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cutaneous candidiasis

Etiology: - Candida albicans & other Candida species - risk factors: - diabetes, immunodeficiency, hyperhidrosis Pathology: - superficial fungal infection occuring on moist cutaneous sites Clinical manifestations: - erythematous, pruritic, inflamed skin - painless papules or pustules on an erythematous base [2] - cheesy, white substance in body folds (see intertrigo), web spaces, occluded skin, scrotum [2] - initial pustules on an ethythematous base become eroded & confluent - subsequently fairly sharply demarcated eroded patches with small yellow, fluid-filled pustular lesions at periphery of confluent erythema (satellite lesions) Laboratory: - microscopic examination of scrapings using Gram stain or 10% KOH preparation to visualize pseudohyphae & yeast forms - spores occur with pseudohypae (discrimination from yeast not described) [2] - fungal culture - bacterial culture to rule out bacterial infection Differential diagnosis: - psoriasis - erythrasma - intertrigo Management: - keep intertrigenous areas dry (often difficult) - washing with 2.5% benzoyl peroxide may diminish Candida colonization - powder with miconazole daily - short-term use of topical glucocorticoid may speed resolution - nystatin or antifungal cream - Mycolog II combines nystatin with triamcinolone - topical clotrimazole, ketoconazole, econazole [2]

Related

mucocutaneous candidiasis (includes vulvovaginal candidiasis)

Specific

vulvovaginal candidiasis

General

candidiasis skin disease (dermatologic disorder, dermatopathy, dermatosis)

References

  1. Color Atlas & Synopsis of Clinical Dermatology, Common & Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY, 1997, pg 718
  2. Medical Knowledge Self Assessment Program (MKSAP) 14, 15, American College of Physicians, Philadelphia 2006, 2009 - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  3. Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society