Diaper Dermatitis (Candidiasis) in an Infant or a Baby: Condition, Treatments, and Pictures for Parents – Overview

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Images of Candidiasis, Diaper Dermatitis

Overview

Candida albicans is a type of fungus normally found in the digestive (gastrointestinal) tract. If your baby is wearing a moist or blocked up (occluded) diaper, particularly one that is dirty (has fecal contamination), an inflammatory skin rash (dermatitis) may develop on the baby’s skin. Diarrhea increases the risk for developing candidal diaper dermatitis, and candida infection in the mouth (oral thrush) may also occur.

Who’s at risk?

Diaper dermatitis is one of the most common skin conditions in infants and children. Candidal diaper dermatitis is the second most common type of diaper dermatitis, with noninfected areas of redness and tenderness (irritant diaper dermatitis) being the most common type.

Signs and Symptoms

• Candidal diaper dermatitis most commonly appears in the genitals and diaper area, particularly the deep folds, and it consists of red elevated areas (papules) and flat, solid areas of skin (plaques) with sharp edges and skin flakes (scale) as well as surrounding “satellite” skin elevations containing pus (pustules).
• Redness (erythema) may appear to be joined into one area (confluent).
• Breakdown (erosions) or loss of the upper layer of skin may be present.
• Alternatively, the lesions may be merging together (coalescing) small pink bumps with overlying scale, without any redness.

Self-Care Guidelines

• Keep the diaper open as much as possible while the infant sleeps to allow drying of the skin.
• Use barrier ointments such as zinc oxide paste or petrolatum (Vaseline®) with diaper changes.
• Gently cleanse the diaper area with plain water or mild soap.
• Be sure to change your baby’s diapers, using disposable diapers.

When to Seek Medical Care

See your baby’s doctor or a dermatologist for evaluation if your baby’s diaper dermatitis does not improve with self-care measures.

Treatments Your Physician May Prescribe

Topical therapies, applied twice a day:

• Nystatin cream
• Econazole cream
• Miconazole cream
• Clotrimazole cream

The doctor may also reassure you that once your baby is toilet trained, the diaper dermatitis will no longer develop.

Trusted Links

MedlinePlus: Common Infant and Newborn Problems
Clinical Information and Differential Diagnosis of Candidiasis, Diaper Dermatitis

References

Bolognia, Jean L., ed. Dermatology, pp.1186. New York: Mosby, 2003.

Freedberg, Irwin M. , ed. Fitzpatrick’s Dermatology in General Medicine. 6^th ed. pp.1373-1374, 2010-2011. New York: McGraw-Hill, 2003.

Diaper Dermatitis – StatPearls – NCBI Bookshelf

Continuing Education Activity

Diaper dermatitis is an inflammatory reaction of the skin of the perineal and perianal areas (diaper area). It is the most common skin disorder seen in young infants. It can be caused by chemical irritation, infection, or atopy. This activity reviews the evaluation, management, and treatment of diaper dermatitis. The role of the interprofessional team will be reviewed.

Objectives:

• Identify the etiology of diaper dermatitis.

• Describe the pathophysiology of diaper dermatitis.

• Summarize the key physical examination findings of diaper dermatitis.

• Outline the management options available for diaper dermatitis.

Access free multiple choice questions on this topic.

Introduction

Diaper dermatitis is an inflammatory reaction of the skin of the perineal and perianal areas (diaper area). It is the most common skin disorder seen in young infants. It is most commonly caused by irritation of the skin; however, there are other causes such as atopic dermatitis and seborrheic dermatitis that can present as a diaper rash. Another common reason is infection with Candida albicans, which can be primary or secondary. Diaper dermatitis is usually a mild and self-limited condition that requires minimal intervention. Some of the management approaches include skincare, adequate hygiene, and avoidance of any irritant substance.[1]

Etiology

Diaper dermatitis is an inflammatory reaction of the skin around the diaper area. It results due to a combination of multiple factors such as increased moisture, prolonged contact with urine or feces, and other irritants like detergents.[2]

 The second most common cause of diaper dermatitis is infection. Fungal infection, especially by Candida albicans, is the most common infectious cause. Candida infection can be a primary cause of diaper dermatitis and can also result as a superimposed infection to chronic irritation. Other mycoses that can be associated with diaper dermatitis include dermatophytosis, exacerbation of seborrheic dermatitis by Malassezia, and other pseudomycotic conditions like erythrasma.[3]

 Bacterial infections follow fungal as the second most common cause of infectious diaper dermatitis. Staphylococcus aureus infection can occur in newborns, secondary to colonization from the umbilical cord. Streptococcus pyogenes is also seen as an etiologic agent causing the condition.[4]

Epidemiology

Diaper dermatitis can affect any individual using diapers without any gender preference. Newborns and infants are at an increased risk due to skin immaturity. Peak incidence is around 9 to 12 months of age. Diaper dermatitis occurs in about 50% of infants, and it accounts for about 25% of visits to primary care physicians related to dermatologic complaints in the first year of life.[5]

There are risk factors associated with the development of diaper dermatitis, such as:

• Age: newborn and infant skin are more immature and show increased susceptibility.

• Diet: changes in diet as the infant grows are related to changes in intestinal microbiota and stool pH. Breastfeeding has been proven to be a protective factor.

• Frequency of diaper changes: prolonged contact with irritants such as urine and feces increases the risk of skin inflammation. Newborns and young infants whose diapers are changed more frequently tend to be less affected than older infants.[6]

Pathophysiology

The most important predisposing factor for diaper dermatitis is the increased moist that results from wearing diapers, which leads to increased friction and maceration, which makes the skin more susceptible to damage and penetration by skin microorganisms and other irritants.[7][6]

Changes in skin pH also play an essential role; an increase in pH around the diaper area from the breakdown of urinary urea can, in turn, increase fecal enzyme activity that can further damage the skin.[8][9] The combination of these processes results in colonization and infection from organisms such as Staphylococcus aureus, Streptococcus pyogenes, and Candida albicans.

History and Physical

The presentation may begin with a history of increased frequency of stools or changes in its appearance (loose), followed by the development of erythema around the diaper area about two days after. Physicians must elicit from parents hygiene practices, frequency of diaper changes, type of diapers used, and use of any substance that may be worsening the irritation.

Clinical presentation can be variable. Skin findings include erythema, papules, scaling, and erosions that can be present around the thighs, scrotum, suprapubic area, and buttocks. It usually spares skin creases.[6]

Candida dermatitis presents with erythema and scaly plaques, accompanied by edema. The most characteristic feature is the presence of satellite pustules or papules. Candidal dermatitis can be present in the skin folds.  In severe cases, erosions and ulceration can occur.[3]

Clinical manifestation of S. aureus infection can range from small papules and pustules to large, fragile blisters of bullous impetigo. S. pyogenes presents with fiery-red erythema and maceration that involves the skin folds.[4]

Evaluation

Diaper dermatitis is a clinical diagnosis based on history and physical examination findings. Overall, there is no need to perform any laboratory testing. However, when considering infection by Candida albicans, confirmation of the diagnosis by examination with KOH can be useful, although not necessary. If there is suspicion of bacterial infection, Gram staining can be performed.[3]

Treatment / Management

Management of diaper dermatitis has two main goals: healing of damaged skin and prevention of rash recurrence.

