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Satellite lesions yeast. Candidal Intertrigo: Causes, Symptoms, and Treatments for Yeast Infections in Skin Folds

What is candidal intertrigo. How does it develop in skin folds. What are the risk factors for this yeast infection. How is candidal intertrigo diagnosed and treated. What are the clinical features and differential diagnoses to consider.

Understanding Candidal Intertrigo: A Common Yeast Infection of Skin Folds

Candidal intertrigo is a superficial fungal infection that occurs in skin folds, caused by yeast organisms belonging to the Candida genus, most commonly Candida albicans. This condition thrives in warm, moist environments where skin surfaces rub together, creating an ideal habitat for yeast proliferation.

Why does candidal intertrigo develop in skin folds? The combination of heat, moisture, and friction in these areas creates a perfect breeding ground for Candida species. Additionally, factors such as obesity, excessive sweating, and compromised immune function can increase susceptibility to this infection.

Common Sites of Candidal Intertrigo

  • Under the breasts
  • Abdominal folds
  • Armpits
  • Groin area
  • Between fingers and toes

Risk Factors and Predisposing Conditions for Candidal Intertrigo

Who is most likely to develop candidal intertrigo? Several factors can increase an individual’s risk of developing this yeast infection:

  • Obesity
  • Diabetes mellitus
  • Hyperhidrosis (excessive sweating)
  • Immunocompromised states (e.g., HIV infection, chemotherapy)
  • Use of systemic corticosteroids
  • Tight, occlusive clothing
  • Incontinence

How does obesity contribute to candidal intertrigo? Excess body weight creates deeper skin folds, increasing moisture and friction in these areas. This environment is conducive to yeast growth, making obese individuals more susceptible to candidal intertrigo.

Clinical Presentation and Diagnostic Features of Candidal Intertrigo

What are the characteristic signs of candidal intertrigo? The infection typically presents as:

  • Erythematous (red) and macerated plaques in skin folds
  • Peripheral scaling around the affected areas
  • Satellite lesions – small papules or pustules near the main infection site
  • Possible itching, burning, or discomfort in the affected areas

How is candidal intertrigo diagnosed? While the clinical presentation is often sufficient for diagnosis, confirmation may be obtained through:

  1. Fungal microscopy
  2. Culture of skin swabs and scrapings

Is a skin biopsy necessary for diagnosing candidal intertrigo? In most cases, a skin biopsy is not required for diagnosis. However, it may be performed if there is uncertainty or to rule out other conditions.

Differential Diagnosis: Conditions That Mimic Candidal Intertrigo

Which other skin conditions can be mistaken for candidal intertrigo? Healthcare providers must consider several differential diagnoses when evaluating a patient with suspected candidal intertrigo:

  • Tinea cruris (jock itch) and tinea pedis (athlete’s foot)
  • Contact dermatitis
  • Atopic dermatitis
  • Seborrheic dermatitis
  • Flexural psoriasis
  • Impetigo
  • Extramammary Paget disease
  • Herpes simplex infection
  • Hailey-Hailey disease

How can healthcare providers differentiate between candidal intertrigo and other skin fold infections? Careful examination of the lesion characteristics, distribution, and associated symptoms can help distinguish candidal intertrigo from other conditions. In some cases, laboratory tests or skin biopsies may be necessary for a definitive diagnosis.

Treatment Approaches for Candidal Intertrigo

What are the primary treatment strategies for candidal intertrigo? The management of this condition involves a multi-faceted approach:

  1. Addressing predisposing factors
  2. Maintaining skin dryness
  3. Topical antifungal therapy
  4. Systemic antifungal treatment in severe cases

Lifestyle Modifications and Preventive Measures

How can patients reduce their risk of developing candidal intertrigo? Implementing the following lifestyle changes can help prevent and manage the condition:

  • Weight loss for obese individuals
  • Blood glucose control for diabetic patients
  • Avoiding tight, occlusive clothing
  • Keeping skin folds cool and dry
  • Using talcum powder or other drying agents in susceptible areas

Topical Antifungal Treatments

Which topical medications are effective against candidal intertrigo? First-line pharmacological treatments often include:

  • Clotrimazole cream
  • Miconazole cream
  • Ketoconazole cream
  • Nystatin cream or powder

How should topical antifungals be applied for optimal effect? These medications should be applied to clean, dry skin in a thin layer, covering the affected area and a small margin of surrounding healthy skin. Treatment typically continues for 1-2 weeks after symptoms resolve.

