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Episode 69 Melanoma

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Time for Two by Alex Grohl

Courtesy of Pixabay under Creative Commons non-commercial use.

Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

Answers for Episode 68.1 Fungal Skin Infections

Question 1

A 34‑year‑old man presents with a 6‑month history of pruritic, annular plaques on the groin and inner thighs. He has been treated multiple times with over‑the‑counter antifungal–corticosteroid combination creams with minimal improvement. Physical examination reveals erythematous plaques with indistinct borders and no central clearing. Which of the following best explains the patient’s current presentation?

C. Steroid‑modified dermatophyte infection (tinea incognito)

A multicenter molecular study cited in the article examined 351 cases of dermatophytosis in India. Which of the following findings was most strongly associated with the recent epidemic‑like increase in treatment‑resistant cutaneous fungal infections?

C. Emergence of Trichophyton indotineae with squalene epoxidase gene mutations

Question 3

A 68‑year‑old woman with diabetes presents with thickened, yellow‑brown toenails involving the great toe and second toe. She has no concurrent rash on the feet or hands. Initial KOH testing is positive for fungal hyphae. Which diagnostic approach is most appropriate to confirm the suspected etiology and guide management?

C. Repeated fungal cultures to evaluate for non‑dermatophyte mold infection

Sergi, Maria Chiara, Francesca Ambrogio, Mario Della Mura, Joana Sorino, and Gerardo Cazzato.
“Basal Cell Carcinoma: An Old Friend with Multiple Faces.” Cancers 17, no. 6 (2025): 993.
https://doi.org/10.3390/cancers17060993.

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