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Section of Dermatology
• ' Tinea' is derived from the Latin word meaning
clothes-moth which the Romans thought wasresponsible for this condition.
• It is caused by a superficial fungus that colonizes
keratin (hair, nails and the stratum corneum)
• There are three genera of dennatophytes infecting
the skin: Microsporum. Epidermophyton andTrichopyton
• Tinea infections often result from damage
• Occlusion increases the local temperature
and hydration of the skin, leading toimpaired barrier function.
• This probably explains why tinea pedis is a
disorder of the shod and not those who go
• The margin is most active with a tendency
• Tinea corporis (body)• Tinea cruris (groin)
• In tinea capitis, there is scaling and
• Tinea pedis (feet)• Tinea unguium (nails)• Tinea incognito (tinea masked by steroids)
• Scrapings should be taken from the skin and
• Whifield's ointment (3% benzoic acid. 3%
• Allylamines e.g terbinafine (Lamisil).
mouth, gemtalia, flexures and nails usually
the oropharynx. gastrointestinal tract or
vagina in 80% of normal individuals.
• Nystatin. This is a polyene antibiotic. It is too
toxic to use parenterally hut is effective topically.
• Extremes of age. menses and pregnancy
• Amphotericin. Tills is another polyene antibiotic.
• latrogenic factors, for example antibiotics,
It is used in a similar manner to nystatin.
• Imidazoles. These are easy to use topically. They
have a broad spectrum, being also effectiveagainst tinea and pityriasis versicolor.
Ketaconazole is effective orallv.
• Fluconazole. This is a broad spectrum triazole that
• Pityriasis versicolor is an infection of the skin
is effective against dermatophytes, most Candida
caused by a yeast that is ordinarily a commensal
species and pityriasis versicolor. It may be given
• Irtraconazole. This is a broad spectrum triazolc that
• It is caused by the yeasts Pitvrosporum orbiculare
is effective against dermatophytes, candida species
and pityriasis versicolor. It is given orally.
• The yeasts become pathogenic and produce
• Amphotericin B Very toxic therefore reserved lor
pseudohyphae - in this state the organism is
• The yeast is an opportunist, and growth in
• The condition starts as a rnacule which
grows insiduously and coalesces with other
increase in environmental
• The macules may be darker or lighter than
• It is a disorder of the healthy, but the
• Topical glucocorticostcroids account for
• P. versicolor occurs usually on the front of
• Imidazoles - these are all effective topically
light; the affected areas fluoresce a yellow
• Oral therapy - Ketaconazole. fluconazolc
• Chromoblastomycosis is a chronic, warty
cutaneous and subcutaneous infection with a
• Chromoblastomycosis is caused by fungi that are
saprophytic in wood or soil and are found in ruralareas.
• The organism enters via a wound (e.g. a splinter)
and is most common in males who work outsidebare-legged.
• Skin biopsy is helpful in diagnosis.
• Scabies is an infestation with Sarcoptes
• Surgical excision is used for early lesions or
• It is transmitted from one individual to
• Itraconazole is effective . often combined
another by prolonged physical, and usually
• Terbinafine is reported as being effective.
• Amphotericin intralesionally and
• The burrow is visible early but itching is delayed a
• The burrow is a serpiginous. linear track, a few
millimetres long with a black dot visible at one
• The itching results from an allergic reaction to the
• Ivermectin. This is the only oral treatment.
• Papules are found between the fingers, elbows,
buttocks, axillae, around the nipples and on thegenitalia.
Patients Who Visited the General Medical Center Emergency Department Age in Yrs Pt Visits Patients Who Visited the General Medical Center Emergency Department Patient Medical Record Number: M001004269 Ptchartnum Ptcomplaint ICD9 Desc Finaldispoid Physician Name Rxnamegrp H00043895309 Ptchartnum Ptcomplaint ICD9 Desc Finaldispoid Physician Name Rxname
Medical Office of Elizabeth L Schultz, DO, FACOG Phone: (706) 769-0720 The below article is from David I. Minkoff, MD "Optimum Health Report", May 3, 2004. Many of these on-line reports, after a time, are no longer accessible, so we have copied this article in its entirety. NEWS does Vitamin D testing routinely. If you need this type of testing done, please call for an appointment @ 706