Yeast Infection | Johns Hopkins Medicine

What is a yeast infection?

Yeast is a fungus normally found on your skin. It’s also found in your digestive system. If you’re a woman, you also have yeast in your vaginal area. When too much yeast grows on your skin or other areas, it can cause an infection. This infection is also called candidiasis.

What causes a yeast infection?

A yeast infection can happen if your skin gets damaged. Yeast can also “overgrow” in warm or humid conditions. An infection can also happen if you have a weak immune system. Taking antibiotics can also cause an overgrowth of yeast. That’s because antibiotics kill the healthy bacteria in your body that normally keep the yeast in balance.

What are the risk factors for yeast infection?

Anyone can get a yeast infection. Those at higher risk for it include:

• Infants
• People who wear dentures
• People taking antibiotics
• People getting cancer treatment
• People with other health conditions, such as HIV or diabetes

What are the symptoms of a yeast infection?

The symptoms of a yeast infection depend on where it is located in the body. The chart below shows the most common symptoms of a yeast infection. But yours may be slightly different.

The symptoms of a yeast infection may look like other skin conditions. Always see your healthcare provider for a diagnosis.

How is yeast infection diagnosed?

Your healthcare provider will ask about your symptoms and medical history. He or she will also give you a physical exam. He or she may scrape off a bit of skin or remove part of a nail and examine it to confirm the diagnosis.

How is yeast infection treated?

Your healthcare provider will consider your age, overall health, how widespread the infection is and other factors to determine your treatment.

Yeast infections can be easily treated with ointments or other anti-yeast (antifungal) creams.

• Yeast infections of the vagina or penis can be treated with creams or medicated suppositories. Sometimes an oral anti-yeast medicine is used.
• Yeast infection in the mouth (thrush) may be treated with a medicated mouthwash. Or it may be treated with lozenges that dissolve in the mouth.
• If you have a severe infection and have a weak immune system, you may need to take an oral anti-yeast medicine.
• Esophageal yeast infections are usually treated with oral or intravenous anti-yeast medicines.
• Yeast infections of the nails are treated with an oral anti-yeast medicine.
• Yeast infections in the skin folds can be treated with anti-yeast powders.

Can a yeast infection be prevented?

You can prevent some yeast infections by doing these things:

• Use good oral hygiene to help prevent yeast infection in your mouth (thrush). This includes brushing and flossing your teeth every day and using mouthwash as needed.
• Wear cotton underwear to help to prevent a vaginal or genital yeast infection. If you are a woman and get vaginal yeast infections often, you may want to take probiotics.
• Keep areas where skin rubs up against skin dry and try to reduce friction.

When should I call my healthcare provider?

If you get symptoms of infection, such as warm, reddened skin or drainage, tell your healthcare provider. A secondary bacterial infection can happen, so monitor for spreading redness, or swelling, or pain.

Key points about yeast infection

• Yeast infection is caused by yeast on the skin or mucous membranes.
• The symptoms of a yeast infection depend on where it happens on your body. Common symptoms are a rash, white discharge, or itching.
• Yeast infections are treated with medicated ointments or other anti-yeast (antifungal) preparations.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Yeast Skin Infection | Michigan Medicine

Topic Overview

What is a yeast skin infection?

A yeast infection is usually caused by a fungus called Candida albicans. This kind of yeast naturally lives on your skin. When too much yeast grows, it is called a yeast skin infection.

Yeast skin infections tend to happen in skin-to-skin areas. These include the underarms, as well as skin folds under the breasts, neck, belly, or groin.

What causes a yeast skin infection?

Things that make it easier for too much yeast to grow include:

• Warm and moist areas on the body.
• Tight-fitting, “nonbreathable” clothing that keeps moisture on the skin.
• Antibiotic use.
• Certain health problems, such as diabetes, that weaken the body’s immune system.

What are the symptoms?

The most common symptoms of a yeast skin infection are:

• Red, scaly, moist patches on the skin.
• Itching or burning.
• Irritation or tenderness.

How is a yeast skin infection diagnosed?

A yeast skin infection can often be diagnosed based on how it looks and feels. Sometimes a KOH test or culture is done to be sure that yeast is the cause.

How is it treated?

A yeast skin infection is treated with an antifungal medicine. Your doctor may give you a prescription for the cream or ointment. Or you may be able to buy it over the counter at a drugstore. Examples of these medicines are miconazole and clotrimazole.

