Internal Medicine

0521779407-20 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:22

Tinea Cruris/Corporis/Pedis Torsion of Appendix Testis 1433

■terbinafine, naftifine, butenafine

■2–4 weeks – tinea pedis

■1–2 weeks – tinea corporis/cruris

■Prevent reinfection: disinfect/discard shoes

■Oral therapy may be used in patients with widespread disease or

recurrent disease.

➣Options – griseofulvin, itraconazole, fluconazole, terbinafine

follow-up

■Rash should clear during therapy.

complications and prognosis

■Total clearing expected

■Treat onychomycosis to prevent recurrent disease.

➣Recurrent or severe widespread disease may be indicative of an

underlying immune disorder.

TORSION OF APPENDIX TESTIS

ARTHUR I. SAGALOWSKY, MD

history & physical

■vestigial mullerian remnant at upper pole of testis

■most often in children

■acute pain

■palpable, tender “BB-like” dot

■diffuse scrotal swelling may mask signs

tests

■urinalysis usually normal

■elevated WBC, fever variable

■ultrasound highly effective

differential diagnosis

n/a

management

n/a

specific therapy

■observation if Dx confident; self-limited

■prompt exploration if cannot exclude torsion of spermatic cord