Systemic Antifungal Therapy

When is oral antifungal treatment necessary for candidal intertrigo? Systemic therapy may be required in cases that are:

  • Severe
  • Widespread
  • Resistant to topical treatment
  • Recurrent

Which oral antifungal medications are commonly prescribed for candidal intertrigo?

  • Fluconazole
  • Itraconazole

How long does oral antifungal treatment typically last? The duration of therapy varies depending on the severity of the infection and the patient’s response to treatment, but it often ranges from 1-2 weeks.

Complications and Recurrence of Candidal Intertrigo

Can candidal intertrigo lead to complications if left untreated? While generally not life-threatening, untreated candidal intertrigo can cause significant discomfort and potentially lead to:

  • Secondary bacterial infections
  • Skin breakdown and ulceration
  • Chronic inflammation and scarring

How common is recurrence of candidal intertrigo? Recurrence is relatively common, especially in individuals with persistent risk factors. Implementing preventive measures and addressing underlying conditions are crucial for reducing the likelihood of recurrence.

Special Considerations for Candidal Intertrigo in Specific Populations

Are there unique challenges in managing candidal intertrigo in certain patient groups? Yes, some populations require special attention:

Infants and Young Children

How does candidal intertrigo present in infants? In babies, the infection often manifests as diaper rash, affecting the groin, buttocks, and skin folds. Treatment typically involves gentle cleansing, frequent diaper changes, and topical antifungal creams formulated for infants.

Elderly Patients

Why are older adults at increased risk for candidal intertrigo? Factors such as decreased mobility, incontinence, and age-related changes in skin integrity make the elderly more susceptible to this condition. Management often requires a multidisciplinary approach, addressing underlying medical conditions and optimizing skin care practices.

Immunocompromised Individuals

How does an impaired immune system affect the management of candidal intertrigo? Patients with compromised immunity may experience more severe or widespread infections, often requiring longer treatment durations and sometimes systemic antifungal therapy. Close monitoring and aggressive management are essential in this population.

Emerging Research and Future Directions in Candidal Intertrigo Management

What are some promising areas of research in the treatment of candidal intertrigo? Current investigations focus on:

  • Novel antifungal agents with improved efficacy and safety profiles
  • Topical formulations that enhance drug penetration and retention in skin folds
  • Probiotic therapies to restore normal skin flora and prevent Candida overgrowth
  • Innovative moisture-wicking fabrics and materials for individuals at high risk of intertrigo

How might future developments impact the management of candidal intertrigo? Advancements in these areas could lead to more effective prevention strategies, targeted treatments, and improved outcomes for patients suffering from this common fungal infection.

As research progresses, healthcare providers must stay informed about the latest developments in candidal intertrigo management to offer their patients the most up-to-date and effective care strategies. By combining emerging therapies with established preventive measures and treatment approaches, the burden of candidal intertrigo can be significantly reduced, improving quality of life for affected individuals.

Candidal Intertrigo — DermNet

Author: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, 2003. Update: Dr Thomas Stewart, General Practitioner, Sydney, Australia, November 2017.


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What is candidal intertrigo?

Candidal intertrigo refers to superficial skin-fold infection caused by the yeast, candida.

Candida intertrigo

Axillary candidosis

Submammary candidosis

Erosio-interdigitalis blastomycetica

See more images of candida intertrigo.

What causes candidal intertrigo?

Candidal intertrigo is triggered by a combination of the following factors:

  • The hot and damp environment of skin folds, which is conducive to the growth of candida species, particularly Candida albicans 
  • Increased skin friction
  • Immunocompromise.

Who gets candidal intertrigo?

Factors that increase an individual’s risk of developing candidal intertrigo include:

  • Occlusive clothing, gloves and footwear
  • Obesity
  • Excessive sweating (hyperhidrosis)
  • Incontinence causing irritant contact dermatitis (incontinence-associated dermatitis)
  • Diabetes mellitus
  • Immune deficiency conditions, such as human immunodeficiency virus infection (HIV) or immune suppression by medications (chemotherapy, systemic corticosteroids).

What are the clinical features of candidal intertrigo?

Candidal intertrigo classically presents as erythematous and macerated plaques with peripheral scaling. There are often associated superficial satellite papules or pustules.

Affected areas may include: 

  • Skin folds below the breasts or under the abdomen
  • Armpits and groin
  • Web spaces between the fingers or toes (erosio-interdigitalis blastomycetica).  

How is candidal intertrigo diagnosed?

Diagnosis of candidal intertrigo requires recognition of consistent clinical features. In cases of uncertainty, confirmation can be sought by way of fungal microscopy and culture of skin swabs and scrapings. Skin biopsy is usually not necessary.

What is the differential diagnosis for candidal intertrigo?

