Thread by @shakiratgold

Back to dermatology
#dermatologylectures
Today we'll be talking about superficial fungal infections of the skin.
I chose this because it's quite common and it's one of the infections triple action creams are mostly used on by 'Dr. Nigerians'😕

So called superficial fungal infections because the group of organisms that causes them usually cannot invade more than the superficial uppermost layer of the skin(stratum corneum). The infection is named according to different the area affected

Tinea capitis- Scalp
Tinea unguium- Nails
Tinea corporis - the trunk and other parts of the body excluding the feet and hands.
Tinea manuum- Hands
Tinea pedis- Feet
Tinea cruris- Groin (aka Jock itch)
Tinea interdigitalis- Inbetween the toes

So the infection can run for years if left untreated. It is also called ringworm especially on the scalp and skin bcos it appears like a ring. For doctors when you want to send a sample for the test called skin scraping for KOH microscopy and culture, it is best to take the edge

The advancing outer edge is the active edge which keeps expanding over months or years. It is typically described as central clearing because the body attempts to clear the infection from the centre. Fungi are ubiquitous so it is possible to treat and have recurrence.

Unlike pityriasis versicolor which we talked about, this is more contagious. If a child has T. Capitis, its better you keep away from school till you commence treatment. Avoid sharing combs if this infection is present.

Treatment is usually with topical ANTIFUNGAL creams in form of shampoo, creams, ointment, lotion or powder depending on the affected area. NOT triple action creams. What happens when you use triple action creams is that you alter it and diagnosis becomes very difficult.

It then becomes a condition called Tinea incognito (hidden tinea) because you have thoroughly confused the skin and it's now more difficult to treat.
Of all of the infections, Tinea unguium and interdigitalis may be difficult to treat

For T.unguium, it's because drugs do not penetrate the nails easily. For interdigitalis, its because of the heat from shoes. As with all conditions, outcome is better if treatment is commenced early. For T cruris, wearing tight fitted underwear can predispose or make it worse

Let that place breathe😁
Cotton underwear at all times.
For females...stop taking away your normal flora all in the name of wanting the place to smell like strawberries 🙄
The vagina is self cleansing. Use a soap that has compatible ph with the skin (NOT medicated soaps pls)

And lastly for my colleagues
1) Please send a sample for skin scraping for KOH microscopy and culture before commencing treatment for confirmation
2) Of all the SFI,it is a MUST to use oral antifungals in addition to topical for tinea capitis and unguium (you can check duration

As always. This is meant to educate, enlighten and sensitize. Not to replace seeing your doctor. I am trying to give back in this way. Any doctor should be able to treat these common conditions I'm talking about.
Ask me any questions on the thread, I'll respond. Not in DMs

For my colleagues. Please give me two differentials each for tinea corporis and tinea capitis. 😁

Tinea capitis

Another way Tinea capitis can appear

Tinea interdigitalis

Tinea pedis

Tinea unguium

Tinea cruris aka Jock itch

Tinea corporis

And these infections typically do not produce any symptoms. But let's not forget that Nigeria is a tropical area, so it might be itchy because of the heat in some people.
All pictures from Google images.
Any questions?😊

Tinea manuum