Candida infection of the skin Information | Mount Sinai

Skin infection – fungal; Fungal infection – skin; Skin infection – yeast; Yeast infection – skin; Intertriginous candidiasis; Cutaneous candidiasis

Candida infection of the skin is a yeast infection of the skin. The medical name of the condition is cutaneous candidiasis.

This microscopic film shows a fluorescent stain of Candida. Candida is a yeast (fungus) that causes mild disease, but in immunocompromised individuals it may cause life-threatening illness. (Image courtesy of the Centers for Disease Control and Prevention.)

This child has a large rash caused by candidiasis, affecting the skin around the mouth. There are also other lesions that aren’t connected to the large lesion, called satellite lesions.

Fungal infections are caused by microscopic organisms (fungi) that can live on the skin. They can live on the dead tissues of the hair, nails, and outer skin layers.

Causes

The body normally hosts a variety of germs, 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 often live on the hair, nails, and outer skin layers. They include yeast-like fungi such as candida. Sometimes, these yeast penetrate beneath the surface of the skin and cause infection.

In cutaneous candidiasis, the skin is infected with candida fungi. This type of infection is fairly common. It 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 also particularly common in people with diabetes and in those who are obese. Antibiotics, steroid therapy, and chemotherapy increase the risk of cutaneous candidiasis. Candida can also cause infections of the nails, edges of the nails, and corners of the mouth.

Oral thrush, a form of candida infection of the moist lining of the mouth, usually occurs when people take antibiotics though only a small number of people who take antibiotics get thrush. It may also be a sign of an HIV infection or other weakened immune system disorders when it occurs in adults. Individuals with candida infections are not usually contagious, though in some settings people with weakened immune systems may catch the infection. When it occurs in the mouth or vagina, it is sometimes called mucocutaneous candidiasis.

Candida is also the most frequent cause of vaginal yeast infections. These infections are common and often occur with antibiotic use.

Symptoms

Candida infection of the skin can cause intense itching.

Symptoms also include:

• Red, growing skin rash
• Rash on the skin folds, genitals, middle of the body, buttocks, under the breasts, and other areas of skin
• Infection of the hair follicles that may look like pimples

Exams and Tests

Your health care provider can usually diagnose this condition by looking at your skin. Your provider may gently scrape off a sample of skin for testing.

Older children and adults with a yeast skin infection should be tested for diabetes. High sugar levels, seen in people with diabetes, act as food for the yeast fungus and help it grow.

Treatment

Good general health and hygiene are very important for treating candida infections of the skin. Keeping the skin dry and exposed to air is helpful. Drying (absorbent) powders may help prevent fungal infections.

Losing weight may help eliminate the problem if you are overweight.

Proper blood sugar control may also be helpful to those with diabetes.

Antifungal skin creams, ointments, or powders may be used to treat a yeast infection of the skin, mouth, or vagina. You may need to take antifungal medicine by mouth for severe candida infections in the mouth, throat, or vagina.

Outlook (Prognosis)

Cutaneous candidiasis often goes away with treatment, especially if the underlying cause is corrected. Repeat infections are common.

Possible Complications

These complications may occur:

• Infection of the nails may cause the nails to become oddly shaped and may cause an infection around the nail.
• Candida skin infections may return.
• Widespread candidiasis may occur in people with weakened immune systems.

When to Contact a Medical Professional

Contact your provider if you develop symptoms of cutaneous candidiasis.

Centers for Disease Control and Prevention website. Fungal diseases: candidiasis. www.cdc.gov/fungal/diseases/candidiasis/index.html. Updated June 28, 2022. Accessed January 3, 2023.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Diseases resulting from fungi and yeasts. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews’ Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 15.

Lionakis MS, Edwards JE. Candida species. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 256.