The strategies to achieve these goals include:

• Good hygiene is essential to maintain skin integrity and prevent further breakdown. Reducing the exposure to irritants, like urine and feces, can be achieved with frequent diaper changes and using superabsorbent diapers that help reduce skin over-hydration.

• Bathing and cleaning the diaper area with water and a soap-free cleanser.

• The use of wet wipes has been controversial over the years, mainly due to the concern that the components could cause further irritation to the skin. However, recent studies have shown that baby wipes do not cause any harm to the skin. Furthermore, the newer formulations of wipes that include pH buffers help to balance the alkaline pH of the urine and prevent skin damage due to pH changes. It is important to advise parents that the wipes should be free of soap, essential oils, or other fragrances and harsh detergents that can be irritant to the skin.[10]
• The use of topical emollients is recommended for both prevention and treatment. They can improve the skin barrier function, and they also provide a barrier between the skin and the diaper, urine, and feces, not limiting the contact with the skin and diminishing irritation, but also preventing over-hydration to the skin. For the management of current diaper dermatitis, apply with each diaper change. Examples of emollients available include zinc oxide, petrolatum, cod liver oil, lanolin, among others. [10]
• For cases of diaper dermatitis that do not improve within 2 to 3 days of implementing the measures above, or in moderate to severe cases, a short course of low-potency corticosteroids can be used. Hydrocortisone 0.5% 2 times a day for one week.[3]

• When treating candida diaper dermatitis, topical antifungals should be added to the regimen. Nystatin can be used first, applied with every diaper change, with a generally good response; however, if by 1 to 3 days, there is no improvement of symptoms (also keeping in mind Candida resistance to nystatin), switching to azoles is recommended. Clotrimazole, miconazole, or ketoconazole can be used, applied twice a day for 7 to 10 days. 

• In cases of bacterial infection, topical antibiotics may be necessary. And in cases of severe infections, such as perianal streptococcal dermatitis, oral antibiotics are indicated.[10]

Differential Diagnosis

The differential diagnosis of diaper dermatitis includes any skin condition that can present around the diaper area.

• Seborrheic dermatitis usually presents in the first month of life. Characterized by skin erythema and scaling, that begins in the scalp and distributes to the face. It has the potential to spread to the diaper area, making babies more susceptible to the development of irritant diaper dermatitis.[6]
• Atopic dermatitis usually presents between 3 and 12 months of age. The presentation includes extreme pruritus with dryness and erythema. Lesions typically involve skin flexures. The diaper area is generally spared.[6]
• Allergic contact dermatitis, secondary to reactions to fragrances or preservatives. It usually occurs after the introduction of a new skin product, and it involves any part of the skin where the product was applied.[5]

 Other differential diagnoses that need to be taken into consideration include tinea cruris, scabies, acrodermatitis enteropathica, biotin deficiency, Langerhans cell histiocytosis (Letterer-Siwe disease), congenital syphilis, Kawasaki disease, and HIV infection. [11][12] 

Prognosis

Diaper dermatitis has an excellent prognosis with appropriate diagnosis and with timely adequate management. It is usually a mild, self-limiting disease.

Complications

Complications of irritant diaper dermatitis include superimposed infection either with fungal or bacterial microorganisms. Special consideration must be taken when these infections occur in immunocompromised patients since they are at risk of invasive disease.[13]

Consultations

Diaper dermatitis is a condition that can be safely managed by a general practitioner. However, a consult to dermatology may be warranted in cases of an extensive disease that does not respond to treatment. If there is suspicion of a superimposed bacterial infection or extensive/invasive disease, consultation with infectious disease specialists may be required. 

Deterrence and Patient Education

Education on proper diaper skincare must be provided as part of the anticipatory guidance of each well-care visit. including frequency of diaper change, guidance on the types of diapers and wipes to use, and application of the barrier emollients with diaper changes.[10] 

Pearls and Other Issues

• Diaper dermatitis is one of the most common skin disorders in infants. 

• The most common cause is irritant contact dermatitis due to occlusive diapers and prolonged exposure to urine and feces.

• Candida infection is the second most common cause, but superimposed infection by bacterial microorganisms can also develop.

• Management is based on good hygiene and diaper area skincare. 

• Other causes of diaper rash, such as seborrheic dermatitis and psoriasis, may also be present.

Enhancing Healthcare Team Outcomes

Diaper dermatitis is one of the most common dermatologic conditions in the newborn period and early infancy. It is of great importance that all healthcare professionals at any level be familiar with the characteristics of the disease and how to manage it, and to be able to provide appropriate guidance to the parents and caregivers.  

Management of diaper dermatitis does not necessitate the involvement of an interprofessional team to achieve appropriate treatment; however, as some cases can be more challenging, it is important to obtain timely consults whenever the need arises. 

References

1.

Ravanfar P, Wallace JS, Pace NC. Diaper dermatitis: a review and update. Curr Opin Pediatr. 2012 Aug;24(4):472-9. [PubMed: 22790100]

2.

Prasad HR, Srivastava P, Verma KK. Diaper dermatitis–an overview. Indian J Pediatr. 2003 Aug;70(8):635-7. [PubMed: 14510084]

3.

Bonifaz A, Rojas R, Tirado-Sánchez A, Chávez-López D, Mena C, Calderón L, María PO. Superficial Mycoses Associated with Diaper Dermatitis. Mycopathologia. 2016 Oct;181(9-10):671-9. [PMC free article: PMC5014885] [PubMed: 27193417]

4.

Coughlin CC, Eichenfield LF, Frieden IJ. Diaper dermatitis: clinical characteristics and differential diagnosis. Pediatr Dermatol. 2014 Nov;31 Suppl 1:19-24. [PubMed: 25403935]

5.

Cohen B. Differential Diagnosis of Diaper Dermatitis. Clin Pediatr (Phila). 2017 May;56(5_suppl):16S-22S. [PubMed: 28420251]

6.

Kellen PE. Diaper dermatitis: differential diagnosis and management. Can Fam Physician. 1990 Sep;36:1569-72. [PMC free article: PMC2280139] [PubMed: 21233927]

7.

Stamatas GN, Tierney NK. Diaper dermatitis: etiology, manifestations, prevention, and management. Pediatr Dermatol. 2014 Jan-Feb;31(1):1-7. [PubMed: 24224482]

8.

Berg RW, Buckingham KW, Stewart RL. Etiologic factors in diaper dermatitis: the role of urine. Pediatr Dermatol. 1986 Feb;3(2):102-6. [PubMed: 3952026]

9.

Buckingham KW, Berg RW. Etiologic factors in diaper dermatitis: the role of feces. Pediatr Dermatol. 1986 Feb;3(2):107-12. [PubMed: 3513143]

10.

Blume-Peytavi U, Kanti V. Prevention and treatment of diaper dermatitis. Pediatr Dermatol. 2018 Mar;35 Suppl 1:s19-s23. [PubMed: 29596731]

11.

Higuchi R, Mizukoshi M, Koyama H, Kitano N, Koike M. Intractable diaper dermatitis as an early sign of biotin deficiency. Acta Paediatr. 1998 Feb;87(2):228-9. [PubMed: 9512215]

12.

Fölster-Holst R. Differential diagnoses of diaper dermatitis. Pediatr Dermatol. 2018 Mar;35 Suppl 1:s10-s18. [PubMed: 29596730]

13.

