Tinea Infections: Exam, Diagnosis, and Management (Pediatric Nursing)

00:00 So tinea, how do we examine the patient? We want to collect a full health history and then observe their vital signs. Next, we'll do a physical exam and this involves a general inspection, a cardiac exam, a respiratory exam, and a full exam of the skin. Now, make sure you use all the tools that you have including lights and magnification if needed. Tinea is usually diagnosed based on the clinical exam and the history. The lesions are unique. If you're not quite sure, you can do a skin scraping for KOH microscopy and you can also collect a fungal culture, but remember this takes a few days to get the results. Here's how you do a KOH prep. First, you'll use a scalpel or another glass slide to do a skin scraping and get the scale. You're going to scrape this on to your glass slide. Then you're going to make a small pile into the center of the slide and put a drop of KOH at the center. Next, you'll apply your cover slip and there are 2 options after this. You can either apply heat and that's going to speed up the process or you can wait about 3-5 minutes to allow this to take effect before you look under the microscope.

01:06 Now regarding tinea, the recurrence is likely and the treatment depends on the site of infection, the age of the patient, their overall health, and their medical history. Tinea capitis, remember on the scalp. This requires oral antifungals and this is a long duration, about 4-8 weeks. So remember to monitor your patient's liver functions. You can also do adjunctive therapy with topical antifungal shampoos but this is not a primary treatment. Next is tinea corporis on the body, tinea cruris which is Jock itch, or tinea pedis which is athlete's foot.

01:40 And you can treat these with topical antifungals or oral antifungals if the topicals fail. Lastly, tinea unguium which is the nail infection and this requires oral antifungal therapy for a long duration, 6+ weeks. While complications are not common, fungal infections can spread to another site. They rarely spread below the surface of the skin. They can cause alopecia or baldness. Remember when your patient has tinea capitis and secondary bacterial infections can result such as impetigo, cellulitis, and osteomyelitis and this is due to the breakdown in the skin from the fungus. The patient can also have scarring from excessive scratching.