Last reviewed on: 12/4/2022

Reviewed by: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Cutaneous Candidiasis / Candida Skin Infection

• Candida
• Causes of candidiasis
• Signs and symptoms of candidiasis
• Oropharyngeal / oesophageal candidiasis (oral thrush)
• Genital Candidiasis / vulvovaginal candidiasis (VVC) / Candidal vulvovaginitis
• Cutaneous Candidiasis / Candida Skin Infection
• Invasive candidiasis
• What is Candida die-off?
• Candida Diet and Outlook for the infection

Cutaneous candidiasis is the medical term for a fungal yeast infection of the skin, commonly referred to as a candida skin infection. It is estimated that 20 to 25% of the global population are affected by fungal skin infections, making these a rather current occurrence¹.

The body is usually able to keep skin infections at bay when a person is healthy. If, however, the immune system is compromised for some reason, an upset in the natural balance of fungi that normally reside on the skin without causing any issues may occur. When this happens, opportunistic species (including candida) multiply and penetrate the skin’s barrier, causing infection. Of the over 200 known candida species, just a few that are commonly found on the skin cause infection. These include:

• Candida tropicalis
• Candida parapsilosis
• Candida orthopsilosis
• Candida albicans – which most commonly causes symptomatic skin infections²

Yeast infections of the skin can occur anywhere on the body but are most common in warm, moist skinfold and creases such as those found:

• In the armpits
• In the groin
• Under the breasts
• In the folds of the buttocks (in infants, cutaneous candida infection can cause diaper / nappy rash).
• In the webbing between the fingers and toes
• Around the edges or corners of the mouth
• In the creases of joints

Infections may also occur in the area around the anus (this is referred to as perianal candidiasis) and on or around the nails (referred to as paronychial and onychial infections).

In overweight individuals, candida infections may spread to various areas where fat rolls have accumulated.

Candida-related skin infections are also common in those with ill-managed diabetes³. This is due to the fact that diabetes interferes with the body’s immune system and suppresses it. This, coupled with blood sugar level spikes in those whose diabetes is not under control, facilitates the overgrowth of yeast which feeds on the excess sugar.

Lactating women who experience nipple injuries due to breastfeeding may also be at increased risk of developing skin or breast-related candida infections. In some but not all lactating women, candida infections may cause sore nipples and a deep, sharp, shooting and/or burning pain in the breasts. When candida infects the breasts, this is referred to as mammary candidiasis.

Candidal infections may also commonly affect those being treated for psoriasis as the treatments for this condition may increase the risk of developing fungal infections⁴.

Symptoms of candida skin infections (cutaneous candidiasis)

A candidal infection of the skin can cause the following symptoms:

• Intense itching and/or burning sensation in the affected area
• A spreading, red, crusted skin rash (generally starting in the folds of the skin) which may include satellite pustules (little bumps that look like pimples) and overlaying white plaques (hardened areas of skin).
• Sore, cracked skin
• When affecting the breasts, the nipples may appear shiny or flaky

A candidal infection affecting the toenails or fingernails may cause:

• Nail discolouration (greenish-yellow, ochre, or whitish discoloration)
• Nail thickening
• Detachment of the nail from the nailbed

What do candida skin infections look like?

When candida affects the skin, well-defined, red and sometimes itchy patches of lesions in various shapes and sizes appear, generally in the folds of the skin, this is referred to as candidal intertrigo. While the infection generally starts in the folds of the skin, it can spread to the face, trunk or fingertips. On the scalp, crusts may form and can cause hair loss in these areas, infection of the hair follicles may look like pimples.

What do candida foot and nail infections look like?

When candida infects the nails the most noticeable symptom is discoloration and thickening. The images below illustrate what candida skin infections of the feet and nails may look like.

Diagnosing a candida skin infection

If you have any of the above-mentioned symptoms, make an appointment with your doctor. He or she will generally be able to diagnose the condition by looking at the skin or nails in the affected area during a physical examination. A sample may be taken for testing.

Adolescents and adults with candida skin infections will generally also be tested for diabetes as these are commonly seen in those with high blood sugar levels. A diabetes test may involve giving a blood and/or urine sample.