Shin HT. Diagnosis and management of diaper dermatitis. Pediatr Clin North Am. 2014 Apr;61(2):367-82. [PubMed: 24636651]

What causes Candida infection in diaper rash?

Author

Rania Dib, MD Pediatric Senior Specialist, Procare Riaya Hospital, Al Khobar, Saudia Arabia

Disclosure: Nothing to disclose.

Coauthor(s)

Amin Antoine Kazzi, MD Professor of Clinical Emergency Medicine, Department of Emergency Medicine, American University of Beirut, Lebanon

Amin Antoine Kazzi, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Wayne Wolfram, MD, MPH Professor, Department of Emergency Medicine, Mercy St Vincent Medical Center; Chairman, Pediatric Institutional Review Board, Mercy St Vincent Medical Center, Toledo, Ohio

Wayne Wolfram, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Pediatrics, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Kirsten A Bechtel, MD Associate Professor of Pediatrics, Section of Pediatric Emergency Medicine, Yale University School of Medicine; Co-Director, Injury Free Coalition for Kids, Yale-New Haven Children’s Hospital

Kirsten A Bechtel, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Additional Contributors

Jerry R Balentine, DO, FACEP, FACOEP Vice President, Medical Affairs and Global Health, New York Institute of Technology; Professor of Emergency Medicine, New York Institute of Technology College of Osteopathic Medicine

Jerry R Balentine, DO, FACEP, FACOEP is a member of the following medical societies: American College of Emergency Physicians, New York Academy of Medicine, American College of Osteopathic Emergency Physicians, American Association for Physician Leadership, American Osteopathic Association

Disclosure: Nothing to disclose.

Diaper Rash, Candida (Infant/Toddler)

Candida is type of yeast. It grows best in warm, moist areas. It is common for Candida to grow in the skin folds under a child’s diaper. When there is an overgrowth of Candida, it can cause a rash called a Candida diaper rash.

The entire area under the diaper may be bright red. The borders of the rash may be raised. There may be smaller patches that blend in with the larger rash. The rash may have small bumps and pimples filled with pus. The scrotum in boys may be very red and scaly. The area will itch and cause the child to be fussy.

Candida diaper rash is most often treated with over-the-counter antifungal cream or ointment. The rash should clear a few days after starting the medicine. Infections that don’t go away may need a prescription medicine. In rare cases, a bacterial infection can also occur.

Home care

Medicines

Your child’s healthcare provider will recommend an antifungal cream or ointment for the diaper rash. He or she may also prescribe a medicine to help relieve itching. Follow all instructions for giving these medicines to your child. Apply a thick layer of cream or ointment on the rash. It can be left on the skin between diaper changes. You can apply more cream or ointment on top, if the area is clean.

General care

Follow these tips when caring for your child:

• Be sure to wash your hands well with soap and warm water before and after changing your child’s diaper and applying any medicine.

• Check for soiled diapers regularly. Change your child’s diaper as soon as you notice it is soiled. Gently pat the area clean with a warm, wet soft cloth. If you use soap, it should be gentle and scent-free. Topical barriers such as zinc oxide paste or petroleum jelly can be liberally applied to help prevent urine and stool contact with the skin.

• Change your child’s diaper at least once at night. Put the diaper on loosely. 

• Use a breathable cover for cloth diapers instead of rubber pants. Slit the elastic legs or cover of a disposable diaper in a few places. This will allow air to reach your child’s skin. Note: Disposable diapers may be preferred until the rash has healed.

• Allow your child to go without a diaper for periods of time. Exposing the skin to air will help it to heal.

• Don’t over clean the affected skin areas. This can irritate the skin further. Also don’t apply powders such as talc or cornstarch to the affected skin areas. Talc can be harmful to a child’s lungs. Cornstarch can cause the Candida infection to get worse.

Follow-up care

Follow up with your child’s healthcare provider, or as directed.

When to seek medical advice

Unless your child’s healthcare provider advises otherwise, call the provider right away if:

• Your child has a fever (see Fever and children, below)

• Your child is fussier than normal or keeps crying and can’t be soothed.

• Your child’s symptoms worsen, or they don’t get better with treatment.

• Your child develops new symptoms such as blisters, open sores, raw skin, or bleeding.

• Your child has unusual or foul-smelling drainage in the affected skin areas.

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

• Ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

• Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

• Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

• Armpit temperature of 101°F (38. 3°C) or higher, or as directed by the provider

Child of any age:

• Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

• Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

Tips From Other Journals – American Family Physician

Tips from Other Journals

Am Fam Physician. 1998 Jun 1;57(11):2857.

Oropharyngeal candidiasis (also called oral thrush) and candidal diaper dermatitis are annoying problems that resolve spontaneously in most healthy infants. In some cases, however, the symptoms may be persistent, causing pain, anorexia and discomfort. For these reasons, rapid control is often desirable. Hoppe reviews the management of oropharyngeal candidiasis and candidal diaper dermatitis in neonates and infants.

Oropharyngeal candidiasis is rare in the first week of life. The peak prevalence of this disorder occurs at four weeks of age. Nonabsorbed agents should be used to treat neonates and infants without major underlying considerations. Gentian violet is moderately effective but may cause irritation and ulceration of the mucosa with prolonged use. Topical nystatin is virtually free of harmful reactions, although high doses of the oral preparation can cause nausea and vomiting. Nystatin suspension has suboptimal efficacy, because its antifungal activity is only moderate. Amphotericin B suspension appears to have slightly better efficacy than nystatin. Neither gentian violet, nystatin nor amphotericin has a clinical cure rate of greater than 80 percent. Miconazole gel and topical clotrimazole appear to be more effective, but miconazole oral gel is not available in the United States, and oral clotrimazole can raise liver enzyme levels and cause gastrointestinal side effects in infants. This lack of an efficacious treatment preparation has led to the unconventional oral administration of topical or vaginal antifungal agents. When miconazole is used, it is probably not necessary to administer the medication beyond the day of clinical cure.

Candidal diaper rash starts in the perianal area and spreads to adjacent areas. Treatment includes aerating the diaper area and keeping the infant dry. Zinc oxide paste may be soothing and protective when the acute phase of the eruption has subsided. Baby powder application also may be useful. Antifungal therapy is mandatory to achieve resolution. Nystatin, amphotericin, miconazole and clotrimazole are all useful, although cure rates are higher with use of miconazole and clotrimazole. Oral treatment of candidal diaper dermatitis and the possible accompanying intestinal infection is recommended by many experts.

The author concludes that for treatment of oropharyngeal candidiasis, miconazole oral gel is clearly superior to nystatin suspension. If nystatin suspension must be used, dosages higher than those conventionally administered might improve the outcome. For topical therapy of candidal diaper dermatitis, several agents appear to be equivalent. The addition of an oral agent to the topical treatment is probably appropriate. Nystatin suspension may be used for this purpose.

Diaper rash | Caring for kids

What is diaper rash?

Diaper rash happens when your baby’s skin gets irritated from wet or soiled diapers. It can happen if your child has very sensitive skin or when urine or stool in the diaper touches skin for too long, making it sore and red.

What causes diaper rash?

• Irritation by urine and stool. 
• Irritation from eating new foods.
• Sensitive skin.
• Irritation by diarrhea,
• Yeast infection, also known as Candida.
• Snug-fitting, air-tight plastic pants or plastic-covered diapers that prevent wetness from drying or that rub the skin.

How can I prevent diaper rash?