If the infection is severe, your doctor may prescribe antifungal pills.

A yeast infection usually goes away after about a week of treatment. But it’s important to use the medicine for as long as your doctor tells you to.

To help keep yeast growth under control, keep your skin clean and dry. Wear loose clothing. Your doctor may suggest a powder that contains an antifungal medicine. You only need to apply it in problem areas, such as skin folds.

Credits

Current as of: July 2, 2020

Author: Healthwise Staff
Medical Review: Kathleen Romito MD – Family Medicine
Martin J. Gabica MD – Family Medicine
Adam Husney MD – Family Medicine
Adam Husney MD – Family Medicine

Current as of: July 2, 2020

Author:
Healthwise Staff

Medical Review:Kathleen Romito MD – Family Medicine & Martin J. Gabica MD – Family Medicine & Adam Husney MD – Family Medicine & Adam Husney MD – Family Medicine

Intertrigo and Secondary Skin Infections

1. Scott TD.
Intertrigo [handout]. J Dermatol Nurses Assoc.
2010;2(5):226….

2. Klenk AS, Martin AG, Heffernan MP. Yeast infections: candidiasis, pityriasis (tinea) versicolor. In: Fitzpatrick TB, Freedberg IM, eds. Fitzpatrick’s Dermatology in General Medicine. 6th ed. New York, NY: McGraw-Hill; 2003:2006.

3. Janniger CK,
Schwartz RA,
Szepietowski JC,
Reich A.
Intertrigo and common secondary skin infections. Am Fam Physician.
2005;72(5):833–838.

4. James WD, Elston DM, Berger TG, Andrews GC, eds. Andrews’ Diseases of the Skin: Clinical Dermatology. 11th ed. London, United Kingdom: Saunders/Elsevier; 2011.

5. Yosipovitch G,
DeVore A,
Dawn A.
Obesity and the skin: skin physiology and skin manifestations of obesity. J Am Acad Dermatol.
2007;56(6):901–916.

6. Seale P,
Lazar MA.
Brown fat in humans: turning up the heat on obesity. Diabetes.
2009;58(7):1482–1484.

7. Del Rosso JQ,
Draelos ZD,
Jorizzo JL,
Joseph WS,
Ribotsky BM,
Rich P.
Modern methods to treat superficial fungal disease. Cutis.
2007;79(2 suppl):6–29.

8. Fitzpatrick TB, ed. Color Atlas and Synopsis of Clinical Dermatology: Common and Serious Diseases. 3rd ed. New York, NY: McGraw-Hill; 1997.

9. Lipsky BA.
Medical treatment of diabetic foot infections. Clin Infect Dis.
2004;39(suppl 2):S104–S114.

10. Boulton AJ,
Vileikyte L,
Ragnarson-Tennvall G,
Apelqvist J.
The global burden of diabetic foot disease. Lancet.
2005;366(9498):1719–1724.

11. Guitart J,
Woodley DT.
Intertrigo: a practical approach. Compr Ther.
1994;20(7):402–409.

12. Black JM,
Gray M,
Bliss DZ,

et al.
MASD part 2: incontinence-associated dermatitis and intertriginous dermatitis: a consensus. J Wound Ostomy Continence Nurs.
2011;38(4):359–370.

13. Sundaram SV,
Srinivas CR,
Thirumurthy M.
Candidal intertrigo: treatment with filter paper soaked in Castellani’s paint. Indian J Dermatol Venereol Leprol.
2006;72(5):386–387.

14. Habif TP, et al., eds. Skin Disease: Diagnosis and Treatment. 3rd ed. Edinburgh, Scotland: Saunders; 2011.

15. Honig PJ,
Frieden IJ,
Kim HJ,
Yan AC.
Streptococcal intertrigo: an under-recognized condition in children. Pediatrics.
2003;112(6 pt 1):1427–1429.

16. Gupta AK,
Madzia SE,
Batra R.
Etiology and management of seborrheic dermatitis. Dermatology.
2004;208(2):89–93.

17. Holdiness MR.
Management of cutaneous erythrasma. Drugs.
2002;62(8):1131–1141.

18. Stulberg DL,
Penrod MA,
Blatny RA.
Common bacterial skin infections. Am Fam Physician.
2002;66(1):119–124.

19. Chadbourne EB,
Zhang S,
Gordon MJ,

et al.
Clinical outcomes in reduction mammaplasty: a systematic review and meta-analysis of published studies. Mayo Clin Proc.
2001;76(5):503–510.

