What are satellite lesions in yeast infections. How does candidal intertrigo develop. What are the symptoms of candidal intertrigo. How is candidal intertrigo diagnosed and treated. Who is at risk for developing candidal intertrigo. What are the clinical features of candidal intertrigo. How can candidal intertrigo be prevented.

Understanding Candidal Intertrigo: A Common Yeast Infection

Candidal intertrigo is a superficial skin-fold infection caused by the yeast Candida, most commonly Candida albicans. This condition thrives in warm, moist environments, making skin folds particularly susceptible. The infection presents as red, macerated plaques with scaling edges, often accompanied by satellite lesions – small pustules or papules surrounding the main affected area.

What are satellite lesions in yeast infections?

Satellite lesions are a hallmark of candidal infections. These small, isolated pustules or papules appear near the main infected area, resembling tiny islands around a larger landmass. Their presence is a key diagnostic feature, helping distinguish candidal intertrigo from other skin fold conditions.

Causes and Risk Factors of Candidal Intertrigo

Several factors contribute to the development of candidal intertrigo:

• Moisture and heat in skin folds
• Increased skin friction
• Compromised immune system

Individuals at higher risk include:

• Those who wear tight, occlusive clothing
• People with obesity
• Individuals who sweat excessively
• Those with incontinence
• Diabetics
• People with weakened immune systems (e.g., HIV patients or those on immunosuppressive medications)

How does candidal intertrigo develop?

Candidal intertrigo develops when the yeast Candida, normally present on the skin in small amounts, overgrows in warm, moist skin folds. The combination of heat, moisture, and friction creates an ideal environment for yeast proliferation. As the infection progresses, the skin becomes inflamed, leading to the characteristic redness and scaling.

Clinical Features and Symptoms of Candidal Intertrigo

Recognizing the symptoms of candidal intertrigo is crucial for prompt diagnosis and treatment. The condition typically presents with the following features:

• Erythematous (red) and macerated plaques in skin folds
• Peripheral scaling around the affected areas
• Satellite papules or pustules
• Itching, burning, or discomfort in the affected areas

What are the symptoms of candidal intertrigo?

The primary symptoms of candidal intertrigo include redness, itching, and a burning sensation in the affected skin folds. Patients may also experience a distinct odor and notice small, red bumps (satellite lesions) around the main infected area. In severe cases, the skin may crack or develop fissures, leading to increased pain and discomfort.

Common Locations for Candidal Intertrigo

Candidal intertrigo can occur in various skin folds throughout the body. The most commonly affected areas include:

1. Under the breasts (submammary region)
2. In the groin and inner thighs
3. In the armpits (axillary region)
4. Between the fingers or toes (interdigital spaces)
5. Under abdominal folds in individuals with obesity
6. In the gluteal cleft (between the buttocks)

Why are these areas more prone to candidal intertrigo?

These locations are particularly susceptible to candidal intertrigo due to their tendency to trap moisture and heat. The skin-to-skin contact in these areas also increases friction, creating an environment conducive to yeast overgrowth. Additionally, these regions often have reduced air circulation, further promoting the development of infection.

Diagnosis and Differential Diagnosis of Candidal Intertrigo

Diagnosing candidal intertrigo primarily relies on recognizing its characteristic clinical features. However, in some cases, additional tests may be necessary to confirm the diagnosis or rule out other conditions.

How is candidal intertrigo diagnosed?

Diagnosis of candidal intertrigo typically involves the following steps:

1. Clinical examination: A healthcare provider will inspect the affected areas, looking for the characteristic redness, scaling, and satellite lesions.
2. Skin scrapings or swabs: If there’s uncertainty, samples may be taken for fungal microscopy and culture to confirm the presence of Candida.
3. Wood’s lamp examination: In some cases, this ultraviolet light may be used to detect certain types of fungal infections, although it’s not always conclusive for Candida.
4. Skin biopsy: Rarely needed, but may be performed if other diagnoses are suspected.