The best way to prevent diaper rash is to change your baby’s diaper often, especially if your baby has diarrhea. If your child has diarrhea, you can also help to prevent diaper rash with an unscented barrier cream, such as petroleum jelly or a zinc oxide-based paste, to protect the skin.

How can I treat diaper rash?

• When you change your baby’s diaper, wash her bottom with mild soap and warm water (just water if there is no stool) or unscented baby wipes, rinse and pat dry. If the skin is really sore and red, it may be less painful to wash the area in a warm bath.
• Use an unscented barrier ointment, such as petroleum jelly or a cream with zinc oxide, to protect and lubricate the area after each diaper change. Wipe off any stool-contaminated cream with soap and water (or unscented baby wipe) after each change and reapply.
• Do not share creams and ointments with other children and don’t touch the affected skin and then put your fingers back into the jar. Use a different finger if you need more ointment.
• Do not use baby powder or talc.
• If possible, keep your baby’s diaper off for short periods to expose her skin to open air. This can help your baby feel better and heal the rash faster.

What is

Candida?

Candida is a yeast-like fungus that exists naturally in the intestines (organs where food is digested). If it overgrows it can cause a rash or infection.

What are the symptoms of

Candida diaper rash?

Candida usually causes diaper rash in the deepest part of the skin in the groin area and buttocks. The rash is usually very red, with raised red spots and defined edges.

How do I treat a

Candida infection?

• Candida skin infections are treated with an antifungal cream that is prescribed by a doctor.
• When you change your baby’s diaper, wash the diaper area with mild soap and warm water, rinse and pat dry. Apply the cream to the rash.
• Wash your own and your child’s hands carefully after the diaper change.

When should I call the doctor?

• If the rash is severe, or gets worse even when you treat it.
• If the rash also has blisters or boils, pus or discharge.

More information from the CPS

Reviewed by the following CPS committees

• Community Paediatrics Committee
• Public Education Advisory Committee

Oral Thrush (for Parents) – Nemours Kidshealth

What Is Oral Thrush?

Oral thrush is a very common yeast infection in babies. It causes irritation in and around a baby’s mouth.

What Are the Signs and Symptoms of Oral Thrush?

Oral thrush (also called oral candidiasis) can affect anyone, but is most common in babies younger than 6 months old and in older adults.

A baby with oral thrush might have cracked skin in the corners of the mouth or white patches on the lips, tongue, or inside the cheeks that look a little like cottage cheese but can’t be wiped away.

Some babies may not feed well or are uncomfortable when sucking because their mouth feels sore, but many babies don’t feel any pain or discomfort.

What Causes Oral Thrush?

Oral thrush is caused by the overgrowth of a yeast (a type of fungus) called Candida albicans.

Most people (including infants) naturally have Candida in their mouths and digestive tracts, which is considered normal growth. Usually, a healthy immune system and some “good” bacteria control the amount of this fungus in the body.

But if the immune system is weakened (from an illness or medicines like chemotherapy) or not fully developed (as in babies), Candida in the digestive tract can overgrow and lead to an infection. Candida overgrowth also causes diaper rash and vaginal yeast infections. Babies can have oral thrush and a diaper rash at the same time.

Candida overgrowth also can happen after a baby has been given antibiotics for a bacterial infection because antibiotics can kill off the “good” bacteria that keep the Candida from growing. Oral thrush also can happen after the use of steroid medicines.

How Is Oral Thrush Treated?

See your doctor if you think your baby may have thrush. Some cases go away without medical treatment within a week or two, but the doctor may prescribe an antifungal solution for your baby’s mouth. This medicine is usually applied several times a day by “painting” it on the inside of the mouth and tongue with a sponge applicator.

Depending on your baby’s age, the doctor also might suggest adding yogurt with lactobacilli to your baby’s diet. The lactobacilli are “good” bacteria that can help get rid of the yeast in your child’s mouth.

If your baby keeps getting oral thrush, especially if he or she is older than 9 months old, talk with your doctor because this might be a sign of another health issue.

Can Oral Thrush Be Prevented?

Oral thrush is a common infection in babies, but you can help prevent it:

• If you formula-feed your baby or use a pacifier, thoroughly clean the nipples and pacifiers in hot water or a dishwasher after each use. That way, if there’s yeast on the bottle nipple or pacifier, your baby won’t be reinfected. Store milk and prepared bottles in the refrigerator to prevent yeast from growing.
• If you breastfeed and your nipples are red and sore, you might have a yeast infection on your nipples, which you and your baby can pass back and forth. Talk to your doctor, who might recommend using an antifungal ointment on your nipples while your baby is treated with the antifungal solution.

To prevent diaper rash, change diapers often.

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90,000 Dermatovenereology. Part 4.

Key findings on the topic:

• The skin of folds and genitals is thin, prone to irritation from sebum, sweat, moisture and friction, prone to contamination with bacteria and fungi
• In the folds of the skin and on the genitals, acute infectious diseases occur ( mycoses, STIs, etc.) and conditions requiring emergency care (paraphimosis)
• Diseases of the skin of folds and genitals may not be noticed or deliberately concealed by patients, avoiding medical visits
• It is important to take into account the high risk of systemic absorption of external medicinal products means

Sexually transmitted infections and infectious dermatoses

• Syphilis, genital herpes, anogenital warts, candidiasis of the genitals
• Infectious dermatoses: scabies, phthiriasis, molluscum contagiosum
• STIs causing urethritis and cystitis VCD HIV infection

General information about sexually transmitted infections
• The predominant route of transmission is sexual
• Infection often occurs in a state of alcoholic or drug intoxication
• The transferred genital infection often leaves a person with a heavy emotional mark and can cause the development of sexual dysfunctions
• Shame, accessibility diagnostics and the abundance of available information often induce patients to self-medicate, which increases the risk of developing further infertility and complications of the course of pregnancy
of genital infections, it is very important to convince the patient of the need to be tested for others, including HIV

Syphilis – an infectious disease caused by treponema pallidum (Treponema pallidum), with the advantage sexually transmitted, affecting the skin, mucous membranes, nervous system and musculoskeletal system

A51. 0 Primary syphilis of the genital organs
• Develops at the end of the incubation period (on average 21 days)
• In typical cases – painless erosion or ulcers on a compacted base
• A week after the onset of the primary affect, regional lymphadenitis joins

Fluconazole in the therapy of candidiasis | Chuvirov G.N., Markova T.P.

SPC “Medbiospektr”, Institute for Advanced Studies FUMB and EP at the Ministry of Health of the Russian Federation, Moscow

In , the prevalence of fungal diseases has significantly increased in recent years, which is associated with the wide and not always rational use of antibiotics, cytostatics, corticosteroid hormones, an increase in the frequency of nosocomial infections, and the development of immunodeficiency states.

The most common candidiasis in clinical practice is caused by the yeast-like fungus Candida albicans . Both local and systemic factors contribute to the development of candidiasis. For example, with candidiasis of the skin, the presence of maceration, diaper rash, paronychia is of great importance. Most often, candidiasis occurs in patients with diabetes mellitus, HIV infection, hemoblastosis, as well as with prolonged and uncontrolled intake of antibiotics and corticosteroid hormones.

Clinical manifestations of candidiasis are characterized by lesions of the mucous membranes of the oral cavity (stomatitis), esophagus (esophagitis), urogenital tract, skin and nails.The most severe manifestations are hematogenous dissemination (endocarditis, meningitis, arthritis, osteomyelitis, brain abscess).