Candida skin infection treatment

If it is determined that a skin infection is caused by candida, a doctor may prescribe⁵:

• An antifungal skin cream, ointment or powder to be used for between two and four weeks. Common first-line therapy includes imidazole (either clotrimazole 1% or miconazole 2% applied twice daily). In those who are allergic to imidazole, nystatin cream may be prescribed.
• For severe symptoms, a single dose of oral antifungal medication (fluconazole – 150mg) or a combination antifungal and cortisone cream may be prescribed.
• For acute lesions: Domeboro^®solution, Castellani paint or vinegar–water solutions may be applied twice daily for 5–10 minutes. After these dry a mixture of zinc oxide, talc, and glycerine may be applied twice daily.
• For less serious lesions cleansing with benzoyl peroxide, Castellani stain, or vinegar may be recommended followed by the application of the above-mentioned topical antifungal creams, ointments or powders.
• Chronic lesions may be treated with a rinsing lotion comprised of zinc-talc applied twice a day. Applying an antifungal and corticosteroid combination ointment at night may also be recommended.

Home remedies for candida skin infection

Practicing good hygiene is key when treating a candida infection of the skin. It is vital to keep the skin dry and exposed to air as much as possible. Absorbent powders may assist in keeping moist areas that are prone to perspiration dry.

If a person is overweight, weight loss may aid in the elimination of the issues associated with candida infection. In those with diabetes, getting blood sugar under control and continuing to manage it may also help to clear candida infection and prevent recurrences.

Consuming lactobacillus-containing yogurt has proven to be effective in reducing the candida colonisation of the rectum and vagina in women, as such, there is theoretical evidence that it may be useful in treating various types of candidal infections, including those of the skin.

Plant-based alternative therapies that include the use of garlic, calendula, and the goldenseal herb to treat candida are not usually recommended by medical doctors as there is no reliable data the proves their effectiveness in treating candida at present.

Prognosis (outlook) for those suffering from candida skin infection

While cutaneous candidiasis often resolves with treatment, especially when the underlying cause is addressed, repeat infections are common. In those with weakened immune systems, widespread candidiasis may occur. For this reason, the symptoms of any type of skin infection should never be ignored and rather examined and treated by a medical doctor as soon as possible.

Chronic mucocutaneous candidiasis

Chronic mucocutaneous candidiasis (CMCC) refers to a group of rare syndromes that usually develop in childhood but may only be diagnosed in adulthood. In some sufferers, these syndromes are caused by hereditary genetic defects as a result of the mutation of specific genes that affect the immune system.

These defects affect the ability of the immune system’s lymphocytes / T-cells (i.e. the white blood cells that fight off infection) to defend against candida infections. If the immune system’s antibodies (other immune system cells involved in fighting off foreign bodies) are functioning the body may still be able to fight off infections. However, in some individuals both T-cells and antibodies are compromised, making it difficult for them to resist infection.

Symptoms of chronic mucocutaneous candidiasis

Chronic mucocutaneous candidiasis symptoms include those experienced with non-invasive Candida infections of the skin, nails, and mucous membranes⁶. These include:

• Severe, recurrent oral thrush
• Onychomycosis (nail infections that may cause one or more nails to thicken, crack, and become discoloured)
• Vaginitis (vaginal yeast infection also referred to as vaginal thrush that is often associated with an abnormal, itchy vaginal discharge)
• Chronic skin lesions (including a thick, crusted rash that may develop over the face and scalp, often causing hair loss)

The above can be experienced along with autoimmune manifestations, often associated with diseases of the endocrine glands (i. e. the glands that secrete hormones). The most common of which include:

Other non-endocrine related autoimmune manifestations include:

• Autoimmune haemolytic anaemia (a condition that occurs when the sufferer’s antibodies attack their own red blood cells (RBCs) cause them to burst, resulting in a deficiency of oxygen-carrying red blood cells in the body).
• Immune thrombocytopenia purpura
• Autoimmune neutropenia
• Rheumatoid arthritis

Chronic mucocutaneous candidiasis diagnosis

A doctor will usually diagnose a candida infection by looking at the infected area during a physical examination. He/she may take a sample of the infected area for examination under a microscope in order to confirm that Candida is, in fact, causing the infection.

Due to the fact that people without underlying immune system disorders can also develop candida infections, risk factors for these will be explored such as recent antibiotic use or whether a person is diabetic.