Other forms of intertrigo should be considered, including:

  • Tinea cruris (groin) and athlete’s foot (between toes)
  • Contact dermatitis
  • Atopic dermatitis
  • Seborrhoeic dermatitis
  • Flexural psoriasis
  • Impetigo
  • Extramammary Paget disease
  • Herpes simplex
  • Hailey Hailey disease.

How is candidal intertrigo treated?

  • Predisposing factors should be addressed primarily, such as weight loss, blood glucose control, and avoidance of tight clothing.
  • Patients should be advised to maintain cool and moisture-free skin. This may be aided by regular use of a drying agent such as talcum powder, especially if infection is recurrent.
  • Topical antifungal agents such as clotrimazole cream are recommended as first-line pharmacological treatments.
  • Severe, generalised and/or refractory cases may require oral antifungal treatments such as fluconazole or itraconazole.

 

References

  1. Yaar M, Gilchrest BA. Aging of skin. In: Fitzpatrick’s Dermatology in General Medicine, Freedberg IM, Eisen AZ, Wolff K, et al (Eds), McGraw-Hill, New York 2003. p.1386
  2. Garcia Hidalgo L. Dermatologic complications of obesity. Am J Clin Dermatol. 2002;3(7):497. PubMed.
  3. Jautova J, Baloghova J, Dorko E, et al. Cutaneous candiosis in immunosuppressed patients. Folia Microbiol. 2001;46(4):359. Journal full text  PDF file
  4. Ingordo V, Naldi L, Fracchiolla S. Prevalence and risk factors for superficial fungal infections among italian navy cadets. Dermatol.2004;209(3):190-6. PubMed.
  5. Klenk AS, Martin AG, Heffernan MP. Yeast infections: candidiasis, pityriasis (tinea) versicolor. In: Dermatology in General Medicine, Freedberg IM, Eisen AZ, Wolff K, et al (Eds), McGraw-Hill, New York 2003. p.2006.
  6. Sobera JO, Elewski BE. Fungal Diseases. In: Dermatology, Bolognia JL, Jorizzo JL, Rapini RP (Eds), Mosby, London 2003. p.1171.
  7. Guitart J, Woodley DT. Intertrigo: a practical approach. Compr Ther. 1994;20(7):402. PubMed.
  8. Runeman B. Skin interaction with absorbent hygiene products. Clin Dermatol. 2008;26(1):45. PubMed.
  9. Gray M. Optimal management of incontinence-associated dermatitis in the elderly. Am J Clin Dermatol. 2010;11(3):201. PubMed.
  10. Hay RJ. The management of superficial candidiasis. J Am Acad Dermatol. 1999;40(6 Pt 2):s35. PubMed.
  11. Metin A, Dilek N, Demireseven DD. Fungal infections of the folds (intertriginous areas). Clin Dermatol. 2015;33(4):437–47. PubMed.
  12. 12. Karla MG, Higgins KE, Kinney BS. Intertrigo and secondary skin infections. Am Fam Physician. 2014.89(1):569–73. PubMed.

On DermNet

  • Candida
  • Images of candida intertrigo 
  • Introduction to fungal infections
  • Laboratory tests for fungal infections
  • Treatment of fungal infections
  • Napkin dermatitis

Other websites

  • Cutaneous candidiasis — Medscape Reference

Books about skin diseases

  • Books about the skin
  • Dermatology Made Easy book

 

3 Symptoms, Diagnosis, and Management of Candida

 

*This course has been retired.

There is no replacement course at this time. Please click here to view the current ATrain course listings.

 

Clinical Symptoms

The clinical symptoms vary depending on the location affected by the yeast. From head to toe, the most common sites for fungal infections include the scalp, skin, mouth, gastrointestinal tract, genitourinary tract, vagina, and nail beds of the hands and feet. The most dangerous type of fungal infection is an invasive infection (or systemic infection) that enters the bloodstream; it is called candidemia.  Fungal infections that originate in the oral cavity and extend into the esophagus have a higher potential to become an invasive infection because they become systemic.

Classically, yeast infections look red, warm, sometimes scaly, and continue to spread if not treated. They can be itchy but not generally painful unless directly on the skin of the genitals and buttocks. They generally do not cause a fever but if not treated can cause a sense of malaise and gastrointestinal upset and bloating if in the GI tract. To review the specific symptoms, let’s look at each of them based on locations of the body.

