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Cutaneous candidiasis

Definition

Cutaneous candidiasis is infection of the skin with candida fungus.

Alternative Names

Skin infection - fungal; Fungal infection - skin; Skin infection - yeast; Yeast infection - skin; Intertriginous candidiasis

Causes, incidence, and risk factors

The body normally hosts a variety of microorganisms, including bacteria and fungi. Some of these are useful to the body, some produce no harm or benefit, and some can cause harmful infections.

Some fungal infections are caused by fungi that live on the hair, nails, and outer skin layers. They include mold-like fungi (dermatophytes, which cause tinea infections) and yeast-like fungi (such as candida).

In cutaneous candidiasis, the skin is infected with candida fungi. It is fairly common. Infection can involve almost any skin on the body, but most often it occurs in warm, moist, creased areas such as the armpits and groin. The fungus that most often causes cutaneous candidiasis is Candida albicans.

Candida is the most common cause of diaper rash in infants. The fungi take advantage of the warm, moist conditions inside the diaper. Candida infection is particularly common in people with diabetes and in people who are obese. Antibiotics and oral contraceptives (birth control pills) increase the risk of cutaneous candidiasis. Candida can also cause infections of the nails (onychomycosis), at the edge of the nails (paronychia), and at the corners of the mouth (angular cheilitis).

Oral thrush, a form of candida infection of the moist lining (mucous membranes) of the mouth, is usually associated with taking antibiotics. It may also be a sign of HIV infection or other immunodeficiency disorders when it occurs in adults. Individuals with candida infections are not usually contagious, though in some settings immunocompromised people can catch the infection.

Candida is also the most frequent cause of vaginal yeast infections, which are extremely common and often associated with antibiotics use.

Symptoms

• Itching (may be intense)
• Skin lesion or rash
  • Growing red, inflammed area
  • Infection of hair follicles (folliculitis) may look like pimples
  • Located on the skin folds, genitals, trunk, buttocks, under the breasts, or on other skin areas
  • Macule or papule
  • May have satellite lesions (smaller lesions next to bigger ones)
  • Skin redness or inflammation

Signs and tests

A diagnosis of cutaneous candidiasis is based mainly on the appearance of the skin, particularly if there are risk factors. Skin scrapings may reveal yeast forms, which usually indicates candida.

Treatment

General hygiene is vital to the treatment of cutaneous candidiasis. Keeping the skin dry and exposed to air is helpful. Weight loss may eliminate the problem in obese people. Proper blood sugar control may also be helpful to those with diabetes.

Antifungal skin creams or ointments may be used to treat infection of the skin, mouth, or vagina. Antifungal medications taken by mouth may be necessary for folliculitis, nail infection, or severe candida infections involving the mouth, throat, or vagina.

Support Groups

Expectations (prognosis)

Cutaneous candidiasis usually goes away with treatment. Repeat infections are common.

Complications

• Infection of nails may cause nails to become oddly shaped and may cause infection around the nail
• Recurrence (repeat episodes) of candida skin infection
• Widespread (disseminated) candidiasis may occur in immunocompromised individuals

Calling your health care provider

Call for an appointment with your health care provider if you develop symptoms of cutaneous candidiasis.

Prevention

Good general health and hygiene help prevent candida infections. Keep the skin clean and dry. Drying powders may help prevent fungal infections in people who are susceptible to them.

References

Kauffman CA. Candidiasis. In: Goldman L, Ausiello D, eds. . 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 359.

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