OTC: Fungal Skin Infections

3 types of fungal skin infections

1. dermatophyte infections

   1. group of molds (majority of infections)

      1. skin, hair, and nail infections

2. non-dermatophyte infections

3. candidate infections → yeast infections

tinea infection

• exclusively dermatophyte infections

  • superficial fungal infections

nomenclature for tinea infections…

• barbae: beard

• capitis: scalp

• corporis: body (ringworm)

• cruris: groin

• manuum: hands

• pedis: feet

• unguium: nails

excluded from self care: barbae, capitis, and unguium

• beard, scalp, and nail infections

factors that contribute to tinea infection development

• trauma to skin

• fungi

• warm/humid climate

• sweating

• wearing wet clothing

• diabetes/obesity

• high-impact sports

• public showers

4 types of tinea pedis

1. chronic interdigital

2. chronic hyperkeratotic

3. vesicular

4. acute ulcerative

chronic interdigital tinea pedis

• between the toes

  • fourth and fifth between most common

• macerated skin, stinging

chronic hyperkeratotic tinea pedis

• usually involves both feet

• mild inflammation

• “diffuse scaling” in moccasin like distribution

vesicular tinea pedis

• near instep/mid plantar surface of foot

  • small vesciles

  • skin scaling

• summer months produce symptomatic

acute ulcerative type tinea pedis

sole or foot presentation

• macerated, weeping ulcerations

• white hyperkeratosis

• painful: hinders patient’s ability to walk

4 clinical presentations of tinea capitis

scalp tinea infection

1. noninflammatory

   1. small papules

   2. spreads centrifugally

   3. dull gray colored lesions

2. inflammatory

   1. fever, pain, pustules

3. black dot

   1. black dots on scalp surface, hair loss, scaling

4. favus

   1. yellow crusts/scales, patchy areas of hair loss

all of which are exclusions to selfcare

fungal skin infections: exclusions to self care

• unsuccessful initial treatment

• nails or scalp involved

• face, mucus membranes, genitalia involved

• diabetes

• systemic infection

• immune deficiency

• fever, malaise

nonpharm for fungal infections

not intended to treat, just complement OTC pharm treatments

• separate towel

• no share personal articles

• cleanse skin daily

• dry shoes/new shoes

pharm treatment for tinea pedis formula

lesion location:

• on bottom/sides of feet: terbinafine

• no: antifungal

lesions with inflammation:

• aluminium acetate solution followed by antifungal tx

small vesciles, scaling, NO inflamation

• antifungal

wet, soggy type athlete’s foot WITHOUT fissures

• aluminium chloride then antifungal

WITH fissures:

• aluminium chloride x 2, antifungal

aluminium acetate

domeboro or Burow’s solution

• for tinea pedis with inflammation

• diluted 10-40 parts of water

• 1 week treatment after inflammation is resolved

aluminum chloride

“no sweat” products

• treatment of wet, soggy type athlete’s foot

• twice daily applications until S/S symptoms disappear → then once daily

• treat with antifungal/nonpharm after aluminum chloride treatment

topical antifungal agents for fungal skin infections

• clotrimazole

• miconazole

• terbinafine hydrochloride

• butenafine hydrochloride

• tolnaftate

• undecyclenic acid

relieve itching, burning, cracking, and scaling