How well do you understand fungal skin infections?
For each of the following scenarios, think about what you have learned on this website and how you would deal with each customer. Discuss your answers with your pharmacist.
Remember: the WWHAM questions should be used as part of your conversation with the customer and you should listen carefully to their answers to avoid unnecessary questions.
Customer 1
An embarrassed woman in her 20s asks you for a deodorant for sensitive skin as she has developed a rash under her armpits. She has also noticed it under her breasts.
QUESTION: How would you deal with this customer?
WHO IS THE TREATMENT FOR?
Since the treatment is for the customer, you need to establish if she is pregnant. If she is, she should be referred to the pharmacist for further advice.
WHAT ARE THE SYMPTOMS?
She describes the rash as very itchy and red. Sweat rash commonly affects the skin folds, such as the armpits and breasts. This can be due to sweating, or tight, synthetic clothing. Bear in mind that this customer may be sensitive to the idea she may have a sweat rash as she thinks she has had a reaction to her deodorant.
Ask if her environment has changed recently - for example, she may now be working in a hot environment or doing more exercise than usual, all of which can upset the natural balance of yeast on the skin.
HOW LONG HAS SHE HAD THE SYMPTOMS?
They began to appear over the last week.
WHAT ACTION HAS SHE ALREADY TAKEN?
She has not tried any treatments as yet.
WHAT OTHER MEDICATION IS SHE TAKING?
She replies none.
QUESTION: Do you think an antifungal treatment alone should be used by this customer?
ACTION: What treatment would you recommend and why? What advice would you offer to prevent the problem recurring again?
Customer 2
A man in his 30s asks for a cream for a rash at the top of his thighs and groin area.
QUESTION: How would you deal with this customer?
WHO IS THE TREATMENT FOR?
Since the man has answered this question you can proceed onto the next question.
WHAT ARE THE SYMPTOMS?
Quietly and discreetly ask the man to describe the symptoms. He tells you he has itchy and red areas around his groin.
Men aged between 18 and 40 years are the most likely sufferers of jock itch. Men who play sport are particularly affected as they tend to use communal changing areas where fungi exist in dead skin cells from other infected sufferers. This fungus can be picked up by feet, causing athlete's foot which is then transferred to the warm, moist groin area when dressing.
HOW LONG HAS HE HAD THE SYMPTOMS?
He has had the symptoms for a couple of weeks.
WHAT ACTION HAS HE ALREADY TAKEN?
He has tried an antiseptic cream but it has not got rid of the rash.
WHAT OTHER MEDICATION IS HE TAKING?
He replies none.
QUESTION: What else should you check? Remember the risk of cross infection from other fungal infections.
ACTION: What would be the best treatment for this customer? Which preventative measures would you recommend?