Skin lesions in candidiasis are characterized by the appearance of vesicles, pustules, which quickly open and erosion forms in their place. The lesions are dark red, shiny, with a moist surface, clear boundaries and a strip of exfoliating stratum corneum of the epidermis. In children, the process can spread to the skin of the thighs, buttocks, and abdomen. The appearance of interdigital candidal erosion is often observed, more often between the III and IV IV and V fingers of the hands, less often the feet.From subjective sensations, itching, burning, and sometimes soreness in the affected area are noted.

Candidiasis of the oral mucosa is characterized by lesions of the mucous membranes of the cheeks, tongue, gums, corners of the mouth. The process begins with reddening of the mucous membrane, then white blooms appear, merging to form large films. At first, the films are easily peeled off, then they become dense. In the corners of the mouth, cracks form with pronounced maceration, there is a burning sensation and soreness when eating.

Candidiasis of the nail folds and nails begins with redness and swelling of the roller at the base of the nail, which swells and when pressed, pus or ichor is released.When a fungal infection is introduced into the nail plate, it becomes yellowish, dull.

Urogenital candidiasis can be acute or chronic. The acute form is characterized by reddening of the mucous membrane, the presence of vesicles, pinpoint erosions and the presence of curdled or flocculent, creamy discharge. The affected mucosa tends to bleed and crack in the vestibule and perineum. Itching is characteristic of candidiasis of the vulva, labia majora and labia minora, intensifies during menstruation, sexual intercourse and with prolonged walking.Chronic urogenital candidiasis is characterized by infiltration and cracks in the clitoris, anus, perineum, and inguinal folds. Urinary candidiasis occurs in the form of urethritis, cystitis, pyelonephritis. Candidal cystitis is characterized by frequent urination, pain in the suprapubic region. With urethritis, mucopurulent discharge of white or yellow appears, mainly in the morning. Itching and burning are worse when urinating.

Candidal balanoposthitis is manifested by redness, swelling of the glans penis, itching and burning when urinating.On the contacting surfaces of the head and foreskin, yellowish films and a loose curdled mass are formed.

With candidiasis of the digestive tract, damage to the esophagus, stomach, intestines and gallbladder develops, which is associated with the spread of infection from the oral cavity and pharynx. Patients complain of nausea, belching, vomiting, loose stools mixed with mucus, abdominal pain. The mucous membrane is hyperemic, eroded, covered with multiple deposits of white or yellow.

Candidal lesion of the central nervous system proceeds as meningitis, develops as a result of hematogenous dissemination of the infection. There are no specific clinical manifestations, and fungal infection is often confirmed only by autopsy.

Hematogenous dissemination of fungal infection C. albicans is accompanied by fever, toxic and focal manifestations (retinal abscess, endocardial candidiasis, arthritis, meningitis, pneumonia).

Candidal sepsis develops when the mucous membrane of the oral cavity and esophagus is affected in young children and in patients with diabetes mellitus, HIV infection. The clinical picture is dominated by symptoms of intoxication, sharp rises and falls in temperature, and a decrease in blood pressure.

Diagnosis of candidiasis is based on clinical manifestations (itching, burning, plaque, mucosal edema, hyperemia and others), microbiological tests (cultivation of in vitro , histology and detection of specific antigens in the reaction of immunofluorescence with monoclonal antibodies against C. albicans , detection of specific antibodies by enzyme immunoassay).

For for the treatment of candidiasis , antimycotic drugs of systemic action are used (polyene antimycotics, triazole derivatives, pyrimidine derivatives and allylamines). Among the triazole derivatives, the leading place is occupied by fluconazole (Mikosist) , which is a selective inhibitor of sterol synthesis in the fungal cell.

Fluconazole is highly active against C. albicans : only about 3-5% of strains C. albicans are resistant to fluconazole or have intermediate sensitivity. Candida krusei and selected strains Candida glabrata are resistant to fluconazole.

After oral administration of fluconazole, more than 90% of the drug enters the systemic circulation. It perfectly penetrates into saliva, phlegm, urine and other tissue fluids. Fluconazole is excreted mainly in the urine unchanged. The half-life with normal renal function is 27-34 hours. Mycosist (fluconazole) is available in two forms – for intravenous and oral administration, the oral form has very good bioavailability.

Fluconazole is the drug of choice for candidal urinary tract infection, esophagitis, peritonitis, wound infection, and is used in the treatment of febrile neutropenia. In urogenital candidiasis, fluconazole is prescribed in a dose of 50 to 200 mg per day for 7-28 days. For candidal esophagitis, a dose of 400 mg is recommended, followed by a decrease to 200 mg.

Fluconazole is considered the agent of choice in the systemic therapy of oral candidiasis. In case of oropharyngeal candidiasis, fluconazole is prescribed for adults in a dose of 100 mg once a day for 7-14 days.In atrophic candidiasis of the oral cavity, it is preferable to prescribe fluconazole at a dose of 50 mg per day for 14 days. With the developing resistance of C. albicans , the dose of fluconazole is increased to 400-800 mg / day. With frequent relapses, it is possible to prescribe pulse therapy with fluconazole (150 mg once a week). Intermittent schemes prevent the development of resilience.

For skin candidiasis, the effective dose of fluconazole ranges from 50 to 100 mg per day for 14-28 days.For candidiasis of the skin of the feet, we recommend a dose of 150 mg per day for 14-28 days.

The choice of treatment for candidal paronychia depends on the stage of the process, the severity of inflammation, the presence of candidiasis of the skin or mucous membranes, and onychomycosis. Fluconazole is prescribed for concomitant onychomycosis, combination of paronychia with candidiasis of the skin or mucous membranes. In these cases, only local therapy does not guarantee the cure and elimination of the pathogen. Fluconazole is prescribed 150 mg once a week for 2-6 weeks.Systemic therapy can be combined with treatment with topical antiseptics or antifungal agents.

For the prevention of candidiasis during antibiotic therapy, the dose of fluconazole is from 50 to 300 mg per day once, depending on the risk of developing a fungal infection.

In children, the daily dose is 3 mg / kg of body weight per day. On the first day, it is advisable to prescribe a loading dose of 6 mg / kg per day. The duration of therapy in children is from 1 to 14 days, depending on the severity of the candidal infection.

Fluconazole is well tolerated, adverse reactions occur mainly from the gastrointestinal tract (abdominal pain, nausea, flatulence), less often headache, skin rashes are observed.

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Candidal intertrigo | Dermatology in Russia

Patient data

Skin color:

II light Life history

Bad habits:

No bad habits Disease history

Duration of illness:

several months

Debut at the age:

Over 60 years old

Nature of the course of the disease:

Chronic persistent Status localis

Description of rash:

The process is widespread with localization in the area of ​​skin folds (submammary and interdigital), where there are foci of hyperemia with an eroded surface, covered with a whitish coating.

