front 21

What are the symptoms of Initial Tinea Corporis? (4)

Back 21

1) Plaque on neck, limb or trunk

2) Round or Oval shape

3) Expands outward centriugally

4) Itching and Redness

Front 22

What are the symptoms of Eventual Tinea Corporis? (5)

Back 22

1) Annular Lesion (Ring)

2) Lesion Circumference (1-10cm)

3) Raised, scaly, erythmous border (mm wide)

4) Centre is usually clear

5) Several lesions may be close together (like a flower)

6) Itching and Burning

Front 23

What are the alternate names for Tinea Cruris?

Back 23

"Ringworm Groin" or "Jock Itch"

Front 24

What is the prevelance of Tinea Cruris?

Back 24

Affects 10-20% of population, Men> Women

Front 25

What are the common organisms of Tinea Cruris?

Back 25

1) T.Tubrum (most common)

2) Epidermophyton 3) T.Mentagrophytes

Front 26

What is the method of transmission of Tinea Cruris?

Back 26

Usually post physical activity and sweating

Front 27

What are the risk factors of Tinea Cruris? (6)

Back 27

1) Increased moisture

2) Genetic predisposition

3) Immunocompromised

4) Males

5) Patients with another tinea infections

6) Athletes (unwashed gear)

Front 28

What are the symptoms of Tinea Cruris? (5)

Back 28

1) Large well defined, red brown round plaques 2) Bumpy, scaly margins

3) Usually bilateral, symmetrical

4) May extend to involve inner thighs, buttocks, anal clefts and stomach

5) Does not affect the penis, scrotum, vulva and anus

Front 29

What are the non drug measures for Tinea Pedis? (7)

Back 29

1) Keep your feet clean & dry

2) Wear sandals and flip flops in public areas

3) Wear cotton socks and avoid thin nylon materials

4) Wear breathable shoes and keep different types

5) Avoid sharing shoes and socks

6) Bathe feet daily and dry throughly, talcum powder or anti-fungal products

Front 30

What are the non drug measures for Tinea Corporis? (3)

Back 30

1) Keep skin dry (blow dry area[NOT HOT]

2) Wash clothing, bedding and towels frequently 3) Inspects pets as a source of infection

Front 31

What are the non drug measures for Tinea Cruris? (2)

Back 31

1) Keep area clean and dry

2) Since it is frequently related to transition from dermatophytes from feet then suggest patient bathe and dry feet and put on socks before undergarments

Front 32

When would you refer Tinea Pedis? (3)

Back 32

1) Extensive Lesions (e.g. Moccasin)

2) It involves toenails

3) Bacterial infection component (severely inflame, oozing, purulent)

Front 33

When would you refer Tinea Corporis? (6)

Back 33

1) Large lesions (>10cm circumference)

2) Multiple lesions over a widespread area

3) No improvement after 1 week of treatment

4) Immunocompromised status

5) Systemic illness, bacterial infection

6) Unsure of diagnosis

Front 34

When would you refer Tinea Crurus? (7)

Back 34

1) Large lesions (>10cm circumference)

2) Multiple lesions over a widespread area

3) No improvement after 1 week of treatment

4) Immunocompromised status

5) Systemic illness, bacterial infection

6) Unsure of diagnosis

7) If genitella are affected

Front 35

What is the efficacy of the various drug classes for Tinea infections?

Back 35

Allylamines>Azoles>Undecylenic Acid>Tolnaftate

Front 36

"All drugs within a class are considered equi-efficacious for Tinea Infections" True or False?

Back 36

TRUE

Front 37

What are the product names for Azoles?

Back 37

Clotrimazole 1%: Canesten Cream

Micronazole Nitrate 2%: Micatin Cream/Aerosol

Front 38

What is the recommended dose of Topical Azoles for Tinea Infections?

Back 38

BID x 4 weeks

Front 39

What are the side effects of Topical Azoles ?

Back 39

1) Skin Irritation (burning, redness, stinging)

Front 40

What are the product names for Undecylenic Acid for Tinea Infections?

Back 40

Fungicure 10% liquid

Fungicure Professional 12.5% liquid

Flexitol 25% liquid

Front 41

What is the recommended dose of Topical Undecylenic Acid for Tinea Infections?

Back 41

BID x 4 weeks

Front 42

What are the side effects of Topical Undecylenic Acid?

Back 42

1) Local Irritation (stinging, itching, redness) [avoid contact with mucous membranes]

Front 43

Which drugs are considered for Tinea Infections and safe for pregnancy and lactation?

Back 43

Azoles: Clotrimazole , Micronazole

[No studies done on Undecylenic Acid or Thiocarbamate so not recommended]

Front 44

What is the duration of therapy for Tinea Products?

Back 44

Suggested to continue treatment for 10-14 days beyond disappearance of symptoms

{limit to max of 6 weeks}

Front 45

Why aren't topical corticosteroids recommended for Itching with Tinea Infections?

Back 45

Since it can mask symptoms giving illusions they are better

Front 46

What are the general application tips for Tinea Products? (4)

Back 46

1) Wash and Dry the affected area pre-applications

2) Apply the product In a thin layer

3) May take several days to see initial improvement

4) Use product for a further 10-14 days after disappearance of symptoms

Front 47

What is the recommendation if there is no improvement after 2 weeks of product use or not resolved by 6 weeks?

Back 47

Refer to MD

Front 48

What is the recommendation if there are signs of bacterial infection with the tinea infection?

Back 48

Refer to MD

Front 49

"Creams, Gels are preferred over liquids for most areas" True or False?

Back 49

True (because liquids are messy)

Front 50

Which dosage form are easier to apply on hairy areas?

Back 50

Liquids

Front 51

What are Dermatophytid Reactions?

Back 51

Secondary eruptions of tinea infections usually on fingers on hands (but can occur anywhere on the body)

Front 52

What are the symptoms of Dermatophytid Reactions?

Back 52

1) Sterile Vesicles 2) Due to hypersensitivity to fungus 3) Improves as original infection site is treated

Front 53

"Antihelminth products are used to treat ringworm" True or False?

Back 53

FALSE

Front 54

"Ringworms are highly contagious" True or False?

Back 54

TRUE

Front 55

"Polysporin cream is an effective treatment for "Jock Infection" "True or False?

Back 55

FALSE

Front 56

"Dermatophytes usually live in the dermis" True or False?

Back 56

TRUE

Front 57

"A human can catch ringworms from a puppy or a kitten" True or False?

Back 57

TRUE