20. Runeman B.
Skin interaction with absorbent hygiene products. Clin Dermatol.
2008;26(1):45–51.

21. Gray M.
Optimal management of incontinence-associated dermatitis in the elderly. Am J Clin Dermatol.
2010;11(3):201–210.

Fungal Groin Infection (Tinea Cruris) | Symptoms and Treatment

Fungal groin infection (tinea cruris) is an infection of the groin caused by a fungus. It is a common problem, particularly in athletes and in the elderly. Treatment with an antifungal cream usually works well. The tips given below may help to prevent recurrences.

What is fungal groin infection and how do you get it?

Fungal groin infection (tinea cruris)

By Robertgascoin, via Wikimedia Commons

By Robertgascoin (Own work), via Wikimedia Commons

Fungal groin infection (tinea cruris) is a fungal skin infection of the groin. Some types of fungal germs (fungi) are commonly found on human skin. They usually do no harm. However, if conditions are right they can ‘invade’ the skin, multiply and cause infection. The conditions fungi like best are warm, moist and airless areas of skin, such as the groin, under the arms and under the breasts.

What are the symptoms of fungal groin infection?

Typically the groin becomes itchy and a bit sore, mainly in the crease between the top of the leg and the genitals. It is more common in men and the scrotum may also be itchy. Red, slightly scaly skin then develops in the groin, usually with a definite edge or border. Both sides are commonly affected. The rash often spreads a short way down the inside of both thighs.

Sometimes the infection spreads to the skin on other parts of the body (or may have first started in another area, such as athlete’s foot (tinea pedis)). Fungal infections do not usually go deeper than the skin into the body and are not usually serious.

What is the treatment for fungal groin infection?

You can buy an antifungal cream from pharmacies, or obtain one on prescription. There are various types and brands – for example, terbinafine, clotrimazole, econazole, ketoconazole and miconazole. These modern creams are good at clearing fungal skin infections.

• Apply the cream to the surrounding 4-6 cm of normal skin in addition to the rash.
• Apply for as long as advised. This varies between the different creams, so read the instructions carefully.
• For skin that is particularly inflamed, your doctor may prescribe an antifungal cream combined with a mild steroid cream. This would normally be used for no more than seven days. You may need to continue with an antifungal cream alone for a time afterwards. The steroid reduces inflammation and may ease itch and redness quickly. However, the steroid does not kill the fungus and so a steroid cream alone should not be used.

An antifungal medicine taken by mouth is sometimes prescribed if the infection is widespread or severe – for example, terbinafine, griseofulvin, or itraconazole tablets.

You can read more about treatments for fungal infections in the separate leaflet called Antifungal Medicines.

Photographs showing the typical appearance of fungal groin infection (tinea cruris) and showing  how it is treated with an antifungal cream until it is almost gone are available in our Further Reading and References section, below.

Preventing recurring fungal groin infection

• Wash your groin daily; then dry thoroughly. Drying is perhaps the most important point. It is easy to put on underwear when your groin is not quite dry. The damp groin is then an ideal site for fungal germs (fungi) to multiply. (A hairdryer is useful if you have hairy groins.)
• Change underwear daily. Fungi may multiply in flakes of skin in unwashed underwear.
• Check for athlete’s foot (tinea pedis) and treat it if you have it. Athlete’s foot is a common fungal infection of the toes. In a typical case of athlete’s foot, the skin between the toes is itchy and flaky – especially between the outer two toes. The fungi from athlete’s foot may spread to the groin. The same creams are used to treat athlete’s foot and fungal groin infection (tinea cruris).
• Do not share towels with people in communal changing rooms. Wash towels frequently.
• Keep your own towel when you have a fungal skin infection to reduce the chance of passing on the fungus to others.

Identifying and Managing Fungal Skin Infections

Fungal skin infections typically will not go away by themselves and may spread if not appropriately managed.¹ Fungal skin infections are common worldwide diseases; an estimated 20% to 25% of the world’s population suffers from one of them.¹ The most common infections in prepubertal children are ringworm on the scalp (tinea capitis) or the body (tinea corporis). In adolescents and adults, the most common infections are jock itch (tinea cruris) and athlete’s foot (tinea pedis) (figure).³

Fungal skin infections are more likely to develop in people living in tropical climates or who wear tight, nonbreathable clothing. Obese individuals or persons with diabetes also are at higher risk.¹

ATHLETE’S FOOT (TINEA PEDIS)

What Is It?

