Deep Tinea Infections on Darker Skin: Diagnosis and Treatment

00:01 Now let's look at the investigation and diagnosis of patients with deep fungal infections, which sort of tends to follow a similar pathway.

00:13 The history and physical examination is crucial.

00:17 Skin scraping for direct microscopy and fungal culture is essential.

00:22 The biopsy is almost needed in most cases for both histology and culture.

00:30 Differential diagnosis can resemble infections caused by viruses, bacteria, protozoa and other fungi.

00:37 And of course, foreign body granulomas also are listed as differentials as well as soft tissue tumors. The management is we use oral antifungal treatment, and it is the primary therapy for patients with moderate to severe disease.

00:56 Again, this depends on the location, the extent, the comorbidities and the age of the patient.

01:04 Antifungals are usually used for long periods.

01:07 For example itraconazole.

01:09 The range of duration may be from 8 to 36 months.

01:13 Terbinafine is also used.

01:15 And of course, cryotherapy and surgical intervention in some cases.

01:21 When faced with these patients, most of the time they have to be referred to dermatologists for further management.