Skin Infections

Topical skin infections include the scalp, head, face, back, chest, axilla, under the breast or in other skin folds, and anywhere on the body from head to toe. When a yeast infection develops on the skin it generally appears red, scaly and inflamed with symptoms of itching and burning, however unique configurations can occur that help diagnose the yeast. An example is the classic shape of a ringworm infection on the skin, called Tinea corporis. Ringworm is misnamed because there is no actual worm on the skin, rather the unique shape caused by the dermatophyte yeast. Superficial skin infections by yeast at the epidermis are caused by fungi called dermatophytes.

Internal Infections

Because yeast is very common as topical normal flora, skin infections can easily develop given the right environment. Additionally, the moist and warm internal environment of the body offers ideal growth for candida.

Vaginal Candidiasis

Speculum exam in candidal vulvovaginitis, showing thick, curd-like plaque on the anterior vaginal wall. A slightly erythematous base is visible close to the center of the image, where some of the plaque was scraped off. Mikael Häggström. Source: Wikimedia Commons. Creative Commons CC0 1.0 Universal Public Domain Dedication.

From head to toe, internal candida infections commonly occur in the mouth, known as oral thrush. It appears as a white sticky coating and can even appear hairy from the extensions of hyphae. It can be easily treated with an oral antifungal, such as a swish and swallow medication. Good oral hygiene for patients on ventilators and rinsing after taking an inhaled glucocorticoid can help prevent this.

Gastrointestinal yeast infections often present as GI bloating, nausea, vomiting, diarrhea and generalized malaise. In diets high in sugar, the GI yeast can easily grow and contribute to belly fat, constipation, poor metabolism of food, and further infection (García-Elorriaga & Rey-Pineda, 2013).

A very common internal yeast infection occurs in the vagina. Symptoms include vaginal itching, foul fishy odor, and white cottage-cheese–like discharge. Upon visualization using a speculum, it is easy to diagnose because of its white discharge. It can be cultured for definitive diagnosis, however, most clinicians will easily recognize it and treat it with antifungals intravaginally, or orally.

Skin yeast infections can also appear as a red, flat rash with scalloped edges. Satellite lesions are extensions of the original yeast that grow to extend the rash. As noted above, tinea infections are identified by their location on the body.

Diagnosing Candida

KOH Test on a Candida Specimen

KOH test on a vaginal wet mount showing slings of pseudohyphae of Candida albicans surrounded by vaginal epithelial cells conferring a diagnosis of candidal vulvovaginitis. Mikael Häggström. Source: Wikimedia Commons. Creative Commons CC0 1.0 Universal Public Domain Dedication.

Often a candida infection is easily identifiable but a definitive diagnosis can only be done via a microscope or culturing. A skin scraping or swab sampling can be placed under a microscope, which reveals the typical and classic hyphae or fern-like growths. A single drop of potassium hydroxide, KOH, is often added to the microscopic slide, which dissolves the human skin cell wall and exposes the yeast and identifiable hyphae.

When using the culture method, a simple sterile swab of the infected surface is wiped on the culture medium (e.g., a blood agar petri dish) and allowed to grow in an incubated temperature of 98.6ºF for several days. Yeast and bacterial colonies easily occur within 3 to 5 days. Because candida is part of the normal flora, identifying a true infection is based on the various candida species that may grow in an agar culture, the agar fermentation, and assimilation tests.

Agar Plate Culture of C. Albicans

Source: CDC Public Health Image Library. Public domain.

Clinicians can often recognize a yeast infection based on its location and classic morphology and do not order diagnostic tests but treat right away. For example, when a practitioner sees the classic ring worm formation a topical antifungal is ordered. Occasionally a clinician may observe the skin directly with an ultraviolet light known as a Wood’s lamp. The spores of the yeast become fluorescent with a Wood’s lamp and appear blue-green when exposed to ultraviolet light.

For invasive agents within the bloodstream, non-culture candida detection tests can be done with antigen testing such as the Beta-D-Glucan, or candida PCR, which detects candidal DNA. Candida heat-liable-antigen assays—D-arabinitol assay or D-inositol assay—can also be used based on the laboratory’s preference and equipment. Immunological tests such as skin tests can also be performed.

Treatment of Yeast

Prompt treatment is key to quick destruction of out of control yeast.

Pharmacological treatment of candida depends on the location. The severity of the fungal infection also dictates the type of antifungal to be used for treatment. An acute fungal infection on the skin can often easily be treated with topical antifungals, however if they have become extensive or chronic, often long-term topical agents in addition to oral agents need to be prescribed.