If a person with chronic, recurrent candida infections that have not become invasive (i.e. they have not spread to the internal organs) has no evident risk factors, a doctor may suspect that he/she has chronic mucocutaneous candidiasis⁷ and will order blood tests to check for various genetic mutations in order to confirm the diagnosis.

Chronic mucocutaneous candidiasis treatment

Mucocutaneous candidiasis is treated with antifungal therapy. Fluconazole is often the preferred form of treatment as it is effective, has few side effects and is affordable.

The underlying autoimmune or endocrine disorders associated with the condition will also be treated with replacement therapies (i.e. treatments aimed at making up the deficit of a hormone or substance naturally present in the body).

Prognosis (outlook) for those with chronic mucocutaneous candidiasis

While mucocutaneous candidiasis is a chronic disorder, it can be effectively managed and does not affect a person’s lifespan.

References

<sup>1. Kühbacher A, Burger-Kentischer A, Rupp S. Interaction of Candida Species with the Skin. Microorganisms. 2017;5(2):32. doi:10.3390/microorganisms5020032
2. Palese E, Nudo M, Zino G et al. Cutaneous candidiasis caused by Candida albicans in a young non-immunosuppressed patient: an unusual presentation. Int J Immunopathol Pharmacol. 2018;32:205873841878136. doi:10.1177/2058738418781368
3. Rodrigues C, Rodrigues M, Henriques M. Candida sp. Infections in Patients with Diabetes Mellitus. J Clin Med. 2019;8(1):76. doi:10.3390/jcm8010076
4. Pietrzak A, Grywalska E, Socha M et al. Prevalence and Possible Role of Candida Species in Patients with Psoriasis: A Systematic Review and Meta-Analysis. Mediators Inflamm. 2018;2018:1-7. doi:10.1155/2018/9602362
5. Metin A, Genç Dilek N, Gunes Bilgili S. Recurrent candidal intertrigo: challenges and solutions.  Clin Cosmet Investig Dermatol. 2018;Volume 11:175-185. doi:10.2147/ccid.s127841
6. Firinu, D., Massidda, O., Lorrai, M., Serusi, L., Peralta, M., Barca, M., Serra, P. and Manconi, P. (2011). Successful Treatment of Chronic Mucocutaneous Candidiasis Caused by Azole-ResistantCandida albicanswith Posaconazole. Clinical and Developmental Immunology, 2011, pp.1-4.
7. Khalsa, K., Yang, Q., Shen, X., Pasha, M. and Celestin, J. (2018). Immunologic characterization of patients with chronic mucocutaneous candidiasis disease. Clinical Case Reports, 7(1), pp.180-185.</sup>

Skin candidiasis – daily symptoms in children and adults, diagnosis and treatment

Itching

Fungus

Eczema

Diabetes mellitus

Cushing’s disease

HIV

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26 April

Candidiasis of the skin: causes, symptoms, diagnosis and treatment.

Definition

Skin candidiasis is an infectious skin disease caused by microscopic fungi of the genus Candida (most often Candida albicans ).

Causes of skin candidiasis

Candida albicans is believed to be the cause of almost 70-80% of cases of candidiasis. In addition to it, C. glabrata , C. tropicalis , C. krusei , and C. Dubliniensis , can cause skin candidiasis, but incomparably less often.

The fungus Candida is normally present on the skin and mucous membranes without causing harm. However, with a prolonged increase in humidity, thermal exposure and violation of the protective mechanisms of the skin, the pathogen begins to multiply rapidly.

There are risk factors that contribute to the manifestation of skin candidiasis:

• hot weather,
• tight clothing made of synthetic fabrics,
• non-compliance with personal hygiene,
• violation of microflora as a result of antibiotic therapy,
• inflammatory processes in skin folds,
• taking corticosteroids and immunosuppressants,
• diabetes mellitus and other endocrine disorders (eg, Cushing’s disease), HIV/AIDS, or T cell defects.

