Superficial Fungal Infections

 

Mild infections of the skin, hair and nails caused by fungi (Candida albicans and dermatophytes).

Clinical features and treatment:

Candidiasis:

– E rythème infant diaper erythema anogenital with peripheral desquamation and sometimes pustules. Secondary infections may develop.

• Clean the skin with water and plain soap, dry well and apply gentian violet 2 times / day for 2 to 3 weeks depending on the clinical course. Do not use Whitfield’s ointment.

• Avoid maceration: remove plastic pants and diapers; ass in the air.

• In the event of severe and persistent diaper rash despite local treatment, treat intestinal household (nystatin PO 400 000 IU in 4 divided doses for 20 days).

Other candidiasis: large and small folds (same treatment); mouth; vaginal.

Ringworm:

Dermatophytoses the scalp (tinea): mainly in children.

Depending on the species:

– One or more round erythematous, scaly plaques; short broken hair;

– Inflammation, discharge, and crusts lymphadenopathy satellites (kerion)

– Final scarring alopecia (ringworm).

• Shave the hair, clean with soap and water 2 times / day and apply Whitfield’s ointment 2 times / day for at least 15 days, and if needed, throughout the duration of treatment with griseofulvin.

griseofulvin PO

Child: 10 to 20 mg / kg / day in one or two taken for 6 weeks

Adult: 500 mg to 1 g / maximum daily or in 2 divided doses for 6 weeks

The treatment can last up to 12 weeks in severe infections.

• In case of painful kerion: paracetamol PO.

• If infected ringworm: treat the secondary infection before applying Whitfield’s ointment.

• Some moths are contagious: examine simultaneously treat subjects symptomatic contacts.

Ringworm of the hairless skin (vine herpes): macular erythematous, pruritic, scaly clearer to central and well-defined vesicular border.

• Clean with soap and water 2 times / day, dry well and apply Whitfield’s ointment 2 times / day for 3 weeks if the lesions are not extensive.

• Book griseofulvin PO for extended forms (at least 4 weeks of treatment).

Dermatophytoses folds

– Intertrigo interorteil pruritus, crack and whitish scales in the 3rd and / or 4th interdigital space (different infectionsCandida albicans where the lesions are in the 1st and 2nd interdigital spaces).

– Tinea cruris: lupus closet edged, paler center periphery vesicular-pustular centrifugal extension around the groin;pruritus.

• Clean with soap and water 2 times / day, dry well and apply Whitfield’s ointment 2 times / day for 3 weeks.

• If oozing lesions, apply gentian violet 2 times / day before beginning Whitfield’s ointment.

Note: Candida albicans and dermatophytes are responsible for fungal nail infections requiring treatment PO 12 to 18 months, so difficult in practice.

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