For most acute fungal skin infections, topical antifungals commonly used include:

  • Clotrimazole (Lotrimin, Mycelex)
  • Ketoconazole (Xolegel)
  • Miconazole (aloe vesta antifungal, azolen, baza antifungal, carrington antifungal, critic aid clear, cruex prescription strength, dermafungal, desenex, fungoid tincture, micaderm, micatin, micro-guard, miranel, mitrazol, podactin, remedy antifungal, secura antifungal)
  • Terbinafine (Lamisil)

Prescription topical agents for resistant or extensive infections may include:

  • Ciclopirox (Loprox, Penlac)
  • Ketoconazole (Nizoral)
  • Oxiconazole (Oxistat)

Administration of these antifungals are generally via a cream that is applied twice daily for 2 to 4 weeks. The length of application depends of course on the severity of the yeast and if the infection is acute or chronic. A topical ringworm infection may require treatment for 14 days, however a topical great-toenail fungal infection may require months of treatment and be very difficult to get rid of as the yeast have become embedded in the matrix of the nail.

For chronic yeast infections, an oral antifungal should be given and may include (Jaliman, 2019):

  • Fluconazole (Diflucan)
  • Griseofulvin (Fulvicin P/G, Fulvicin U/F, Grifulvin V, Gris-Peg): oral and spray. May need 8-10 weeks for effect. Cannot take during pregnancy or breastfeeding. May cause birth defects. Men should use condoms for up to six months after treatment to prevent birth defects.
  • Itraconazole (Sporanox): 1-2 weeks. Not for use in elderly and children with liver disease.
  • Ketoconazole (Nizoral)
  • Terbinafine (Lamisil): once daily x 4 weeks

All oral antifungals are processed by the liver’s first-pass effect, which may cause nausea, diarrhea, indigestion, headache, dizziness, and even rashes. These oral antifungals are contraindicated for those with liver disease and lupus.

For severe fungal infections that impact a mechanical device, prescription IV antibiotics that are used include:

  • Amphotericin
  • Azole antifungals
  • Echinocandins such as micafungin

Removal of the mechanic device or tube should also be a priority to avoid entry of the pathogen into the bloodstream.

Alternative medicines and folk medicine have been used to treat yeast infections. Although not endorsed by the American Medical Association, patients may be using these remedies and healthcare professionals should be aware of them. Many studies exist demonstrating the effectiveness of various essential oils(e.g., oregano oil) and even food substances (Alves-Silva, 2013). Studies have even shown effectiveness of apple cider vinegar against topical and intestinal yeasts.

Back Next

What does a fungal infection look like on a dog’s skin?

In the early stages of a yeast infection, the skin begins to turn pink or red. In chronic yeast infections, the skin can become leathery, thick, gray, or black. Oily skin. The skin may become oily or overly oily.

Superficial candidal skin infections appear as a red, flat rash with sharp, jagged edges. Small areas of a similar-looking rash known as “satellite lesions” or “satellite pustules” are usually found nearby. These rashes may be hot, itchy, or painful. Intertrigo looks like softened red skin in areas of body folds.

After diagnosing a yeast infection, your veterinarian will prescribe an antifungal medicine. It may include ointments such as miconazole, which are applied to the infected area. Your veterinarian may also suggest using a special antifungal shampoo to help relieve symptoms.

If only a small area is involved, it is probably not necessary to bathe the entire animal. To cleanse the affected area, you can use special wipes with acetic acid. Mixtures of vinegar and water (50:50) can be used, but the pet will have a distinct smell of vinegar.

Answer: Some of the most effective natural topical remedies that can be used to treat a mild Candida skin infection include apple cider vinegar, coconut oil, garlic, and tea tree oil. They are inexpensive, easy to use, and have minimal side effects.

The fastest way to get rid of a yeast infection is to see a doctor and get a prescription for fluconazole. OTC monistat (miconazole) and prophylaxis may also help.

A mild yeast infection can go away on its own, but this is rare. It’s always a good idea to treat a yeast infection, even if it’s mild. If yeast infections are not properly treated, they are more likely to return. Treatment for a yeast infection soothes the affected area and targets the overgrown Candida.

Common causes of yeast infection in dogs may include: Allergies. The most common cause of a yeast infection in dogs is an allergy to fleas, food, or substances in the environment. Allergies can irritate the skin and make the skin more oily. Some dogs can also develop an allergic reaction to yeast.

Bathe weekly with a natural anti-fungal shampoo if yeast appears on the armpits and other parts of the body. DO NOT USE OATMEAL on a yeast dog. Oatmeal is a grain that is a source of nutrition for yeast. After you have completely rinsed with water, rinse again with an antifungal agent.

Carbohydrates are complex chains made up of sugar molecules. Therefore, when your pet consumes carbs, they are broken down into sugar, which feeds the yeast. Therefore, avoid dog foods containing millet, oats, rice, peas, corn, wheat, and potatoes.