Athlete’s foot, the most common fungal skin infection, occurs when feet perspire and warm moisture accumulates, especially on the skin in the areas between the toes.⁴ The genus Trichophyton, a fungus, is the most common cause. Risk factors include wearing tight shoes or exposing one’s feet to the floors of communal showers or bathrooms where others walk barefoot.² The 3 most common presentations are interdigital, moccasin, and inflammatory.¹

Signs and Symptoms

Interdigital: The most common type of athlete’s foot, it typically occurs between the toes. The skin there may peel, crack, or become red and itchy.¹

Moccasin: This form thickens the skin on the sole and sides of the foot. The thickened skin becomes dry and may crack.¹

Inflammatory: Less common than the other forms, this type typically presents as fluid-filled blisters, possibly uncomfortable or painful, on the bottom of the feet. They may also appear between the toes, on top of the foot, or on the heel.¹

Treatment

Athlete’s foot is generally well managed with topical antifungal creams, such as terbinafine or butenafine. Patients who are predisposed to severe forms of athlete’s foot should consult a physician about taking oral medications such as itraconazole or terbinafine tablets. Susceptible patients include those who have the moccasin or inflammatory presentation, are unresponsive to topical treatment, or have diabetes.^3,4 See table for more medication information. To help eliminate the infection and prevent recurrence, patients should wear wide, permeable footwear, frequently change socks, and manually dry the skin in between the toes after bathing.^3,4

JOCK ITCH (TINEA CRURIS)

What Is It?

This fungal skin infection involves the upper inner thighs and usually occurs in young males in whom moisture tends to accumulate between the scrotum and thigh. Though jock itch may occur on 1 or both sides of the thighs, the scrotum is minimally affected.3 Trichophyton is the most common cause of jock itch. Risk factors include living in a warm climate, often wearing moist or tight clothing, and being obese.²

Signs and Symptoms

Jock itch presents as a rash with a scaly, pink border, which may become itchy and painful.² To distinguish jock itch from erythrasma, a bacterial skin disease, a clinician may perform a test called a Wood’s lamp examination; erythrasma, but not jock itch, will produce a coral red fluorescence.³

Treatment

Jock itch is managed with topical antifungal creams, lotions, or gels, such as terbinafine, ketoconazole, miconazole, clotrimazole, naftifine, and potentially ciclopirox.^2,4 Patients who do not respond to these medications or have inflamed, widespread infections should consult a doctor about taking oral medications such as itraconazole or terbinafine tablets (table). ²

BODY RINGWORM (TINEA CORPORIS)

What Is It?

Body ringworm can form anywhere on the skin and spread to other body parts, and to other people in close bodily contact with the original patient. Fungi such as those in the genera Trichophyton or Microsporum typically cause this infection.⁴

Signs and Symptoms

Body ringworm presents as pink or red patches that have scaly borders and a clear center. These “rings” generally range from 1 cm to 5 cm in width, but can be larger. Body ringworm— sometimes itchy or uncomfortable—may be mistaken for other dry-skin conditions such as eczema or psoriasis. To determine the diagnosis, a clinician can examine a sample of infected tissue treated with potassium hydroxide preparation under a microscope, looking for the telltale fungus.³

Treatment

For mild to moderate body ringworm, treatment involves topical anti-fungals such as ciclopirox, naftifine, or terbinafine. ⁴ Patients who do not respond to these treatments or have other debilitating diseases should consult a physician about taking oral medication such as itraconazole or terbinafine tablets (table).²

SCALP RINGWORM (TINEA CAPITIS)

What Is It?