Classification

• Candidal lesions of the lips and mouth.
• Smooth skin lesion.
• Damage to large folds.
• Interdigital candidiasis.
• Candidal lesions of the palms and soles.
• Candidal balanoposthitis.
• Chronic generalized candidiasis (candidiasis granuloma).

There are several forms of candidiasis:

• Carriage. There are no clinical manifestations of candidiasis.
• Sharp. Accompanied by itching, rashes.
• Chronic. Characterized by the remission of symptoms and their re-manifestation. It develops in case of improper and prolonged treatment with antibiotics.

Symptoms of skin candidiasis

The disease is manifested by small vesicles, sometimes with purulent contents, which open with the formation of erosions. Erosions quickly increase, merge with each other, forming extensive areas of damage. Foci of candidiasis have a dark red color and a moist surface. Fresh small erosions form around large foci. In children, the first signs of candidiasis usually appear in the folds of the skin, from where they already spread to the skin of the thighs, buttocks, and abdomen. There may be painful cracks in the depth of the folds.

Candidiasis of smooth skin in children may resemble seborrheic dermatitis with itchy nodules and erosions. In adults, the disease can manifest as red spots with peeling in the center and small vesicles along the periphery.

Interdigital candidal erosion is observed mainly in persons who have prolonged contact with water, which contributes to skin maceration (waterlogging of the skin with its characteristic swelling). Patients are concerned about itching, burning, and in the presence of cracks – soreness.

In lactating women, candidiasis of the smooth skin of the nipples may develop in the form of hyperemia, maceration and small bubbles in the areola of the nipple.

Candidiasis of the palms can proceed according to the type of dry lamellar dyshidrosis (surface lamellar peeling) and have a vesicular-pustular form (vesicles and pustules against the background of hyperemic and edematous skin). Less commonly, the disease resembles hyperkeratotic eczema – against the background of diffuse hyperkeratosis or individual areas of keratinized skin, sharply demarcated wide skin furrows are observed that have a dirty brown color.

Candidiasis of the skin of the soles is observed mainly in children and is characterized by the presence of small vesicles and pustules, hyperemic spots with peeling and exfoliating waterlogged epidermis along the edges.

In chronic generalized (granulomatous) candidiasis, clinical manifestations on the skin can be varied.

Candida balanoposthitis (an inflammatory disease that affects the glans penis and the inner layer of the foreskin) can be mild with slight lamellar peeling or be more pronounced when there is hyperemia, maceration, erosion on the skin of the glans penis and the inner layer of the preputial sac, as well as in the coronary sulcus on the adjacent surfaces. Erosions can merge and form foci with clear boundaries and a shiny surface. Subjectively, patients are concerned about itching and burning. The disease can be complicated by ulceration and the development of phimosis.

Diagnosis of skin candidiasis

On examination, the doctor reveals inflamed areas of the skin, delimited by waterlogged epidermis.

The diagnostic search algorithm for candidiasis of any localization includes taking material from the affected area, followed by microscopy, seeding to determine the type of fungus and its sensitivity to antimycotic (antifungal) drugs.

Candida, determination of DNA (Candida albicans, DNA) in skin epithelial cell scrapings.

Candida, determination of DNA (Candida albicans, DNA) in scraping of epithelial skin cells

Synonyms: Candida DNA in a scraping of epithelial skin cells; Scraping of epithelial skin cells for candida.

Candida albicans, DNA testing; Candida albicans REAL-TIME PCR DNA, scraping of skin epithelial cells; . ..

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Determination of antibodies of the IgG class to Candida.

Candida IgG

An indicator of the immune response used in the diagnosis of invasive forms of candidiasis.

Fungi of the genus Candida (most often Candida albicans) are ubiquitous. They are present…

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The quantitative determination of Candida is of diagnostic value, since the presence of a small number of Candida fungi is the norm.

Identification of the causative agent of skin candidiasis and determination of its sensitivity to antifungal drugs is carried out by sowing the scraping biomaterial.

Yeast Culture. Identification and Antimycotic Susceptibility testing (Yeast Culture. Identification and Antimycotic Susceptibility testing)

Isolated pathogens: yeast-like fungi (genus Candida, Cryptococcus and others). Material for examination: depending on the type of suspected infection, urine is examined…

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With candidiasis of smooth skin of large folds and outside the folds, the disease should be differentiated from seborrheic eczema, psoriasis and other mycoses.

