Candidal Intertrigo Treatment

 Candida Intertrigo (Candidiasis of Large Skinfolds)

Description

  • Pink to red maceration, occurring where two skin folds come together. 
  • Warm moist environment leads to disruption of the skin barrier, predisposing to yeast infection.
    Candida-Intertrigo

History

  • Predisposing factors include obesity, immunodeficiency (e.g. diabetes, prednisone), hot humid weather, poor hygiene, tight-fitting clothing, and use of topical steroids.

Skin Findings

  • Red moist, glistening plaques with satellite pustules and papules with a fringe of white scale. 
  • Painful fissures frequently occur deep within the skin folds.

Laboratory

  • Potassium hydroxide wet mount preparation from a pustule or scaly border shows spores and pseudohyphae.
  • Skin biopsy and a surface culture may be necessary in treatment-resistant cases.

Course and Prognosis

  • Candida intertrigo usually recurs if the underlying conditions are not corrected.

Differential Diagnosis

  • Inverse psoriasis
  • Seborrheic dermatitis
  • Erythrasma
  • Streptococcal infection
  • Irritant contact dermatitis

Treatment

  • Apply wet dressings (tap water or Burow’s solution [aluminum acetate 1 : 40 solution]) with a soft cotton cloth for 20 minutes several times per day to soothe and dry the area.
  • Application of an antiyeast cream (e.g. nystatin) or an antifungal (e.g. econazole) cream should be applied twice daily in a thin layer.  
  • Oral antifungal agents (e.g. fluconazole 100–200 mg per day for 1 week) treat resistant or severe cases.
  • Sealing in the skin with a light moisturizer (e.g. Vanicream Lite or Lubriderm) may prevent recurrences by decreasing friction and acting as a protective barrier.
  • Powders may be helpful to wick away moisture but may clump if there is excessive moisture.
  • Patients should be encouraged to lose weight and avoid tight-fitting clothing.

Pearls

  • Nystatin is not effective for dermatophyte infections, and griseofulvin and terbinafine are not effective for yeast infections.
  • Consider streptococcal infection if the rash is painful and malodorous.
  • Topical corticosteroid use may predispose to yeast and dermatophyte infection.
  • Patients who do not respond to antiyeast medications may have inverse psoriasis.

Comments

Post a Comment

Popular posts from this blog

whiteheads and blackheads removal

Image
Treatment of Blackheads and Whiteheads Blackheads & whiteheads begin forming on our face and body when the pores of our skin get blocked by dead skin cells / the excess oil produced by the skin or the debris and bacteria found on the skin surface. Basically the pores get blocked and closed up. Among these blocked pores, those that have exposed or open tops become black or dark due to being exposed to the dirt and dust of the environment. T hese are thus called blackheads or "open comedones" and those blocked pores whose openings are closed off appear as whitish looking small bumps . T hese are called Whiteheads or "Closed Comedones"
Read more

Rhus Dermatitis

Image
Rhus Dermatitis (Poison Ivy, Poison Oak, Poison Sumac) Description : ■ Poison ivy, poison oak, and poison sumac (plants of the Anacardiaceae family) and Toxicodendron species are the most common causes of allergic contact dermatitis in the United States; this problematic prototype of contact dermatitis is rarely reported in Europe, although related plants grow in Southeast Asia, Central America, and South America. ■ Oleoresin (lipid-soluble portion) contains a mixture of highly allergenic catechol chemicals called urushiols, a term derived from the Japanese word for sap, urushi.
Read more