It’s important to differentiate candidal intertrigo from other conditions that can affect skin folds, including:

• Tinea infections (e.g., jock itch, athlete’s foot)
• Contact dermatitis
• Atopic dermatitis
• Seborrheic dermatitis
• Flexural psoriasis
• Bacterial infections (e.g., impetigo)
• Extramammary Paget’s disease
• Herpes simplex infections
• Hailey-Hailey disease

Treatment Approaches for Candidal Intertrigo

Effective management of candidal intertrigo involves a combination of lifestyle modifications and antifungal treatments. The goal is to eliminate the infection, alleviate symptoms, and prevent recurrence.

How is candidal intertrigo treated?

Treatment for candidal intertrigo typically includes:

1. Topical antifungal medications: These are the first-line treatment and may include:
   • Azoles (e.g., clotrimazole, miconazole)
   • Allylamines (e.g., terbinafine)
   • Polyenes (e.g., nystatin)
2. Oral antifungal medications: For severe or resistant cases, oral antifungals like fluconazole or itraconazole may be prescribed.
3. Combination treatments: In some cases, a combination of antifungal and mild corticosteroid creams may be used to reduce inflammation and provide faster symptom relief.
4. Drying agents: Talcum powder or other moisture-absorbing powders can help keep the affected areas dry.

In addition to medication, patients are advised to:

• Keep the affected areas clean and dry
• Wear loose-fitting, breathable clothing
• Use absorbent materials to wick away moisture in skin folds
• Address underlying conditions (e.g., managing diabetes, losing weight if obese)

Prevention Strategies for Candidal Intertrigo

Preventing candidal intertrigo involves maintaining good hygiene and creating an environment that’s inhospitable to yeast growth. Here are some effective prevention strategies:

How can candidal intertrigo be prevented?

1. Maintain good hygiene: Wash affected areas daily with a mild soap and dry thoroughly.
2. Keep skin folds dry: Use absorbent powders or specialized drying products in susceptible areas.
3. Wear appropriate clothing: Choose loose-fitting, breathable fabrics that wick moisture away from the skin.
4. Manage underlying conditions: Control diabetes, lose weight if obese, and address any issues with excessive sweating.
5. Use preventive antifungals: For those prone to recurrent infections, periodic use of antifungal powders or creams may be recommended.
6. Avoid irritants: Use hypoallergenic products and avoid potential irritants in soaps, detergents, and personal care items.
7. Practice good hand hygiene: Wash hands regularly to prevent spreading the infection to other parts of the body.

Complications and Long-term Management of Candidal Intertrigo

While candidal intertrigo is generally not a serious condition, it can lead to complications if left untreated or if it occurs in individuals with compromised immune systems.

What are the potential complications of untreated candidal intertrigo?

Possible complications include:

• Chronic, persistent infection
• Spread of infection to other areas of the body
• Secondary bacterial infections
• Skin breakdown and ulceration in severe cases
• Systemic candidiasis in immunocompromised individuals (rare)

Long-term management of candidal intertrigo, especially for those prone to recurrent infections, may involve:

1. Regular use of preventive antifungal treatments
2. Ongoing lifestyle modifications to reduce risk factors
3. Regular medical check-ups to monitor for recurrence and address any underlying conditions
4. Education on early recognition of symptoms to facilitate prompt treatment

The Role of Diet and Probiotics in Managing Candidal Infections

While the direct impact of diet on candidal intertrigo is not well-established, some evidence suggests that dietary modifications and probiotic supplementation may play a role in managing overall Candida overgrowth.

Can diet and probiotics help prevent or manage candidal intertrigo?

While more research is needed, some potential dietary strategies include:

• Reducing sugar and refined carbohydrate intake, as these may promote yeast growth
• Incorporating antifungal foods like garlic, coconut oil, and oregano into the diet
• Consuming probiotic-rich foods or supplements to support a healthy balance of microorganisms on the skin and in the gut
• Ensuring adequate intake of nutrients that support immune function, such as vitamin C, vitamin D, and zinc

It’s important to note that while these dietary approaches may be beneficial for overall health, they should not replace conventional medical treatments for candidal intertrigo. Always consult with a healthcare provider before making significant changes to your diet or starting new supplements.

Special Considerations for Candidal Intertrigo in Different Populations

Certain populations may require special considerations when it comes to the prevention and treatment of candidal intertrigo.

How does the management of candidal intertrigo differ for various patient groups?

