hey everyone this lesson is on an
overview of fungal skin infections or
otherwise known as tinea infections so
and this is where I talk about a variety
of different
tinnie infections we're gonna go over
their clinical presentation how we
diagnose them and finally how we treat
them so teeny infections are infections
with fungi known as dermatophytes and
they come up from the genus trichophyton
or epidermal fighten and here are the
images of those trichophyton and
epidermal feyten now the pathophysiology
of Taney infections involves the fungi
metabolizing the protein keratin in our
skin nails and hair this is how they
actually present and why they actually
look the way they do because fungi
metabolize keratin it leads to lesion
scarring brittleness of the nails and
dryness that type of clinical picture
now the tinnie infections are actually
named depending on body location if
there is at any infection on the trunk
it's known as tinea corporis it's a
infection on the feet it's tinea pedis
if it's an infection on the head it's
tinea capitis because an infection of
the groin is 10a icarus and if it's an
infection of the nail with 10 young
doing so we're gonna talk about each of
these in more detail in the next couple
slides so the first one we're talking
about is tinea pedis otherwise known as
athletes for this is probably a very
common one that many people know about
and probably have had it is the most
common dermatophyte infection and it
presents in a few different clinical
presentations at first one of the most
common presentation is an interdigital
tinea pedis this is the most common type
it's eerily - its scaly so we can see in
this image here again it's very scaly
looking and this can be quite a chief or
patients then another presentation is a
hyperkeratosis
you're a feminist but mostly involves
the soles of the feet and the other one
is a vesicular bolus eruption and again
this can be periodic so itchy but also
very painful and it happens on the
medial foot so interdigital so between
the toes hi prokaryotic is no one really
on the soles of the feet and then a
vesicular bolus eruption occurs on the
medial
so again if we take a look at this image
here we can see be noticeable scaling in
this interdigital presentation now the
next one we're going to talk about is
tinea corporis tinea corporis is also
known as ringworm again this one affects
the trunk so when we say trunk it really
basically means anywhere on the body
except the hands the feet the growing or
the face and this one is also periodic
and as you can see in the image is a
circular oval in shape and it too is
also scaling patch or plaque so it's a
patch or plaque patch is a flat surface
or flat lesion that's greater than one
centimeter of plaque is a raised lesion
greater than one centimeter and it
spreads soon terrifically so it really
means that it spreads from the inside
outwards so it can continually get
larger and larger from its central
location so again we take a look at the
image here it's a demarcated very well
demarcated circle or oval and when we
take a look at the lesion itself its
scaling patch or plaque the next
presentation we're going to talk about
is tinea capitis tinea capitis is a
fungal infection of the head and an easy
way to remember this is capitis caps so
you can think of the cap of the top of
your head or you can put it you put a
cap of baseball cap on your head so this
is how you can remember tinea capitis is
an infection of the head and this leads
to leads to hair loss and it it too is
also pure etic and scaling and this one
is actually more related to a direct
contact transmission so if one person's
got tinea capitis you can actually have
a transmission from that person to
another individual that can have another
tinea capitis so again you see this
patchy hair loss with this
characteristic scaling appearance the
next presentation we talked about is
tinea curious to the icarus is an a'
fungal infection of the green
area and this is commonly known as jock
itch and this affects men more than
women and what happens generally in this
presentation is that it begins on the
medial thigh so the inner sides of the
thighs and it's also spread centrically
so it spreads from this its center
outwards it's also ear thinnest and
elevated so it becomes well demarcated
because of this and it has associated
factors involved one is excessive
sweating so a lot of times this is why
it's a jock itch
sometimes in men or someone that's very
active they get very they can become
very sweaty in that area and it can lead
to this jock itch another associated
factors diabetes and obesity and also
immunodeficiency so all these can relate
to getting jock itch or recurrent jock
itch or recurrent tinea curious and the
last presentation to talk about is ten
young yulman this one is basically a
fungal infection of the nail I have an
entire lecture on this topic if you want
more information it's also called
onychomycosis it is basically a
crumbling brittle nail just because the
fungi is actually digesting away the
nail itself and it leads to a yellowish
opaque nail and you also if you're to
take a look underneath the nail you get
some unusual hyper carrot onic debris so
now we've seen a variety of clinical
presentation of tiny infections how to
make the diagnosis the diagnosis
involves doing a Koh preparation of skin
scrapings and what you would see is you
would visualize egg mented - so you'd
see an image like this and you would see
these segmented high feellike so and a
lot of times we don't do this we may
just do a clinical diagnosis of the
abbot a knee infection so once we made
the diagnosis how do we treat it
treatment typically involves topical
antifungals or medications with asel at
the end of their name the Azoff suffix
and you can think
of medications like fluconazole and
another one might be butane afine so
majority of majority of cases and a
majority of tiny infections are treated
with topical antifungals but there are
two special cases I want you to think
about and I'll tell you a way to
remember them in a moment so the two
special cases are tinea capitis and
tinea capitis so the top of your head
we're gonna typically use terbinafine or
griseofulvin and the second one is 10
youngnam's or the fungal infection of
the nail and we're gonna generally
either use an oral antifungal or
depakote if a con is all for a very long
period of time about 48 weeks so a lot
of times we've been moving away from
oral antifungal just because of some
liver toxicity issues so we're more
going toward effect con Azul which is
also a topical treatment but it's a more
special topical treatment for tinium so
these are the two special cases and I
told you and tell you a way to remember
them that the top of your head and your
fingers so they're basically the
extremes right so the top of your heads
the the highest up you're gonna the it's
basically the extreme of your height and
all the way down to the bottom of your
feet at the tip of your toes is the
other special case and those are the two
types of fungal infections that you're
gonna have to use something else other
than just the typical topical antifungal
and if you also want to learn more about
other dermatology conditions please
check out my dermatology playlist thanks
for watching I hope to see you next time