1. Fungal Infections Reena Doshi

2. Two major groups Candida Dermatophyte

3. Candidiasis: Genital Women > Men Itchy, sore vulvovaginitis White plagues on mucous membranes White ‘cheesy’ discharge

4. Candidiasis: Genital

5. Candidiasis: Intertrigo Red, moist, glazed, itchy Submammary, inguinal, axillary folds Occasionally between digits

6. Candidiasis: Intertrigo

7. 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

8. Candidiasis: Oral

9. Candidiasis: Nappy Babies Nappy area

10. Candidiasis: Chronic paronychia Wet workers Chronic nail bed inflammation

11. Candidiasis: Systemic Immunosupressed pts esp. HIV,malignancy Red skin nodules

12. Candidiasis: Systemic

13. Tinea infections… Obtain scrapings/clippings before starting treatment

14. Tinea Corporis: Ringworm Trunk/limbs Plaques with scaling and erythema – esp. at edges Lesions enlarge slowly and clear centrally

15. Tinea Corporis: Ringworm

16. 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

17. Tinea Cruris

18. Tinea Pedis: Athletes Foot Feet Young > Old Men > Women Itchy maceration between toes esp. 4 th /5th RFs: Swimming Occlusive footwear Hot weather Communal showers

19. Tineqa Pedis

20. Tinea Capitis Hair and scalp Defined inflammed scaly areas May have alopecia with broken hair shafts

21. Tinea Capitis

22. Tinea Unguium Nails Old > Young Toenails > Fingernails Distal to proximal spread Thickening, yellowing and crumbling of nail plate Assoc with tinea pedis

23. Tinea Unguium

24. 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

25. Management: Systemic Recurrent, systemic, extensive or resistant infection Genital candida: 200mg fluconazole stat Oral/mucocutaneous/systemic candida: Eg. Oral fluconazole (1-2/52)

26. Management: Systemic Dermatophyte – Oral terbinafine or itraconazole daily Skin: 2-4/52 Nails: 3/12

27. Thank You!