Fungal Infections Reena Doshi
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!