It can take up to six weeks for the infection to clear up. Your veterinarian may recommend a complete cleaning of your dog’s ear canal. If the problem is chronic, ask about special cleansers and ear dryers that you can use at home.

Probiotic yogurts are safe for both dogs and humans and can help with your gut health. Probiotics can help fight yeast infections in dogs that can cause skin and ear problems, boost immunity, and help your dog’s body absorb nutrients. … In general, natural yogurt is best, and probiotic yogurt is better instead.

Classification of mycoses

Disease group

Disease name

Exciters

Superficial mycoses

colorful
lichen

Black lichen
(cladosporiosis)

black piedra
(piedriaz)

white piedra
(trichosporosis)

Malassezia furfur

Hortaea werneckii

Piedraia hortae

Trichosporon beigelii

Dermatomycosis

Trichophytosis

Favus

Microsporia

Epidermophytosis
inguinal

Trichophyton spp.

Trichophyton
schoenlenii

Microsporum
spp.

Epidermophyton
floccosum

Subcutaneous (subcutaneous) mycoses

Sporotrichosis

Chromomycosis

Maduromycosis

Sporothrix schenckii

Fonsecaea spp., Phialophora
spp.

Acremonium
falciforme, Madurella
Grisea

Deep (systemic) mycoses

Coccidioidosis

Histoplasmosis

Blastomycosis

Cryptococcosis

Coccidioides immitis

Histoplasma
capsulatum

Blastomyces
dermatitidis

Cryptococcus
neoformans

Opportunistic mycoses

Aspergillosis

Penicilliosis

Zygomycosis

Fusarium

Candidiasis

Pneumocystosis

Aspergillus spp.

Penicillium spp.

Mucor, Rhizopus, Absidia
spp.

Fusarium spp.

Candida spp.

Pneumocystis carinii

Surface
mycoses (keratomycosis)

– cause keratomycetes, slightly contagious
fungi that infect the stratum corneum of the epidermis
and hair surface .

Exciter

Disease name

Malassezia furfur

(yeast-like)

(L.:
amphotericin B, azoles).

Multicolour
lichen (malasseziosis)

– appearance on the skin of the trunk, neck,
pinkish-yellow non-inflammatory hands
and hypopigmented spots.

Hortaea werneckii

(L . : antimycotics
local use).

Black lichen
(cladosporiosis)

formed on the palms and soles
black spots. Grows in the stratum corneum
epidermis in the form of budding cells
and fragments of brown, branched,
septate hyphae. Forms melanin.

Piedraia hortae

(L.:
topical antimycotics).

Black piedra
(piedriaz)

– appear on infected hair
dense black nodules with a diameter of 1 mm,
consisting of dark brown, septate
branching threads, 4-8 microns thick and
askov.

Trichosporon beigelii

(yeast-like)

(L.:
flucytosine, azoles; depilation
razor).

White piedra
(trichosporosis)

– infection of the hair shafts of the head,
mustache, beard. Formed around the hair
greenish-yellow hard shell
nodules, the cuticle of the hair is affected.

Dermatomycosis
(epidermophytosis)

-caused by dermatophytes or
dermatomycetes. Have septate
mycelium with arthroconidia, chlamydospores,
macro- and microconidia. Resistant to
drying and freezing. Trichophytons
remain in the hair up to 4-7 years. Are dying
at 100′ in 10-20 minutes. Sensitive to
the action of UV, alkali solutions,
formaldehyde, iodine. pathogens
transmitted through contact with a sick person
person or animal or through contact
with various environmental objects
environment, for example, through household items
(combs, towels), as well as in baths,
showers, swimming pools. Allocate anthropo-,
zoo, geophilic dermatophytes. pathogens
live on keratinized substrates
(keratinophilic fungi). development
diseases contribute to minor
skin lesions, maceration, weakened
immunity, increased sweating,
endocrine disorders and long-term
application of AB. Dermatophytes do not penetrate
beyond the basement membrane of the epidermis.
The skin is affected to varying degrees
hair and nails. affected by mushrooms
hair breaks off, develops
focal alopecia, baldness. Leather
flaky, vesicles, pustules appear,
cracks. Itching of lesions develops.
Inflammation is absent or may be
in expressed form. With fungal
nail infections – onychomycosis
(T.rubrum, T.interdigitale) change color,
transparency, thickness, surface,
strength and integrity of the nail
plates.

L.:

  • With dermatophytosis
    scalp – fluconazole,
    itraconazole, griseofulvin.

  • With dermophytosis
    nails carry out systemic (griseofulvin,
    lamisil, nizoral, diflucan) and topical
    antifungal therapy.

