Snapshot A veterinarian presents to his primary care physician for a growing pustule on his right forearm. He reports that he often embarks on hikes through fields and forests, bringing back injured animals to treat. He denies any known animal bites or scratches but recalls being pricked by a thorn while hiking. He denies any fevers, chills, nausea, vomiting, conjunctivitis, or sore throat. On physical exam, there is a 0.5 cm pustule with surrounding erythema and multiple scattered nodules along his right forearm. He is prescribed an oral agent for this disease. (Sporotrichosis) Introduction Introduction login to view 10 more bullets Tinea (Dermatophytes) Introduction login to view 9 more bullets Presentation login to view 1 more bullet Tinea (Dermatophytes) Tinea capitis Tinea corporis ("ringworm") Tinea cruris ("jock itch") Tinea pedis ("athlete's foot") Tinea unguium (onychomycosis) Location Head Scalp Torso Inguinal Feet Nails Clinical characteristics Lymphadenopathy Itchy and scaly plaques with associated alopecia Erythematous annular lesions with central clearing and scaly border Well-demarcated erythematous scaly rash, often symmetric without central clearing Interdigital feet infection Plantar erythema (moccasin distribution) Vesicles, bullae, or pustules Nail thickening Nail discoloration No pain or itching Risk factors African American or Carribbean descent Contact with infected pet Adolescent and adult males Physical activities that cause sweating Occlusive footwear Warm and moist environment Occlusive footwear Warm and moist environment Immunosuppression Communal bathing Treatment Oral antifungals (topicals will not penetrate hair follicles) Topical antifungals Topical antifungals Topical antifungals Topical antifungals Oral antifungals (> 3-4 nails involved or involvement of lunula) Studies login to view 2 more bullets Treatment login to view 13 more bullets Complications login to view 1 more bullet Tinea versicolor Introduction login to view 11 more bullets Presentation login to view 5 more bullets Studies login to view 5 more bullets Treatment login to view 6 more bullets Sporotrichosis Introduction login to view 14 more bullets Presentation login to view 3 more bullets Studies login to view 4 more bullets Differential diagnosis login to view 3 more bullets Treatment login to view 6 more bullets