Skin Fugal infections

Let Dermatologist starve  :: U traet    Candiasis infn of skin::: ABC of  CUTANEOUS   CANDIDIASIS

 In the skin  the most common site   is in the skin folds also  called Candida intertrigo . This   is seen under pendulous breasts between   overhanging  abdominal folds  in the groin and  rectal area   and in the axillae.

Skin folds   contains heat  and moisture   providing   the environment suited     for yeast  infection. Hot   humid weather  tight or  abrasive   underclothing  poor  hygiene   and inflammatory diseases   occurring  in the skin folds such as psoriasis  make a yeast  infection more   likely

A)                   INTERTRIGO

  Obese people are at greatest risk. Itching  burning and   stinging  are the most    common symptoms apposing  skin flods  retain  moisture and become warm  macerated and inflamed Candida is the most  common secondary  infection but  bacteria fungi  or viruses may be a factor . Erosions are possible Sweat  feces urine   and vaginal discharge may aggravate  intertrigo . The course  can be recurrent and chronic.

clinical   features

 There are two  presentations In the first type  pustules form but become macerated under apposing  skin surfaces and develop into red papules with a fringe of moist  scale at the border. Intact   pustules may be found outside the apposing  skin  surfaces.

The second type consists of a red   moist  glistening plaque that extends to or just   beyond  the limits of the apposing skin folds. The advancing border  is long and sharply defined  and has an ocean  wave shaped    fringe of macerated scale. The characteristic  pustule of  candiadiasis is not observed in intertriginous areas because it is macerated as soon as it forms .Pinpoint   pustules do appear  out side  the advancing   border and are an important   diagnostic  feature. There is a tendency for painful fissuring in the skin creases.

 TREATMENT

 General Measures

Education about the role  of moisture  and maceration is important . The following  techniques may be   recommended     drying  affected areas after bathing using a hand held  hair dryer  on low  heat  at least once a day  . supportive clothing and  weight reduction air conditioning in warm     environments    and regular application   of a plain  or medicated  powder    to the areas.

For very  inflammatory lesions open compresses three to four  times a day with water  or normal  saline will expedite  relief  of  symptoms. Cool   water  compresses applied for   ½  hour     two  or three times  a day for just a few   days are rapidly effective in  controlling moisture and suppressing inflammation.