  • With dermatophytosis
    stop applying antifungal creams
    and ointments (lamisil, nizoral, mycospor) in
    combined when indicated with systemic
    therapy and antihistamines.

Disease name

Exciter

Trichophytosis
(ringworm)

allocate:

Anthroponotic
(superficial) trichophytosis

– pathogens T. tonsurans and T.violaceum – incub.
period of 1 week, children are more likely to get sick.
Infection – through close contact
with the patient or through household items.
Inflammation and flaking develop
center of oval skin lesions. Hair
are affected by the “endotrix” type and
break at the surface of the skin.

Zooanthroponic
(infiltrative suppurative)

– T.mentagrophytes (from mice and domestic
animals) – affects the hairy
part of the head, beard, nails, feet. IN
skin develops abscesses, granulomas.
Outside on the hair – arthroconidia
(“ectothrix”), the hair falls out.

Trichophyton spp.

Favus (scab)

rare chronic disease
mostly children. Anthroponosis.
Skin, hair and nails are affected.
Yellow fetid crusts form
(skutula) with clusters of spores and mycelium
fungus, epidermal cells and fat. Inside
affected hair – gas bubbles
and elements of the fungus: septate
mycelium, clusters of spores.

Trichophyton schoenlenii

Microsporia
(ringworm)

– a highly contagious disease
mostly children. Distinguish microsporia
scalp and microsporia
smooth skin. Around the hair are formed
clutches or covers from mosaically arranged
spore (“ecto- and endotrix”). source
diseases can serve people
(M.audouinii), animals (M.canis), soil (M.gypseum –
transmitted when tilling the soil bare
hands, causing gardeners’ microsporia.
Causes a purulent-inflammatory process
scalp (kerion)
ending in a week moderate
scarring).

Microsporum spp.

Epidermophytosis
inguinal

– the skin of the inguinal, axillary is affected
folds and shins, less often – skin
interdigital folds and and nail
stop plates. In flakes of skin
septate branching is detected
mycelium, rectangular arthrospores,
arranged in chains.

Epidermophyton floccosum

Subcutaneous (subcutaneous) mycoses
– pathogens
found in soil, wood or
dying, decaying plants. Infiltrating
in places of skin microtraumas (damages
splinter, thorn), they involve in the process
deep layers of the dermis, subcutaneous tissues,
muscles and fascia.

Exciter

Disease name

Sporothrix schenckii

(L.:

local
– potassium iodide;

system
– amphotericin B, itraconazole)

Sporotrichosis
(Schenk’s disease, illness of workers with
roses)

– chronic disease with localized
damage to the skin, subcutaneous tissue
and LU, damage to internal
organs. S.schenckii is a dimorphic fungus, in
the patient’s body grows in the yeast
shape (cigar-shaped oval cells
2-10 µm, + asteroid bodies 10-20 µm), on
growing medium in the form
septate mycelium. Infection –
through microtraumas of the skin, through
intact skin or contact with
lungs by aerogenic mechanism
(primary pulmonary sporotrichosis). On
an ulcer forms at the site of entry
irregular shape, nodules and abscesses.
Spread by lymphatics
– lymphocutaneous sporotrichosis. Sometimes
possible generalization of the disease.

Fonsecaea spp.

Phialophora spp.

(L.:

Itraconazole
5-flucytosine; surgical removal
affected areas)

Chromomycosis
(chromoblastomycosis)

– chronic granulomatous
inflammation with lesions of the skin, subcutaneous
leg tissue. Pathogens – often
dimorphic demacia fungi (form
brown-black colonies and the same
shade of the CS of the elements of the fungus, due to
the presence of melanin). infection
occurs when a pathogen enters
in microtraumas of the skin, more often on the feet and
shins. Within a few months
or years on the skin are formed warty
nodules, abscesses and scarring appear
changes. Around the primary lesion
convex satellites are formed
changes in the form of cauliflower.

Acremonium falciforme

Madurella
Grisea

(L .: Itraconazole;
possible resection of affected tissues)

Maduromycosis
(mycetoma, Madurese foot)

pathogens live in the soil and on
plants. Transferred to contact
by (also possible aerogenic
transmission with respiratory failure
pathways), infection occurs through
damaged skin. Gradually formed
papules, deep nodes and abscesses.
The destructive process
fascia, muscles and bones. Developing
fibrin tissue. More often damaged
lower limbs. The foot is swollen and
deformed.

Systemic pathogens (deep)
mycoses

Exciter

Disease name

Coccidioides immitis

(dimorphic
mushroom)

(L. :
amphotericin B, azoles)

Coccidioidosis
– endemic systemic mycosis with
predominantly respiratory
ways. Sapronose. Transfer mechanism –
aerogenic, the path is airborne.

