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daynuhmay
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why are fungal skin infections often referred to as ringworm?
the lesions are characteristically ring-shaped w/ clear centers & red, scaly borders
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where does the dermatophyte grow during the incubation stage?
stratum corneum
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major immunologic defense against fungal skin infections
type IV delayed-hypersensitivity response
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clinical presentation of tinea unguium
affected nails lose shine, become opaque
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clinical presentation of tinea corporis
- begin as small, circular, erythematous, scaly areas
- lesions spread & borders may contain vesicles
- pruritus
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clinical presentation of tinea cruris
- on medial/upper parts of thighs & pubic area
- small vesicles @ margins
- bilateral w/ pruritus
- NOT on penis & scrotum
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exclusions for self-tx of fungal skin infections (4)
- 1) nails or scalp involved
- 2) face, mucous membranes, genitalia involved
- 3) signs of possible secondary infection
- 4) diabetes, systemic infection, immune deficiency
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MOA's of clotrimazole & miconazole in tx of fungal skin infections (3)
- inhibit biosynthesis of ergosterol
- damage fungal cell wall membrane - altering permeability
- inhibit oxidative & peroxidative enzyme activity
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MOA of terbinafine HCl 1% in tx of fungal skin infections
inhibits squalene epoxidase (key enzyme in sterol biosynthesis), resulting in accumulation of squalene & deficiency in sterols needed for fungal cell membranes
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directions for use of clotrimazole & miconazole
apply topically once in morning & once in evening for up to 4 weeks
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antifungal agent known to typically work the fastest
terbinafine (shown to work w/ 1-4 weeks of tx)
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MOA of butenafine HCl 1% in the tx of fungal skin infections
squalene epoxidase inhibitor prevents synthesis of ergosterol, resulting in deficiency
(same as terbinafine)
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directions for use of butenafine HCl 1% in tx of tinea pedis
apply around affected toes BID x 1 week
OR
QD x 4 weeks
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butenafine HCl effective tx time
1-4 weeks
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MOA of tolnaftate for tx of fungal skin infections
believed to distort hyphae & stunts mycelial growth of fungi species
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only non-prescription drug approved for both preventing & treating tinea infections
tolnaftate
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tolnaftate effective tx time
2-4 weeks (but up to 4-6 weeks)
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use of aluminum salts in the tx of fungal skin infections
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MOA's of aluminum salts in the tx of fungal skin infections
- as astringent:
- - complexes w/ proteins, altering protein's ability to swell & hold water
- - decrease edema, exudation, inflammation by reducing cell membrane permeability & hardening cement substance of capillary epithelium
in concentrations >20%, possess antibacterial activity to prevent secondary infections
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why creams and solutions are the preferred formulation for tx of fungal skin infections
most efficient & effective at delivering active ingredient to the epidermis
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complementary therapy shown to have higher mycologic cure rate than terbinafine 1% cream
ajoene 1% cream
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