Excellence in Dermatology™
Excellence in Dermatologic Surgery™
Excellence in Medical Dermatology™
Excellence in Dermatopathology™

Adult Fungal Infections


A 68 year-old Vietnam veteran comes to your clinic for evaluation of high blood pressure and high cholesterol. He asks you in passing about some dryness and mild itching on both his feet for several years that has not improved with 1% hydrocortisone cream and moisturizers. What is the next step in diagnosis?


A 26-year-old male presents with two years of white spots on his neck, upper chest, and back, that are more noticeable in the spring and summer months and get better in winter (see photo). You perform a KOH exam in the office is shown. What treatment would you recommend?


Mrs. H. is a 30-year-old female who presents with several months of worsening pruritic dry scaly skin between the toes and over the lateral aspects of the foot (see photos). More recently she developed blisters on the plantar aspect of the foot beneath the toes. She does not report any new shoes or lotions to the feet. Which diagnosis is MOST likely?


The following is seen under the microscope. What are the findings?


This 54-year-old man presents with several years of erythema and greasy scale on his central face, including the glabella, eyebrows, and nasolabial folds (see photo). The most appropriate next step is:

6.*A 28 year-old mother of two developed a minimally pruritic rash on her wrist over the past 2 months. She used clotrimazole cream daily for 2 weeks without resolution. She was prescribed topical triamcinolone which decreased the redness and itching but did not resolve the rash after using it for 3 weeks. KOH exam was floridly positive. What is the next appropriate treatment?
7.*A 52 year-old healthy male complains of ten years of thickening of the great toenails with a crusty debris, and he’s worried it’s spreading to other toes. Which of the following do you recommend first?
8.*For a patient with seborrheic dermatitis of the scalp, what advice would you give with regard to using anti-dandruff shampoos?
9.*A 48 year-old woman complains of redness under both her breasts for seven months. It is mildly itchy and did not get better after her husband suggested she use his athlete’s foot cream on it. What do you tell her?
10.*What clinical finding in intertrigo suggests it may be caused by Candida yeast?

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