Page 29 - LECTURE NOTES
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Differential Diagnosis (DDx) Lichen simplex chronicus, numular eczema, atopic
eczema, psoriasis, lichen planus.
Investigation
KOH from active edge of lesion.
Culture for fungus only in doubtful cases if the KOH is negative.
Treatment
Small and single lesion can be treated with topical agents. Clotrimazole 1%,
ketoconazole 2%, meconazole 1%. BID for two weeks
Systemic: ketoconazole 2-4mg per kg of weight for 10 days. Itraconazole and
fluconazole are choices if available. Griseofulvin is also effective for the treatment of
Tinea corporis.
3.7.4. Tinea pedis
Tinea pedis is fungal infection of the feet and is usually related to sweating and
warmth, and use of occlusive footwear. Men between 20 and 40 years of age are
most frequently affected.
th
rd
The infection often presents as white, macerated areas in the 3 or 4 toe webs. It
may also present with a classic pattern on the dorsal surface of the foot or as chronic
dry, scaly hyperkeratosis of the soles and heels. Itching is also common with vesicular
or hullous lesion.
It is transmitted by direct contact or sharing of shoes, towels or bath.
Treatment
Topical anti fungal creams or ointments applied regularly for 4 - 6 wks.
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