Different approaches may be necessary for:

1. Infants and young children:
   • Extra care in diaper areas to prevent diaper rash and candidal infections
   • Use of barrier creams and frequent diaper changes
   • Careful selection of antifungal products safe for pediatric use
2. Elderly individuals:
   • Additional attention to skin care, especially for those with limited mobility
   • Careful management of incontinence to prevent moisture-associated skin damage
   • Consideration of potential drug interactions with existing medications
3. Pregnant women:
   • Use of pregnancy-safe antifungal treatments
   • Extra vigilance in maintaining skin hygiene due to body changes and increased perspiration
4. Immunocompromised patients:
   • More aggressive treatment approaches may be necessary
   • Closer monitoring for potential systemic spread of infection
   • Consideration of prophylactic antifungal treatments in some cases

Healthcare providers should tailor their approach to each individual’s specific needs and risk factors, ensuring safe and effective management of candidal intertrigo across diverse patient populations.

Candidal Intertrigo — DermNet

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

toc-icon

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

Vulvovaginal Candidiasis – TeachMeObGyn

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Original Author(s): Grace Fitzgerald
Last updated: 22nd December 2017
Revisions: 9

Original Author(s): Grace Fitzgerald
Last updated: 22nd December 2017
Revisions: 9

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• 1 Pathophysiology
• 2 Risk Factors
• 3 Clinical Features
  • 3. 1 Symptoms
  • 3.2 Signs
• 4 Differential Diagnosis
• 5 Investigations
• 6 Management
• 7 Candidiasis in Pregnancy

Vulvovaginal candidiasis is a fungal infection of the lower female reproductive tract, commonly known as “thrush” or a “yeast infection”. The prevalence of vulvovaginal candidiasis peaks in women aged 20-40 and it is a highly common infection that most of the female population will experience on at least one occasion.

It is therefore important to consider the pathophysiology, diagnosis and clinical management of this infection, all of which will be discussed in this article.

Pathophysiology

The pathogen in 90% of candidiasis cases is the commensal organism Candida albicans. This particular yeast-like fungus characteristically replicates by budding and can be found as part of the body’s normal flora in the gastro-intestinal tract. Due to this, there are also instances of oral candidiasis in both men and women. For the purposes of this article however we will be focusing on candida infection of the female lower genital tract.

Candidiasis infections have been traditionally thought of as opportunistic infections. These infections exploit opportunities such as weakened host defences e.g. a compromised immune system or altered micro biota.

However, a new line of thinking proposes that symptomatic candidiasis infections may also be as a result of a hypersensitivity reaction to the commensal organism Candida albicans, with genetics and oestrogen levels also thought to play a role.

Note up to 20% of women may carry candida asymptomatically and do not require treatment. Also, a positive Candida swab does not necessarily mean that Candida is the cause of the woman’s symptoms.

By TeachMeSeries Ltd (2023)

Figure 1 – Commensal organism Candida albicans affecting the lower female reproductive tract

Risk Factors

• Pregnancy
• Diabetes
• Use of broad spectrum antibiotics
  • This can alter the normal vaginal micro-biota, allowing candida the opportunity to flourish and grow.
• Use of corticosteroids
  • The immunosuppressive action of corticosteroids can allow commensal candida the opportunity to thrive excessively.
• Immunosuppression or compromised immune system
  • For example in HIV or cancer patients. May be associated with a more advanced and potentially life-threatening candida infection, or recurrent candidiasis which is difficult to treat.

Clinical Features

Symptoms

Taking an appropriate history is essential. Symptoms that patients may complain of that are indicative of candidiasis include:

By TeachMeSeries Ltd (2023)

Figure 2 – Speculum exam showing a white curd-like plaque on the anterior vaginal wall.

• Pruritus vulvae
  • Itchiness of the vulva – which can extend to the perineal region in some women. This is usually a dominant symptom.
• Vaginal discharge
  • Usually white, curd-like and non-offensive in candida infections.
• Dysuria (superficial dysuria)

Signs

Signs on examination may reveal:

• Erythema and swelling of the vulva
• Satellite lesions
  • Red, pustular lesions with superficial white/creamy pseudomembranous plaques that can be scraped off.
• Curd-like discharge in vagina

Differential Diagnosis

Other infectious causes of the reported symptoms must be considered and eliminated. Common infectious differentials for candidiasis are:

• Bacterial vaginosis – In this case there is usually no soreness or irritation, however white discharge is present. The discharge can be offensive due to the bacterial cause of infection. Smear, microscopy and culture of discharge can be used to exclude and differentiate between diagnoses.
• Trichomonas vaginalis – The pathogen responsible for this infection is a flagellated protozoan. Patients may complain of vaginal soreness, pain when passing urine and a change in vaginal discharge. Vaginal discharge may change in a variety of ways, it can become thicker or thinner, frothy or yellow. Trichomonas vaginalis is treated with antibiotics rather than antifungals.
• Urinary Tract Infection – This infection also presents with dysuria and must be excluded.