Histoplasma capsulatum

(dimorphic
mushroom)

(L.:
amphotericin B, ketoconazole)

Histoplasmosis
– natural focal deep mycosis,
predominantly
respiratory tract injury. Sapronose.
The transmission mechanism is aerogenic, the way
– airborne dust. Susceptibility
high, but sick people and animals
not dangerous to others. Manifestations
histoplasmosis can range from
acute lung infection ending
spontaneous recovery to
chronic cavernous histoplasmosis
and generalization of the infection.

Blastomyces dermatitidis

(dimorphic
mushroom)

(L.:
amphotericin B, ketoconazole)

Blastomycosis
– chronic mycosis, primary
damaging the lungs, prone to
hematogenous dissemination in some
patients leading to skin lesions
and subcutaneous tissue, bones and
internal organs. Sapronose. Mechanism
transmission – aerogenic, path – air
dust. susceptibility is high, but
patients are not dangerous to others

Cryptococcus neoformans

(opportunistic
yeast fungus)

(L.:
amphotericin B, fluconazole)

Cryptococcosis
– subacute or chronic
disseminated mycosis observed
in persons with severe immunodeficiency.

Cryptococci
round, rarely oval
yeast cells 6-13 microns in size
(sometimes up to 20 microns), which are surrounded
capsule, the dimensions of which are
directly related to virulence
strain. Invasive forms are presented
yeast cells surrounded by
large capsule, giving them
significant sizes (up to 25 microns). Capsule,
as a pathogenicity factor, protects
pathogen from the action of phagocytes and
humoral protective factors,
non-specifically activates a subpopulation
T-suppressor and induces splitting
complement and serum opsonins.
They do not form toxins. Sapronose. Mechanism
transmission – aerogenic, path – air
dust.

Exciters
opportunistic mycoses

– conditionally pathogenic fungi of the genera
Aspergillus, Mucor, Penicillium, Fusarium, Candida (+ pathogens
pneumocystis pneumonia conditionally pathogenic
yeast-like pneumocystis fungi
Pneumocystis carinii) – They cause diseases
in persons with transplants, against the background of reduced
immunity, irrational long
AB therapy, hormone therapy, use
invasive research methods.
Found in soil, water, air,
rotting plants; are included in the n.m.f.
(for example, fungi of the genus Candida).

Main
pathogens of nosocomial infections

C.albicans ,
Aspergillus
spp.
,
Fusarium spp., Trichosporon spp., Malassezia spp.

Exciters
candidiasis (genus Candida)

cause superficial, invasive
and other forms of candidiasis (candidomycosis).

TO
the most important pathogenic species
include C. albicans, C.glabrata, C.crusei, C.parapsilosis,
C.lusitaniae.

Matt. and Fl.:
Mushrooms of the genus Candida consist of oval
budding yeast cells (4-8 microns),
pseudohyphae and septate hyphae. C.albicans
form chlamydospores
– thick-walled double-circuit large
oval spores. On simple nutrients
media at 22-27′ form yeast
pseudohyphae cells. in Candida tissue
grow in the form of yeast and pseudohyphae.

candida
are part of the n.m.f. person. Can
invade tissue (endogenous infection)
and cause candidiasis in patients with
weakened immune defenses. At
sexual transmission may develop
urogenital candidiasis. More often candidiasis
called C.albicans, which produces
protease
and integrin-like molecules for adhesion

and other virulence factors.

candida
can cause visceral candidiasis
various organs, systemic candidiasis,
superficial mucosal candidiasis
membranes, skin and nails, chronic
(granulomatous) candidiasis, allergy
for AG Candida.

Express D.:
IF method and other serological tests
used to detect antigens
exciter in the material.

L:

[Material for
research: plaque from mucous membranes
membranes, skin scales from the focus
lesions, sputum, urine, CSF, blood and
others]

  • Microscopic
    – in preparations stained according to the method
    Gram, Romanovsky-Giemsa, native
    preparations – unicellular are visible
    microorganisms round or oval
    forms.

  • Mycological
    – inoculation on Sabouraud agar, incubated at
    20′ and 37′. Colony growth starts at 2-3
    day, final formation
    colonies on day 5-6 (colonies are convex,
    shiny, creamy, opaque
    with different shades). Identification
    fungi of the genus Candida are carried out on the basis of
    cell morphology, type of filamentation
    and biochemical properties. candida
    uroinfection is established with
    detection of more than 10^5 colonies of Candida spp.