Highly contagious, scalp ringworm most commonly occurs in children, particularly children of African heritage aged 3-9 years.^{3, 4} Trichophyton fungus causes about 95% of cases.³

Signs and Symptoms

Early signs include a dry, itchy rash on the head. Sometimes, there may be patches of hair loss or flaking that resembles dandruff. The classical presentations of scalp ringworm, however, are “black dot”—in which hair shafts break at the scalp surface—and “gray patch”—in which hair shafts break above the surface, leaving short stubs.2,3

Scalp ringworm may progress to form a kerion—a large, swollen, painful patch that crusts and oozes pus. Kerions develop when the body’s immune system reacts to the fungus and tries to attack it.⁴ The infected patient may also present with swollen, enlarged lymph nodes, a factor that helps clinicians differentiate scalp ringworm from other dry skin conditions.^1,3

Treatment

Scalp ringworm must be treated with systemic anti-fungal medications because topical, external options will not penetrate the hair shaft.^1,3 Systemic options include terbinafine (better for those infected with Trichophyton) or griseofulvin (better for Microsporum).⁵ Patients who are not documented with Trichophyton and develop a kerion must be promptly treated with griseofulvin; failure to do so may result in scarring or hair loss.³ A short course of a corticosteroid like prednisone is appropriate for severe lesions or kerions.⁴

Along with taking medication, patients must wash with 1% or 2.5% selenium or 2% ketoconazole shampoo at least twice a week to reduce transmission. While children may attend school during treatment, imidazole or ciclopirox cream should be applied to their affected scalp areas to minimize the chance of infecting others.⁴

WHEN SHOULD A PATIENT TALK TO A DOCTOR?

While over-the-counter topical antifungals are appropriate first choices for mild skin infections known to be fungal, an affected patient should contact a physician if adverse effects are noted, if symptoms have not improved after the recommended treatment duration (typically 2-4 weeks), or if there is any doubt about the nature of the infection. A physician may perform examinations to confirm or change the diagnosis, and, if necessary, prescribe stronger oral antifungal medications or anti-inflammatory corticosteroids. Patients with diabetes or another immunocompromising condition should speak with a physician before initiating any antifungal treatment.^6-11

REFERENCES

1. Salmon N, Fuller C. Fungal skin infections: current approaches to management. Prescriber. 2013;24(9):31-37. doi: 10.1002/psb.1046.

2. Aaron DM. Overview of fungal skin infections. Merck Manual Consumer Version website. www.merckmanuals.com/home/skin-disorders/fungal-skin-infections/ overview-of-fungal-skin-infections. Updated April 2017. Accessed June 15, 2017.

3. Ely JW, Rosenfeld S, Seabury Stone M. Diagnosis and management of tinea infections. Am Fam Physician. 2014;90(10):702-710.

4. Aaron DM. Overview of dermatophytoses. Merck Manual Professional Version website. www.merckmanuals.com/professional/dermatologic-disorders/ fungal-skin-infections/overview-of-dermatophytoses. Updated April 2017. Accessed June 15, 2017.

5. Elewski BE, Cáceres HW, DeLeon L, et al. Terbinafine hydrochloride oral granules versus oral griseofulvin suspension in children with tinea capitis: results of two randomized, investigator-blinded, multicenter, international, controlled trials. J Am Acad Dermatol. 2008;59(1):41-54. doi: 10.1016/j.jaad.2008.02.019.

6. Terbinafine hydrochloride cream [package insert]. Parsippany, NJ: Novartis Consumer Health, Inc; 2008.

7. Lexicomp Online database. https://online-lexi com.proxy.libraries.rutgers.edu/ lco/action/doc/retrieve/docid/patch_f/750. Accessed June 7, 2017.

8. Butenafine hydrochloride cream [package insert]. Whitehouse Station, NJ: Bayer HealthCare LLC; 2017.

9. Miconazole nitrate cream [package insert]. Sarasota, FL: WellSpring Pharmaceutical Corporation; 2010.

10. Clotrimazole cream [package insert]. Woonsocket, RI: CVS Pharmacy; 2013.

11. Naftifine hydrochloride cream [package insert]. Hayward, CA: Impax Generics; 2017.

Lydia Chou, PharmD, is a graduate from Rutgers University’s Ernest Mario School of Pharmacy.

Male groin – irritation and infection

Irritation in the groin is painful and annoying. It can be caused by many different things, including:

• getting sand in your swimming costumes or board shorts
• a build-up of sweat after exercise
• excess rubbing to the area such as through exercise or sex
• lubricants and spermicides
• latex products, such as condoms
• soaps, shower gels, shampoos, deodorants or hygiene sprays
• disinfectants, antiseptics and ointments
• washing powders or liquids
• new underwear, especially if it is not made from cotton

Irritation can also be due to:

You can ease some of the irritation by using a cool compress or an ice pack — ice packs should never be placed directly on the skin, but should be wrapped in something soft like a tea towel.

If you have broken skin or sores, don’t put on any cream or lotion until you have checked with your doctor.