Primary elements of the rash:

Spot

Secondary elements of the rash:

Erosion

Localization of the rash:

Fingers

Localization of the rash:

Chest

Distribution of the rash:

Common rash

The nature of the location of the rash:

Intertriginous nature (in the folds of the skin) Observation and treatment

Examination plan:

Blood for glucose, glucose tolerance test, glycated hemoglobin

Diagnosis

Clinical diagnosis:

Candidal intertrigo

Differential diagnosis:

Candidiasis of skin folds (candidiasis intertrigo, human yeast folds, affecting superficial infection in which conditions are created for the reproduction of the fungus Candida.Clinically, candidal intertrigo is characterized by the appearance in the depth of the folds of small vesicles with a thin flabby lining; soon they open up with the formation of erosions, which rapidly increase in size and, merging, form extensive erosive areas that can completely occupy the contacting surfaces of the folds. Erosion and maceration of the epidermis is limited, as a rule, to the contacting surfaces of the folds. Most often, this picture is observed with the defeat of the folds under the mammary glands in women.Quite often, the interdigital folds of the hands are affected. This type of candidiasis occurs, with rare exceptions, in adults, and, as a rule, in women who do a lot of household chores or work in food processing plants for fruits and vegetables, as well as in confectionery enterprises. Usually one interdigital fold is affected, more often on the right hand, between the 3rd and 4th fingers.

“Diaper dermatitis (diaper rash)” – Yandex.Q

What is diaper dermatitis (diaper rash)

Diaper rash or diaper rash is a common form of skin inflammation (dermatitis) in young children.It looks like a bright reddening of the skin in the perineum.
Photo 1. Simple diaper dermatitis

Diaper rash is usually caused by prolonged exposure to moisture, urine or faeces on the skin of the perineum and is therefore more likely to occur with irregular diaper changes and diarrhea, but it also occurs in children with good hygiene of the perineum.
Diaper rash can also develop when using the wrong brand of diapers for a particular baby, after introducing a new product into complementary foods, when a nursing mother takes certain foods, or when taking antibiotics.
Diaper dermatitis can be frightening for parents and cause anxiety in a child. However, in most cases, normal home care is sufficient to cure it, even without the intervention of a pediatrician.

Diaper dermatitis symptoms

Diaper rash is manifested by the following symptoms:

• The affected skin becomes bright red and swollen; lesions are located in the perineum: on the buttocks, inner thighs and genitals.
• Changing the child’s mood. You may notice that your baby looks upset, more whiny than usual, especially when changing diapers. A child with diaper rash is more likely to worry or cry when washing and touching the affected skin.

Photo 2. Diaper rash. Characteristic skin changes in diaper dermatitis

Diaper dermatitis can appear at any age until the baby is potty trained, but it most commonly occurs before 15 months of age.The peak incidence is between 9 and 12 months of age.

When to see a doctor
Usually, diaper rash is easy to treat and not worth the attention of a pediatrician. However, if the lesions persist after a few days of your active perineal care (frequent diaper changes, air baths and protective cream), the baby should be seen by a doctor. Sometimes, diaper rash leads to secondary infections that may require special ointments (antibacterial, antifungal, or steroid).
Show the child to the doctor if:

• The rash is pronounced
• The rash gets worse despite your efforts
• Diaper rash accompanied by fever
• There are bubbles or oozing on diaper rash
• The rash is outside the diaper area
• The rash festers
• Baby cries too much
• The child is excessively drowsy

Reasons for the development of diaper rash

Skin irritation from prolonged contact with faeces or urine. Prolonged exposure to urine or feces can irritate a baby’s sensitive skin. Your child may be more prone to diaper rash if he defecates frequently, because feces is more irritating than urine.
Introducing new foods into the diet. The introduction of complementary foods in a child’s diet can provoke diaper dermatitis, since this changes the composition and properties of feces. In addition, complementary foods increase the frequency of bowel movements. If your baby is breastfeeding, he may develop diaper rash in response to food eaten by the mother, although this is rare.
Contact with a new chemical. Disposable wipes, changing brands of diapers, diaper cream, laundry detergent, bleach or fabric softener can all irritate the delicate skin of your baby’s crotch.
Bacterial or fungal infection (candidiasis). Fecal irritated skin is the gateway for infection. In addition, it is always warm and humid under the diaper, which is very convenient for the growth of bacteria and fungi. Secondary skin lesions can be located in folds (bacterial lesions), or be scattered all over the surrounding skin (candidal diaper dermatitis).
Photo 3. Changes characteristic of candidal diaper dermatitis

Sensitive skin. Children with pre-existing chronic skin lesions such as atopic dermatitis or eczema may be more prone to developing diaper rash.
Tightness and friction Tight clothing or diapers – significantly increase the risk of developing diaper rash.
Use of antibiotics. Antibiotics kill bacteria, both good and bad. The good bacteria that held back the development of fungi die – therefore the growth of the yeast infection is activated. This also applies to breastfed babies whose mothers are taking antibiotics.

Preparing for your doctor’s appointment
Typically, diaper rash can be successfully treated at home without a doctor’s supervision. But if the symptoms do not respond to treatment for more than 2-3 days or are accompanied by fever and other dangerous symptoms, you should make an appointment with your pediatrician.
It will be good if you prepare a list of the most important points in advance:

1. Write down key health information about your child, including any other medical conditions your child has been treated for and any medications the child has recently taken. If your baby is receiving breast milk, mom’s drug therapy should also be reviewed.
2. Write down a list of all diapers, creams, and detergents that apply to your baby’s crotch.Your doctor may want to know the brand of diaper, laundry detergent, soaps, lotions, powders, and oils you are using for your baby. In some cases, it will be helpful to bring the doctor a label for the suspect cream or powder, or take a picture of it with a smartphone.

Write down questions to ask your doctor:

• What can I do to help my baby’s skin heal?
• Which diapers and what brands of creams would you recommend for my baby?
• When should I use ointment instead of cream, and when vice versa?
• What foods or topical products should I avoid when caring for and feeding my child?
• Do I need a diet or no medication?
• How soon do you predict that these symptoms will improve with your treatment?
• How can I prevent diaper dermatitis from recurring?

Your doctor is likely to ask you a number of questions. Be prepared to answer them, including in detail. List of most likely doctor questions:

• When did you first notice symptoms in your child?
• What triggers do you think provoked these diaper rash?
• What brand of diapers do you usually use?
• How often do you change your baby’s diaper?
• What brands of soap and wet wipes do you use to wash your baby?
• Do you use any skin care products for your baby, such as lotions, powders, creams or oils?
• What detergent do you use to wash your child’s clothes?
• Is your baby breastfed?
• You have already introduced complementary foods, which ones?
• How did you try to treat diaper rash, what was the effect of the treatment?
• Was your child sick the day before or had diarrhea?
• Has the child received any new medications recently?

What can you do while waiting for a doctor’s appointment?
First of all, you should often wash your baby with cool water, keep the crotch in the air more often, change diapers more often, avoid food and topical products that could cause diaper dermatitis. You should often wash your child with running water as soon as possible after each urination and bowel movement. You should also avoid contact of the perineum with soap and wet wipes until complete recovery from diaper rash.
Keep your baby without diapers for as long as possible. If your baby has loose stools, remember to use a barrier cream in the perianal area (around the anus). No barrier cream is applied to the rest of the skin!

