School of Medicine and Health Sciences Poster Presentations

Document Type

Poster

Keywords

Fungal Infection; Dermatomycosis; Surveys/Questionnaires; Medical Errors/Prevention & Control; Medical Errors/Statistics & Numerical Data; Dermatology Education

Publication Date

Spring 2017

Abstract

Background: Dermatophyte infections involving the skin, hair, or nails affect an estimated 25% of the world's population, and accounted for 51 million outpatient visits over a ten-year period (1995-2004) in the United States alone. Dermatomycosis is routinely managed by dermatologists, though given the diversity of clinical presentations, is sometimes misdiagnosed, which can result in inappropriate therapy, worsening of symptoms, and even result in additional skin and soft tissue infections.

Methods: An interactive survey of board-certified dermatologists was conducted at the 2016 Orlando Dermatology Aesthetic & Clinical Conference, during a seminar on superficial mycotic infections. The structure of the survey entailed reviewing a presentation of a clinical image followed by responding to a simple yes or no question: is this a fungal infection? Data was gathered anonymously via an audience response system and data tabulated using Microsoft excel.

Results: In all, 13 cases were presented. Although the majority of the cases (8/13) were appropriately categorized by 50+% of the audience, this percentage decreased as accuracy of categorization increased. For example, in only 4 of the 13 cases did audience members accurately categorize the cases > 75% accuracy. Moreover, there was only one case for which 90+% of the audience appropriately categorized the case.

Conclusion: The study limitations included a lack of a measureable response rate and a small sample size, which prevent significant conclusions from being made. However, the results do emphasize the protean clinical nature of cutaneous dermatomycoses and the ease with which one may miss the correct diagnosis. Secondary syphilis, annular psoriasis, and pityriasis rosea are among just a few inflammatory skin diseases that can mimic dermatophyte infections as illustrated herein. As such, these data underscore the importance of continued medical education on dermatophyte infections as well as proper education and training on bedside diagnostic techniques such as potassium hydroxide during residency and beyond.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Comments

Poster presented at GW Annual Research Days 2017.

Available for download on Thursday, March 22, 2018

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Fungus Amungus -- A common disease state that is commonly missed: a survey based study

Background: Dermatophyte infections involving the skin, hair, or nails affect an estimated 25% of the world's population, and accounted for 51 million outpatient visits over a ten-year period (1995-2004) in the United States alone. Dermatomycosis is routinely managed by dermatologists, though given the diversity of clinical presentations, is sometimes misdiagnosed, which can result in inappropriate therapy, worsening of symptoms, and even result in additional skin and soft tissue infections.

Methods: An interactive survey of board-certified dermatologists was conducted at the 2016 Orlando Dermatology Aesthetic & Clinical Conference, during a seminar on superficial mycotic infections. The structure of the survey entailed reviewing a presentation of a clinical image followed by responding to a simple yes or no question: is this a fungal infection? Data was gathered anonymously via an audience response system and data tabulated using Microsoft excel.

Results: In all, 13 cases were presented. Although the majority of the cases (8/13) were appropriately categorized by 50+% of the audience, this percentage decreased as accuracy of categorization increased. For example, in only 4 of the 13 cases did audience members accurately categorize the cases > 75% accuracy. Moreover, there was only one case for which 90+% of the audience appropriately categorized the case.

Conclusion: The study limitations included a lack of a measureable response rate and a small sample size, which prevent significant conclusions from being made. However, the results do emphasize the protean clinical nature of cutaneous dermatomycoses and the ease with which one may miss the correct diagnosis. Secondary syphilis, annular psoriasis, and pityriasis rosea are among just a few inflammatory skin diseases that can mimic dermatophyte infections as illustrated herein. As such, these data underscore the importance of continued medical education on dermatophyte infections as well as proper education and training on bedside diagnostic techniques such as potassium hydroxide during residency and beyond.