Superficial Fungal Infections
- DERMATOPHYTES
- YEASTS i. -Candida sp. ii. -Pityrosporum (Malassezia furfur)
Investigation Fungal Infections
- Scraping clipping and Hair sampling
- KOH/microscopy
- Skin biopsy
- Histopathology with PAS stain
- Culture
- Wood’s lamp
KOH exam
- Excellent choice.
- You decide to do a KOH exam in the office.
- Scrape the leading edge for fine scale
- The first step in diagnosing a scaling annular rash on the body is to perform a KOH exam to rule out fungus
- “All that scales must be scraped”
- Rule out dermatophyte infections before moving forward on scaling rashes
Case One, KOH exam
Translucent branching, septate hyphae
Wood’s lamp
Tinea capitis with positive Wood’s lamp
Treatment
-
Topical Antifungal Nystatin preparation (oral thrush) (candiasis) Imidazoles e.g. cotrimazole
-
Systemic Antifungal Itraconazole and fluconazole (Fungal) Allylamine e.g. Terbinafine Griseovulvin. - (Tinea capitis)
Indication of systemic treatment:
- Tinea Capitis
- Paronychia and Onychomycosis
- Failure to respond to topical treatment
- Immunocompromised pts.
- Atypical presentations.