Health Awareness blog

Tinea Pedis is a type of fungal infection. It is also known as athlete’s foot and commonly found in elderly persons. It usually associated with xerosis.

Diagnosis:

• Microscopy (20% potassium hydroxide added to skin scrapings to dissolve keratin; hyphae can be observed in the preparation)
• Samples for culture - skin scrapings taken from skin lesions. (Final result of culture may take 6 weeks)
• Skin biopsy

Manifestations:

• It manifests as maceration in the interdigital web folds.
• Scaly plaques presented on the plantar surface of the feet.

Treatment:

• Topical antifungal agent – imidazoles, triazoles, allylamines
• Haloprogin, undecylenic acid, ciclopiroxolamine and tolnaftate
• It can be aided with keratolytic agent such as lactic acid 12% cream.
• Oral Griseofulvin 500mg per day – if systemic therapy required.

Reference:

1. Medical Progress Journal, February 2008.
2. Harrison’s Manual of medicine. 16^th edition.2005.

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Impetigo is a type of bacterial skin infection that is characterized by vesiculopustular eruption. It mostly found in children.

Causes:

• Mainly a Gram positive bacterium – Staphylococcus aureus

Manifestations:

• honey coloured crusted erosions on erythematous (redness) base
• lesion often well defined
• sometimes, superficial flaccid blisters present
• The crust will turn brown when the lesion resolve
• Pigmentation and scaling will be the evidence of recent impetigo
• This lesion often starts around the nose and face

Diagnosis:

• Mainly done clinically
• Sample of fluid or pus can be sent for culture and sensitivity to look for organism
• Nasal culture from the family members – to determine whether nasal carriage of Staphylococcus aureus is the source of infection (up to 20%-25% of  persons carry staph aureus in their nares

Management:

• Topical fusidic acid works effectively
• Systemic antibiotics (i.e.: flucloxacillin 125mg four times daily to be taken orally – in a child)
• Intranasal mupirocin ( to treat nasal carriage)
• Combination of oral antibiotics, often includes rifampicin (for nasal carriage)

Reference:

1. Medical Progress Journal, February 2008.
2. Oxford Handbook of Clinical Specialties. 5^th edition. 2001.