Which doctors to contact

A dermatologist is engaged in the diagnosis and treatment of skin candidiasis.

Treatment of skin candidiasis

Small lesions of smooth skin can be treated with topical antimycotic (antifungal) agents.

In recent years, azole preparations with a wide spectrum of action, as well as polyene antibiotics, have been used in the treatment of candidiasis.

In case of candidiasis of smooth skin of large folds with acute inflammation, treatment should be started with the use of an aqueous solution of brilliant green (1-2%) in combination with powder and carried out for 2-3 days. Then antimycotic drugs are prescribed: a cream or ointment is applied in a thin layer to the lesions 1-2 times a day. Treatment is continued until resolution of clinical manifestations, plus another 7 days to prevent relapse.

With widespread processes on the skin and the ineffectiveness of local therapy, antifungal agents of systemic action are prescribed: The duration of therapy is 2-4 weeks.

Complications

With a long course, the acute form of candidiasis can turn into a chronic one, which is extremely difficult to treat.

Prevention of skin candidiasis

There is no specific prevention of candidiasis of the skin. Of the generally accepted means of prevention, it should be noted the standard skin hygiene, the priority of underwear and clothing made from natural fabrics.

Sources:

1. Butov Yu.S. Dermatovenereology. National leadership. Brief edition / ed. Yu.S. Butova, Yu.K. Skripkina, O.L. Ivanova – M.: GEOTAR-Media, 2017. – 896 p.
2. Infectious diseases. National leadership / N.D. Yushchuk, Yu.Ya. Vengerov. – M.: GEOTAR-Media, 2018. – 1112 p.
3. Zachinyaeva A.V. Medical mycology / Zachinyaeva A.V., Moskalev A.V., Andreev V.A., Sboychakov V.B. – M.: GEOTAR-Media, 2018. – 288 p.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

Skin candidiasis. What is skin candidiasis?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Skin candidiasis is a superficial skin lesion caused by fungi of the genus Candida. Skin candidiasis presents as red and edematous lesions with vesicles, papules, and erosions. Most often, the process is localized in the skin folds of the axillary and inguinal regions, in the interdigital spaces and under the mammary glands. The diagnosis of candidiasis of the skin is confirmed by the detection of Candida fungi on microscopic examination of skin scrapings. Treatment is carried out by local, and if necessary, general, use of antifungal drugs.

• Causes of skin candidiasis
• Classification of skin candidiasis
• Symptoms of skin candidiasis
• Diagnosis of skin candidiasis
• Treatment of skin candidiasis
• Prices for treatment

General

Recently, there has been an increase in the incidence of fungal infections in general and skin candidiasis in particular. The disease occurs in people of absolutely any age from newborns to the elderly. Since Candida fungi are opportunistic flora and are present in the body of a healthy person, their transition to a pathogenic state with the development of skin candidiasis can signal abnormalities occurring in the body and, first of all, a decrease in immunity.

skin candidiasis

Causes of skin candidiasis

For most people, Candida enters the body in the first year of life. Further fungi are present in the human body as a natural flora. Candidiasis of the skin develops in the case of the transition of fungi from a saprophytic state to a pathogenic one. This may be due to endogenous causes, that is, with changes in the body of the person himself. For example, metabolic disorders (dysproteinemia, obesity, diabetes mellitus), imbalance of the intestinal microflora in dysbacteriosis, decreased immunity, weakening of the body’s defenses against the background of chronic infections, increased sweating, vitamin deficiency can lead to the development of skin candidiasis. Certain types of drug therapy can lead to changes that contribute to the onset of skin candidiasis: treatment with cytostatics or corticosteroids, antibiotic therapy.