Diaper dermatitis treatment

The best treatment for diaper rash is the maximum cleanliness of the baby’s skin, the absence of moisture and irritants.However, if your baby’s diaper rash does not respond to this simple treatment, your doctor may prescribe:

• Light Steroid Cream
• Antifungal cream if secondary fungal infection is suspected
• Topical or oral antibiotics if your child has a secondary bacterial infection

Photo 4: diaper rash with secondary GABHS infection

Photo 5: Erosive diaper dermatitis caused by diarrhea

Photo 6: Erosive diaper dermatitis

Do not use steroid, antifungal and antibacterial creams without first talking to your doctor, even if your child has previously been prescribed them by your doctor. Frequent and unreasonable use of these drugs can cause complications and worsen the condition of the child.
Recovering from diaper dermatitis usually takes several days. If the rash persists despite the treatment prescribed by your doctor, you should return to your doctor and / or seek the advice of a dermatologist.

Home Remedies for Diaper Rash
Again, the most effective way to treat diaper rash is to keep your crotch as clean and open as possible.To do this, you should either keep the baby naked or change diapers very often
In addition, you can apply some local creams before visiting your doctor: for example, zinc cream (Desitin or others)
Zinc oxide is an active ingredient in many diaper rash creams. Apply a thick layer of zinc oxide cream to irritated skin to soothe, heal and protect your baby’s skin. Zinc oxide can also be used to prevent diaper rash on healthy skin (like a regular diaper cream).
Until the baby’s diaper rash has healed, avoid: washing with soap, using disposable wipes, and any irritating topical products. Alcohol and perfumes in these products can irritate your baby’s skin and worsen and prolong the course of diaper dermatitis.
In the recent past, talcum powder was often used to prevent and treat diaper rash. The absorption of excess moisture was believed to have a beneficial effect on the skin of the perineum.However, at present, these recommendations are considered inappropriate: talc acts as an abrasive, leading to traumatic friction when the child moves, and inhalation of talc can irritate the child’s lungs.

Prevention of diaper dermatitis

Diaper dermatitis occurs in almost all children, and not all cases are caused by poor hygiene of the perineum. However, some simple tips can help you reduce your child’s risk and severity of PD:

• Change diapers frequently. Remove any diaper, diaper or panties soiled with faeces as soon as possible. Instruct your nanny or caregiver to do the same.
• Wash your baby’s crotch with cool running water every time you change the diaper. To do this, you can use a bathtub, sink, or just a bottle of water. A damp cloth or cotton balls are also suitable for this purpose. Do not use wet wipes that contain alcohol or fragrances.
• After washing, pat the baby’s crotch with a towel to dry it.Get wet, but don’t rub – rubbing can be an additional annoyance.
• Do not use diapers that are too small or too tight for your child . This increases the moisture in the environment under the diaper, and also leads to direct friction in the areas of the diaper’s elastic bands (at the waist or hips).
• Whenever possible, keep the baby without a diaper. To prevent your child from getting dirty on surfaces that are difficult to clean (for example, a sofa) – use disposable diapers, or oilcloth and reusable diapers.
• Wash cloth diapers thoroughly. Pre-soak heavily soiled cloth diapers and use hot water to wash them. Use softening detergents and do not auto-dry fabrics, which will make the fabric particularly rough.
• Consider using a protective ointment regularly. If your baby has diaper dermatitis frequently, apply barrier ointments or creams based on petroleum jelly and zinc oxide on the perianal area.These drugs protect the skin from irritation and reduce the incidence of diaper rash.
• Wash your hands thoroughly after changing diapers. Hand washing prevents bacteria or fungus from spreading to other parts of your child’s body, you or other family members.

Which diapers to choose?
Many parents find that disposable diapers are more likely to cause diaper rash than cloth diapers. However, according to research, there is no evidence for this opinion.You can use both types or prefer one of them. But whatever diapers you use, try to change them as soon as possible after each bowel movement of your baby.

Candidal intertrigo: treatment, diagnosis, causes

One of the clinical manifestations of candidiasis is candidal intertrigo. The disease affects the large skin folds of the human body. The disease is characterized by an inflammatory process with the formation of small cracks, erosions in areas of the skin with high humidity.Timely and effective therapeutic therapy completely eliminates all manifestations of the disease.

The causative agent and causes of the disease

The causative agent of candidal intertrigo is a pathogenic fungus of the genus Candida. When the protective properties of the human body are weakened, the fungus is activated in a humid environment suitable for its development. The main places of localization of fungal infection include:

• folds of the perineum or between the buttocks;
• inguinal and axillary regions;
• areas under the mammary glands;
• vulva area;
• folds of fat in the neck or abdomen;
• skin between the toes;
• folds behind the auricles.

Back to the table of contents

Causes of the disease

The main causes of the development of the disease are:

The disease does not significantly impair the well-being of a person. The only discomfort is severe itching.

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Symptoms of the development of candidal intertrigo

Symptoms of the disease depend on the causes of the disease and the location of the fungus. The pathological process proceeds in stages:

1. Deep in the folds, the surface layer of the epidermis becomes inflamed and exfoliates.
2. The inflammatory process begins with shallow formation of small erosions and cracks. They have uneven edges, but clear boundaries, along them a white rim is formed from the exfoliated epidermis.
3. Small abscesses and vesicles appear around the lesions. Bursting, they merge and form new erosive areas.
4. In the damaged areas of the skin, severe itching and burning are felt.

With skin lesions between the fingers of the extremities, yeast erosion forms.Its surface is covered with whitish films, which contribute to the suppuration of the skin and the enlargement of the lymph nodes. The pathological process is localized in one or several folds and is accompanied by itching, pain and burning.

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Features of the development of the disease in infants

Infants are also susceptible to this disease.

The main reasons for the development of candidal intertrigo in infants are:

• non-observance of hygienic measures for care;
• use of diapers, clothes made of low-quality materials that cause diaper rash;
• skin irritation by feces or urine;
• dermatological diseases;
• inflammatory processes of the skin.

The development of a fungal infection in infants is characterized by a strong inflammatory process in the anus or intergluteal, inguinal folds. In most cases, candidal intertrigo in infants is associated with thrush of the mucous membranes or lingering dyspeptic disorders. The peculiarities of the development of the disease in infants include:

• the formation of erythematous spots with characteristic distinct edges in the area of ​​intergluteal or inguinal folds;
• formation on the surface of spots of dark red varnish erosion with a wet surface and scalloped outline;
• the appearance around the lesions of superficial pustules, small blisters, delivering severe itching and irritation of the skin.

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Diagnostics and treatment

Diagnosis of candidal intertrigo includes:

• Microscopic examination. Scraping from lesions is examined under a microscope and the type and properties of the pathogenic microorganism are determined.
• Bacteriological inoculation. The morphology of the fungus is investigated and its sensitivity to antifungal agents is revealed.

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Therapeutic therapy

The damaged areas should be treated with “Ketokenazole”.

Treatment of candidal intertrigo is carried out with the use of local and systemic antifungal agents. Therapeutic therapy includes:

• treatment of damaged areas with antiseptic solutions, ointments, gels;
• intake of antimycotics and probiotics;
• use of anti-inflammatory and antibacterial powders, pastes;
• use of traditional medicine.

The main medications for the elimination of candidal intertrigo and their therapeutic effect are presented in the table:

cells and spores 9045

905 ointment

During the treatment of candidal intertrigo, it is forbidden to wet the affected areas of the skin.

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Preventive measures

To prevent an illness, it is necessary to eliminate the causes of the illness and strengthen the protective functions of the body. As a preventive measure, it is recommended to monitor skin hygiene and use disinfectants that dry the skin in areas with high humidity. To accelerate therapeutic therapy, rubbing with decoctions of calendula, oak bark, chamomile is widely used. To prevent the disease in infants, it is necessary to carefully monitor hygiene, dress the child in clothes made of natural fabrics.Timely and effective therapeutic therapy completely eliminates all manifestations of the disease and prevents relapses.