Non-infectious causes should also be considered:

• Contact dermatitis – To gather more information to exclude or include this as a diagnosis it may be useful to enquire about changes in hygiene products.
• Eczema and psoriasis – Skin lesions and pruritus vulvae may be as a result of eczema and/or psoriasis, more information to indicate these differential diagnoses can be obtained through a detailed history.

It is also important to rule out diabetes mellitus as an underlying disorder. The likelihood of underlying diabetes can be evaluated by asking about symptoms of diabetes (polyuria, polydipsia and weight loss) in the history.

Investigations

No investigations are necessary if the history indicates an acute uncomplicated vulvovaginal candidiasis – defined as a sporadic case with mild to moderate symptoms likely to be due to Candida albicans and not associated with risk factors (such as pregnancy, diabetes and compromised immunity). However, measuring vaginal pH is recommended if the woman is examined.

In candidiasis cases that are not classified as ‘uncomplicated’ (for example, recurrent infection) a vaginal smear and microscopic investigation of the sample should be carried out. The presence of spores and mycelia are indicative of candida infection (although it is important to bear in mind that they may also be present in non-symptomatic women due to Candida albicans being a commensal organism).

Management

This article will be discussing the treatment of uncomplicated vulvovaginal candidiasis.

Both intravaginal clotrimazole and oral fluconazole can be purchased over-the-counter. Topical azoles are usually oil-based therefore may weaken latex condoms.

Full management recommendations cane be accessed here (NICE Clinical Knowledge Summaries).

If symptoms have not subsided in 7-14 days, advise the patient to return to seek medical attention. In cases of failure to clear the infection:

• Consider alternative diagnoses by measuring vaginal pH and taking a vaginal swab for microscopy and culture.
• Consider predisposing risk factors and attempt to address them. For example, in the case of a diabetic woman, better control of her diabetes could improve the treatment of vaginal candidiasis or make cases less frequent.
• Consider the patient’s concordance with the medication and reasons why concordance may have been poor. Also assess whether medication has been administered correctly.

If treatment continues to fail and symptoms persist, or if non-albicans Candida species has been identified, referral to a specialist is recommended.

It is worth discussing with the patient ways to best avoid recurrence of candidiasis. Advise using soap substitutes and avoid cleaning the vaginal area more than once a day, avoid potential irritants e.g. shower gels, vaginal deodorants, douches and avoid wearing tight fitting underwear/tights.

Candidiasis in Pregnancy

Oestrogen levels are thought to have an impact on the likelihood of developing a candidiasis infection by stimulating increased glycogen production, this provides a more favourable environment for microorganisms to thrive. It is also thought that oestrogen may have a direct influence on the candida organism by promoting its growth and encouraging it to ‘stick’ to the walls of the vagina. Increased levels of oestrogen in pregnancy could mean that candida infections are more likely in some women.

Management of candidiasis in pregnancy:

• Treat infection with intravaginal antifungal (e.g. clotrimazole)
• Do not give oral antifungals such as fluconazole and itraconazole
• Treat vulval symptoms with topical antifungal
• Advise the patient to be careful to avoid physical damage when inserting intravaginal treatment applicator
• When taking history note of any evidence of sexually transmitted diseases, as many STIs can affect the pregnancy. Refer to GUM (genito-urinary medicine) clinic if STI is suspected.
• Advise patient to return if symptoms have not resolved within 7-14 days

Further information for management of candidiasis in pregnancy can be found here.

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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

Surface
mycoses (keratomycosis)
– cause keratomycetes, slightly contagious
fungi that infect the stratum corneum of the epidermis
and hair surface .

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.

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.

Systemic pathogens (deep)
mycoses

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.