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 Submammary, inguinal, axillary

folds Occasionally between digits

Candidiasis: Intertrigo

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

Candidiasis: Oral

Candidiasis: Nappy

Babies Nappy area

Candidiasis: Chronic paronychia

Wet workers Chronic nail bed inflammation

Candidiasis: Systemic

Immunosupressed pts esp. HIV,malignancy Red skin nodules

Candidiasis: Systemic

Tinea infections…

Obtain scrapings/clippings before starting treatment

Tinea Corporis: Ringworm

Trunk/limbs Plaques with scaling and erythema

– esp. at edges Lesions enlarge slowly and clear

centrally

Tinea Corporis: Ringworm

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

Tinea Cruris

Tinea Pedis: Athletes Foot Feet Young > Old Men > Women Itchy maceration between toes esp.

4th/5th RFs:

Swimming Occlusive footwear Hot weather Communal showers

Tineqa Pedis

Tinea Capitis

Hair and scalp Defined inflammed scaly areas May have alopecia with broken

hair shafts

Tinea Capitis

Tinea Unguium

Nails Old > Young Toenails > Fingernails Distal to proximal spread Thickening, yellowing and

crumbling of nail plate Assoc with tinea pedis

Tinea Unguium

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

Management: Systemic

Recurrent, systemic, extensive or resistant infection

Genital candida: 200mg fluconazole stat

Oral/mucocutaneous/systemic candida:

Eg. Oral fluconazole (1-2/52)

Management: Systemic

Dermatophyte – Oral terbinafine or itraconazole daily

Skin: 2-4/52 Nails: 3/12

Thank You!