Etiology – presentation on Slide-Share.ru 🎓

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First slide of presentation: Etiology

Candidiasis – (candidiasis, moniliasis, thrush) infectious – inflammatory disease caused by fungi of the genus Candida, affects almost all organs and systems of the body.It is a common disease in newborns and immunocompromised individuals.
Yeast-like fungi of the genus Candida are conditionally pathogenic microorganisms. Aerobes are saprophytes of the mucous membranes of the mouth, intestines, vagina, and skin.
These include Candida albicans, tropicalis

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Candidiasis – (candidiasis, moniliasis, thrush) endogenous infectious and inflammatory disease caused by fungi of the genus Candida, affects almost all organs and systems of the body.Candida albicans are yeast-like microorganisms, representatives of the normal microflora of the oropharynx, gastrointestinal tract, and vagina. Found in 70-80% of people. Moreover, most of them do not show any signs of the disease. In healthy people, it does not live on the skin. Infection with candidiasis from a sexual partner is possible.
Oral candidiasis often affects infants. 20% of children under one year old have suffered from this disease, and some several times. It is generally accepted that in childhood, candidiasis or thrush is easier to tolerate and more responsive to treatment.It is an opportunistic infection, affecting primarily a weakened organism.
Indicates immunodeficiency in the body
WIDE USE OF ANTIBIOTICS, CORTICOSTEROIDS, HORMONAL CONTRACEPTIVES ONE OF THE SERIOUS INFECTIOUS COMPLICATIONS OF MEDICAL THERAPY
CANDIDOSIS IS A MANDATORY MARKER for HIV / AIDS, IATRAGENIC IMMUNODEFICIENCIES CAUSED BY CHEMOTHERAPY OF ONCOLOGICAL DISEASES AND IN ORGAN TRANSPLANTATION
CANDIDOUS INFECTION IS A SIGNIFICANT TRIGGERING FACTOR AGAINST THE COURSE OF MANY DERMATOSIS, INCLUDING ALLERGIC GENESIS
At-risk groups
People who are constantly in contact with a humid environment: medical staff, bartenders, flower sellers, car washes, etc.d.

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Slide 3: Epidemiology

Intrauterine infection
When passing through the birth canal, from the mucous membrane of the mouth, from the skin of the nipple when feeding, from the skin of the hands when leaving.From household items, dishes, as well as food
Domestic animals, especially young animals: calves, kittens, foals, as well as poultry.

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Slide 4: Pathogenesis

Endogenous factors:
immunodeficiencies, metabolic diseases (diabetes mellitus, dysproteinemia, ulcerative colitis, dysbiosis, obesity).diseases of the blood system, neoplasms, myxedema, thyrotoxicosis, Itsenko-Cushing’s disease, vegetative dystonia with increased sweating, vitamin deficiency.
Exogenous factors:
temperature that promotes sweating and maceration of the skin, exposure to the skin and mucous membranes of occupational hazards (acids, alkalis, cement, solvents).
skin injuries, especially in the canning industry, where raw materials are seeded with these mushrooms; irrational hygienic regime.
long-term use of antibiotics, glucocorticosteroids and cytostatics;

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Slide 5: Classification

Superficial candidiasis:
Candidiasis of the corners of the mouth
Candidal stomatitis, glossitis, cheilitis
Interdigital yeast erosion
Yeast paronychia and onychia
Chronic generalized
(granulomatous) candidiasis
Visceral candidiasis (systemic)
Vulvovaginal candidiasis, balanitis and
balanoposthitis
With stomatitis, point plaques appear on the oral mucosa, white films, when removed, the eroded surface is exposed.Glossitis is manifested by white filmy deposits on the back, lateral surfaces, in the folds of the tongue.
Candida cheilitis is characterized by: dryness, hyperemia, burning and tightening of the red border of the lips, the appearance of grayish scales.

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Slide 6

CANDIDOSIS OF THE ORAL MUCOSA.

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Slide 7

CANDIDOSIS OF THE ORAL MUCOSA

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Slide 8

CANDIDOSIS
ORAL MUCOSA

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Slide 9

Superficial candidiasis Candidiasis of the corners of the mouth
Smooth skin candidiasis

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With candidiasis of the corners of the mouth (angular stomatitis, candidal seizure), dryness and cracking in the corners of the mouth are noted, often accompanied by infection of the affected skin.The reason is the constant licking of the lips, problems with dentures, insufficient vitamin content in the body, and decreased immunity.
With stomatitis, point plaques appear on the oral mucosa, white films, when removed, the eroded surface is exposed. The tongue turns bright red, “filling the whole mouth.”
Glossitis is manifested by white filmy deposits on the back, lateral surfaces, in the folds of the tongue.
Candida cheilitis is characterized by: dryness, hyperemia, burning and tightening of the red border of the lips, the appearance of grayish scales.

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Slide 11

Interdigital yeast erosion
Yeast porichia and onychia

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Slide 12

Yeast onychium

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Slide 13: Yeast porichia and onychia

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Slide 14

Chronic generalized candidiasis
(granulomatous).

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Visceral candidiasis (systemic)

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Candidal balanoposthitis
Vulvovaginal candidiasis

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Slide 17: Interdigital yeast erosion

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Slide 19: Yeast interdigital erosion

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Slide 20: Candidal intertrigo

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Slide 21: Candida seizures

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Slide 22: Candidal paronychias and onychodystrophies

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Slide 23: Candidal paronychia

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Slide 24: Candidal balanoposthitis

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Slide 25: Yeast balanoposthitis

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Slide 26: Candidal glossitis

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Slide 27: Mucosal candidiasis

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Slide 28: Yeast diaper rash

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Slide 29: Yeast diaper rash

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Slide 30: Candidal Blepharitis

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Slide 31: Diagnosis and Treatment

Diagnosis: candidiasis is diagnosed by detecting yeast-like fungi in the material from the lesion.Treatment:
Antimycotics: intravenous amphotericin at a dose of 100 U / kg in a 5% glucose solution, then the dose is increased to 250 U / kg, and with good tolerance, even higher, even up to 1000 U / kg. Diflucan (fluconazole) is prescribed for adults at 400 mg / day on the 1st day of treatment and 200 mg on the following days, for children at 3-6 mg / (kg / day). Itroconazole is given to adults at 100-200 mg daily with meals. Ancotil (flucytosine) is administered orally and intravenously at a daily dose of 37.5-50 mg / kg for 6 hours, the daily dose is 150-200 mg / kg.

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Last slide of presentation: Etiology: Treatment

Local treatment: derivatives of azole compounds are effective – clotrimazole, ketoconazole, miconazole, isoconazole, etc.in the form of creams or ointments.
In case of damage to the mucous membranes of the mouth, adults are prescribed 20%, children 10% solution of sodium tetraborate (borax) in glycerin, 1-2% aqueous and alcoholic solutions of aniline dyes. You can use levorin in sucking tablets containing 250,000-500,000 IU of antibiotic.
Important conditions for the successful treatment of any form of candidiasis are the correct hygienic regime, rational nutrition with a sufficient amount of vegetables, fruits, fermented milk products, intake of B vitamins, aevit, ascorbic acid, trace elements, phosphorus, iron, calcium.

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