If you are in pain, get advice on medicines you can take. A pharmacist can advise on soothing creams and lotions.

Don’t use any cream or lotion you already have at home until you have discussed your problem with a doctor or pharmacist.

Groin infections

Groin infections can be caused by a fungus (known as tinea or ‘jock itch’), by sexually transmitted infections like herpes, or by other types of infections.

Some skin infections will clear up by themselves if you keep the area clean and dry. But if you have a groin infection that you have not had before, it would be wise to see a doctor or go to a sexual health clinic.

A mild case should clear up quickly with an over the counter ointment from a pharmacy. However, if it is hard to treat you may need a prescription medicine.

If you have a sexually transmitted infection, you may need antibiotics or other medicine. If you have been told you have a sexually transmitted infection, tell any sexual partner so they can also be examined and treated as necessary. Avoid sexual contact until your doctor says it is OK.

Other causes of groin irritation such as pubic and body lice or scabies need to be treated with medicated creams or washes. Talk to your doctor.

If the cause of the irritation is an allergy, antihistamines can help but you will need to try to avoid the trigger in future. You can ease some of the discomfort of an infection by keeping the area clean and dry.

Clean the area in lukewarm water at least twice a day. Dry carefully and then apply any cream you have been given by your doctor or pharmacist according to their instructions. Wash your hands before and after cleaning.

Do not share towels.

If you are in pain, get advice on pain relief medicines you can take.

Not sure what to do next?

If you are still concerned about your groin irritation and infection, check your symptoms with healthdirect’s online Symptom Checker to get advice on when to seek medical attention.

The Symptom Checker guides you to the next appropriate healthcare steps, whether it’s self care, talking to a health professional, going to a hospital or calling triple zero (000).

Vaginal thrush – Better Health Channel

About vaginal thrush

Vaginal thrush is a common infection caused by an overgrowth of the yeast Candida albicans. This yeast lives naturally in the bowel and in small numbers in the vagina. It’s mostly harmless, but symptoms can develop if yeast numbers increase. 

About 75% of women will have vaginal thrush in their lifetime. Other names for this infection are candidiasis or monilia. 

Symptoms can include vaginal itching or burning, a white discharge and stinging or burning while urinating. Vaginal creams or vaginal tablets (pessaries) can help reduce the symptoms of thrush. Thrush can also occur in other parts of the body, such as the mouth. 

Symptoms of vaginal thrush

Symptoms you may experience if you develop vaginal thrush include: 

• vaginal discomfort – itching or burning
• a thick, white discharge with a ‘cottage cheese’ appearance and yeasty smell
• redness or swelling of the vagina or vulva
• splits in the genital skin
• stinging or burning while urinating or during sex.

Diagnosis of vaginal thrush

To make a diagnosis of vaginal thrush, your GP will need to: 

• take a detailed history of your symptoms 
• examine your genitals
• take a swab from the affected area.

Thrush is not sexually transmitted

Vaginal thrush is not a sexually transmitted infection (STI). It’s caused by an overgrowth of the yeast Candida albicans, which is normally found on the genital skin. This overgrowth may occur due to: 

• recent antibiotic use
• oral contraceptive use
• pregnancy
• menstrual cycle changes
• general illnesses like diabetes, iron deficiency and immune system disorders
• associated vulval skin conditions, such as eczema.

Sometimes, the reason for candida overgrowth can’t be identified.

Treatment for vaginal thrush

Treatment aims to reduce the number of yeasts so they no longer cause symptoms. Options that are available from your local pharmacist without a prescription include: 

• antifungal creams or vaginal pessaries (tablets) – these are put inside the vagina with a special applicator and are used from one to six days, depending on the product. Occasionally a second course of treatment is required. Repeated topical treatments (applied to the skin) may occasionally cause skin irritation
• oral tablets – this treatment is more expensive than other options and is not recommended for pregnant women or as a ‘first line’ treatment. If you are on other medications or are pregnant, consult with your doctor or pharmacist before taking oral medication for thrush.

Sometimes symptoms only last for a short time (for example, the week before your period) and treatment is not necessary. 

