[NP-Clinical] help from derm experts

[DICKEY,DONNA]

Ted, I would like the powerpoint also, if you can send it. Send to dickeyd at sanfordhealth.org    
Thanks, Donna Dickey

________________________________

From: np-clinical-bounces at nurse.net on behalf of Andy Craig
Sent: Fri 5/11/2007 10:15 AM
To: 'NP Clinical'
Subject: RE: [NP-Clinical] help from derm experts


"Me too"!  that sounds like a Powerpoint I'd like to see!
 
And while we're tapping your brain, what do you think about this: I have a couple of patients who have minimal onchomycotic-appearing changes in 1 toenail only. I'm leery about rx oral antifungals for just one nail, especially if they are older or on lots of other meds.  I hear that the topical (Penlac) doesn't work well, though I haven't seen it being used long enough on enough patients to form an opinion of my own yet. So--what do you think about surgical removal of the one affected toenail, with or without a short burst (2-4 weeks?) of oral ketoconazole?  I typically use 200 to 400 mg daily.  It's what we have here at our pharmacy and it's cheap.  Your thoughts?
 
Andy Craig, NP
Charlotte, NC

	-----Original Message-----
	From: np-clinical-bounces at nurse.net [mailto:np-clinical-bounces at nurse.net] On Behalf Of Theodore Scott
	Sent: Friday, May 11, 2007 1:48 AM
	To: 'NP Clinical'
	Subject: RE: [NP-Clinical] help from derm experts
	
	

	Well the easiest way to think of the most common pathogens we see is to classify them into three groups based on shape when you do the KOH prep.

	Hyphae, the long thin branching forms, are usually dermatophytes, typically seen in Tinea pedis, cruris, or corporis. Budding yeast forms are usually Candida and this can be found in thrush, vaginitis, intertrigo etc...  When you have Hyphae and spores "Spaghetti and Meatballs", you are looking at Pityrosporum ovale aka Malassezia furfur which causes Tinea versicolor and probably seborrheic dermatitis.  If you have a large inbox I can sen you a POWERPoint I presented to our NP/PA group on the subject (about 4 MB).  

	 

	Ted Scott NP-C

	 

	<snip>

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