Fungal Skin Infections

tinea corporis (self-treat)

• body

• “ringworm”

• transmit among children in daycare and teenagers and athletes in contact sports

tinea cruris (self-treat)

• groin

• “Jock Itch” (often in men)

• transmission through skin in groin area stays warm and moist for long periods

tinea pedis (self-treat)

• feet

• athlete’s foot

• transmission via public pools, bath facilities, sharing w/ infected at home bathroom, high impact sports

tinea capitis (refer on)

• scalp

• occurs in children

• transmission spread by direct contact w/ infected person

• contact w/ infected fomites (combs, toys, hats, towels, linens)

tina unguium (refer on)

• nails

tinea coporis

• small circular, erythematous, scaly areas

• pruritis

tinea cruris

• medial, upper parts of thighs and pubic areas

• acute lesions are bright red

• bilateral

• significant pruritus (more itchy than tina corporis)

• lesions usually spare the penis and scrotum

tinea pedis

• fissuring, scaling, maceration in interdigital spaces

• malodor

• pruritus

• stinging sensation on foot

• can have wet, soggy type

tinea capitis

• lesions surrounding hair shafts

• intense pruritus

• permanent hair loss

tinea unguium

• nails lose shiny luster and become opaque

• untreated

  • become thick, rough, yellow

  • separate from nail bed and be lost

exclusions to self treatment fungal skin infections

• nails or scalp involved

• signs of possible secondary bacterial infection

• excessive and continuous exudation

• condition extensive, seriously inflamed, or debilitating

• diabetes, systemic infection, immune deficiency

nonpharmacological therapy - fungal infections

• keep skin clean and dry

• avoid sharing personal articles

• avoid contact w/ infected fomites or person who have fungal infection

• wear protective footwear (sandals) areas of family or public use

mao clotrimazole and miconazole nitrate

• inhibit biosynthesis of ergosterol

• damages fungal cell wall membrane

  • alters permeability

  • results in loss of essential intracellular elements

uses clotrimazole and miconazole nitrate

• tinea pedis and cruris

• tineas corporis

dosage clotrimazole and miconazole nitrate - pedis + corporis

apply twice daily for 4 weeks

dosage clotrimazole and miconazole nitrate - cruris

apply twice daily for 2 weeks

special populations clotrimazole and miconazole nitrate

pregnant patients ✅

mao terbinafine hydrochloride

• inhibits squalene epoxidase

• deficiency in ergosterol

• accumulation of squalene w/in fungal cell, causing fungal cell death

uses terbinafine hydrochloride

• tinea pedis

• tinea cruris and corporis

dosage terbinafine hydrochloride - pedis

apply twice daily for 1 week (up to 4 weeks)

dosage terbinafine hydrochloride - cruris + corpois

apply once daily or 1 week

special populations terbinafine hydrochloride

pregnant patients ❌

moa butenafine hydrochloride

same as terbinafine hydrochloride

uses butenafine hydrochloride

same as terbinafine hydrochloride

dosage butenafine hydrochloride - pedis

apply twice daily for 1 week OR once daily for 4 weeks

dosage butenafine hydrochloride - cruris or corporis

once daily for 2 weeks

mao tolnadtate

• distorts hyphae

(works on fungal itself)

uses tolnaftate

• tinea cruris

• tinea pedis + corporis

• prevention and treatment

dosage tolnaftate - cruris

apply twice daily for 2 weeks

dosage tolnaftate - pedis + corporis

apply twice daily for 4-6 weeks

dosage tolnaftate - prevention

apply once daily

mao salts of aluminum

astringent

uses salts of aluminum

• do not provide cure

• wet, soggy type of tinea pedis

dosage salts of aluminum - immerse whole foot

• dilute w/ 10-40 parts of water

  • 15-30 minutes

  • up to 3 times daily (every

dosage salts of aluminum - wet dressing

• 15-30 minutes

• repeat as needed for 4 to 8 hours

• APPLY BEFORE ANTIFUNGAL

Refer on when….

clinical improvement is not seen w/in 1 week