Page 237 - ATP-P 11th Ed

FUNGAL SKIN INFECTION PROTOCOL

SPECIAL CONSIDERATIONS
1. Insect bite(s), eczema, and contact dermatitis as differential diagnosis – are also
accompanied by itching, but have discrete red papular lesion(s).
2. Cellulitis as a differential diagnosis – is bright red, painful, not pruritic, and typi-
cally becomes steadily worse without antibiotics.
3. Acute contact dermatitis as a differential diagnosis – is diagnosed by intense
itching, skin erythema and a history of environmental exposure. SECTION 2

Signs and Symptoms
1. Skin erythemas
2. Pruritis is variable
3. Slow spreading
4. Borders of the erythematous plaques are generally irregular and/or circumscribed.
5. Often initially diagnosed as contact dermatitis but gets worse with use of steroids (those
without antifungal agent added).
6. Most common sites of infection are feet (“athlete’s foot” or tinea pedis), groin (“jock
itch” or tinea cruris), scalp (tinea capitus), and torso or extremities (“ring worm” or
tinea corporis).
Management
1. Fluconazole (Diflucan ) 150mg PO once per week for 4 weeks (total of 4 doses
®
in the absence of a cure, or 1 dose after clinically clear). If not resolved after 4 weeks,
refer to physician.
2. Clean rigorously with mild soap without injuring the skin.

Disposition
Evacuation is usually not required for this condition.

226 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 227