It is possible to develop skin candidiasis as a result of exogenous causes, that is, environmental factors that enhance the pathogenic properties of Candida fungi. One of these factors is humidity. The fact is that Candida develops well in a humid environment and at the same time can turn into a pathogenic state. So skin candidiasis is often affected by pool and bath workers, washers and housewives often in contact with water. Elevated ambient temperature, which promotes sweating and maceration of the skin, can also be the cause of skin candidiasis. A favorable environment for the development of pathogenic fungi Candida exists in the confectionery industry and in the canning industry, where, in addition to a large number of fungi in the external environment and raw materials, there is a constant maceration of the skin of the hands of workers with sugary substances, citric, malic and other acids.

Classification of skin candidiasis

There are the following types of candidiasis of the skin:

• candidal intertrigo – candidiasis of large skin folds;
• genital candidiasis;
• candidiasis of the skin of the interdigital spaces of the feet and hands;
• candidal folliculitis – a fungal infection of the hair follicles of the armpit, and in men in the beard and mustache area, occasionally occurs on the scalp;
• dressing skin candidiasis – with increased skin moisture under a plaster cast or on the back in bedridden patients;
• diaper candidiasis – in infants in the perineum.

Symptoms of skin candidiasis

Skin candidiasis begins with the appearance of areas of redness on it with some swelling and various elements of the rash: papules, pustules, vesicles. After the opening of the elements, weeping erosions are formed, which merge to form clearly demarcated lesions with scalloped edges. The erosion surface is shiny and smooth, has a characteristic whitish coating. On the periphery of the foci of skin candidiasis, there are separate seropapules, edematous-erythematous spots, vesicles and pustules. Most often, skin candidiasis begins with large skin folds: between the buttocks, in the armpits, under the mammary glands, in the groin.

Depending on the clinical picture, erythematous and vesicular forms of skin candidiasis are distinguished. In the erythematous form, edematous-erythematous foci with areas of erosion predominate. The vesicular form is characterized by the presence of a large number of vesicles, pustules and papules against the background of inflamed skin.

Candidiasis of the skin can take a chronic relapsing course. In this case, the manifestations described above occur during an exacerbation several times a year and are more common. Chronic candidiasis is more difficult to treat. In severe cases, against the background of concomitant diseases and severe immune disorders, chronic candidiasis can turn into a generalized form with osteoporosis, anemia, recurrent bronchitis and pneumonia, disorders of the gastrointestinal tract and other internal organs.

Interdigital candidiasis of the skin is more often observed in preschoolers and adults working in gardens and orchards. It is manifested by maceration foci with edematous and red skin, along the periphery of which there are vesicles and papules. For employees of vegetable stores and confectionery factories, localization of skin candidiasis between III and IV or IV and V fingers is typical. Candidiasis of the skin of the genital organs is often combined with candidal vaginitis, balanoposthitis and balanitis.

Diagnosis of skin candidiasis

The fastest and easiest way to diagnose fungal etiology of skin lesions is to identify characteristic oval cells with elements of pseudomycelium by direct microscopy of scrapings for pathogenic fungi taken from the affected area of ​​the skin. Preliminary data can be obtained by PCR diagnostics, immunofluorescence reaction (RIF) and enzyme immunoassay (ELISA). The quantitative determination of Candida is of diagnostic value, since the presence of a small number of Candida fungi is normal for the microflora of the human body. Accurate identification of the causative agent of skin candidiasis and determination of its sensitivity to antifungal drugs is carried out by sowing the scraping material on Sabouraud’s medium.

Additionally, to identify concomitant diseases and infections in skin candidiasis, the following can be prescribed: a clinical blood test, determination of blood sugar and urine, an immunogram, a test for HIV infection, etc. If necessary, differential diagnosis of skin candidiasis with eczema, seborrheic dermatitis, psoriasis of the skin folds, favus, recurrent genital herpes, lupus erythematosus, etc.

Treatment of skin candidiasis

The basis of the course treatment of skin candidiasis is the appointment of antifungal drugs. These include: antifungal antibiotics (nystatin, amphotericin B, natamycin, levorin), medicines of the azole group (ketoconazole, isoconazole, clotrimazole, miconazole, econazole, fluconazole) and other drugs (flucytosine, dequalinium chloride, ciclopirox, terbinafine, naftifine, undecylenic acid preparations).