What it is
Skin infections cover four separate groups — fungal, bacterial, viral and parasitic — and each is diagnosed and treated differently, so the visit starts by identifying the organism rather than by writing a prescription. That means a skin scraping and microscopy, a nail clipping and culture, or a Wood lamp examination before any long course is started. Treating by guess is the commonest error here, and the specific local version of it is a corticosteroid or an unlabeled mixed cream applied to a fungal rash, which changes its shape, spreads it, and delays the diagnosis by months.
What this page covers
- Skin scraping, KOH microscopy, fungal culture, nail clipping and Wood lamp examination before treatment
- Tinea corporis and tinea cruris
- Tinea pedis, treated together with the groin and nails as one recurring source
- Tinea capitis in children, with household and pet screening
- Steroid-modified tinea (tinea incognito) from unlabeled mixed creams — and the rule that no lightening or laser treatment starts on a fold before a scraping
- Tinea versicolor, with a maintenance plan discussed at the first visit
- Cutaneous candidiasis and intertrigo, with diabetes screening where it recurs
- Onychomycosis, confirmed in the laboratory before any oral course
- Malassezia (pityrosporum) folliculitis
- Bacterial folliculitis, furuncles and abscesses, including incision, drainage and culture
- Impetigo, with household infection-control measures
- Erythrasma, pitted keratolysis and trichomycosis
- Cellulitis and erysipelas, with the entry point treated and the threshold for emergency referral stated
- Viral warts, plantar warts and molluscum contagiosum
- Herpes simplex, including antiviral prophylaxis before laser, peel, needling or perioral filler
- Herpes zoster (shingles), with same-day ophthalmology referral for eye or nasal-tip involvement
- Scabies, with same-day treatment of the entire household and domestic staff
- Head lice, handled without stigma
Honestly
The diagnosis is confirmed by scraping, clipping or culture before a long course is prescribed, and an antifungal already in use has to be stopped before sampling or the result comes back falsely negative. Cryotherapy and cautery for warts leave a pale or dark mark on Fitzpatrick IV–VI, so the gentler option is chosen on the face and hands; spreading hot redness with fever, and shingles near the eye, are same-day urgent care rather than a clinic appointment.