Prevention of vaginal thrush

To help prevent vaginal thrush: 

• Wipe your bottom from front to back after going to the toilet. This will prevent the spread of Candida albicans from the anus to the vagina.
• Avoid using soap to wash the genital area. Soap substitutes can be used. 
• Avoid using antiseptics, douches or perfumed sprays in the genital area.
• Avoid using perfumed toilet papers and menstrual products.
• Avoid wearing tight-fitting pants and synthetic underwear.
• Consider changing your laundry detergent and don’t use fabric softeners.

Vaginal thrush and sex

You can still have sex when you have vaginal thrush. However, it can be uncomfortable and you may experience a burning sensation during or after sex. Use plenty of lubricant to protect your skin.

Thrush is not an STI, but male partners can sometimes get redness and irritation after sex.

The treatment for thrush can weaken condoms, so apply the treatments after you have had sex if you are using condoms.

Ruling out other vaginal conditions

A few other vaginal conditions result in symptoms that are like those of thrush. See your doctor if you:

• have had several episodes of thrush in a short period
• have had recent sex without a condom with a new partner
• have associated pain in your pelvic area or abnormal bleeding
• treated yourself with a thrush treatment and your symptoms haven’t gone away.

Management of recurrent thrush

If you experience repeated episodes of thrush, it’s recommended that you see your GP to confirm that it’s thrush and that you don’t have an STI. Your GP can check for the presence of other skin conditions that may have similar symptoms and exclude other conditions that can cause thrush (such as diabetes).

Any factor contributing to the overgrowth of Candida albicans should be identified and managed. If no contributing factors are found, a course of preventative treatment may be recommended.

There is no evidence to support the treatment of male partners of women who experience thrush. Thrush outbreaks, while uncomfortable, do not cause any long-term health issues. There is also no clear evidence that dietary changes prevent thrush, but the research is limited.

Where to get help

Arpimed

Influence on the ability to drive and use mechanisms

When driving a car or operating machinery while taking Fluconazole, you should take into account that it can sometimes cause dizziness or convulsions.

Important information about the ingredients of Fluconazole

Fluconazole tablets contain a red dye (E-124), which may cause allergic reactions.

How to take Fluconazole

Fluconazole should be taken exactly as prescribed by your doctor.If you have any doubts about taking the drug, then you should consult with your doctor or pharmacist.

Take the tablets by mouth at the same time every day with a glass of water.

The recommended doses of the drug for various infections are given below:

Adults

Adolescents from 12 to 17 years old

Follow the doses prescribed by your doctor. Depending on the body weight and age of the adolescent, the dose for adults is determined or the dose for children is appropriate for each specific situation.

Children under 11 years old

The maximum recommended dose in children of this age group is up to 400 mg per day.

The dose depends on the child’s body weight.

Children from 0 to 4 weeks

Children from 3 to 4 weeks:

Use the same dose as above, but every 2 days. The maximum dose is 12 mg per kg of body weight every 48 hours.

Children under 2 weeks old:

Use the same dose as above, but every 3 days.The maximum dose is 12 mg per kg of body weight every 72 hours.

Elderly

In the absence of signs of renal failure, the drug is prescribed in the usual dose.

Patients with impaired renal function

Your doctor may change the dose of the drug depending on your kidney function.

If you take more Fluconazole than you recommended

If you accidentally swallow too many tablets, contact your doctor or the nearest hospital admission department. In case of overdose, auditory, visual, tactile and semantic hallucinations and paranoid behavior are observed. Symptomatic treatment is carried out (including supportive therapy and gastric lavage).

If you forget to take Fluconazole

Do not take a double dose to make up for a missed appointment.

If you forget to take the next dose of the drug, take it as soon as you remember.If it is time for your next dose, do not take the missed dose and continue taking as usual.

If you have any further questions on the use of Fluconazole, please ask your doctor or pharmacist.

90,000 Diaper dermatitis (diaper rash) – Evidence-based medicine for all

What is diaper dermatitis (diaper rash)

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

Photo 1. Simple diaper dermatitis

Diaper rash is usually caused by prolonged exposure to moisture, urine or faeces on the skin of the perineum and is therefore more likely to occur with irregular diaper changes and diarrhea, but it also occurs in children with good perineal hygiene.

Diaper rash can also develop when using the wrong brand of diapers for a particular baby, after introducing a new product into complementary foods, when a nursing mother takes certain foods, or when taking antibiotics.

Diaper dermatitis can be frightening for parents and cause anxiety in a child. However, in most cases, normal home care is sufficient to cure it, even without the intervention of a pediatrician.

Diaper dermatitis symptoms

Diaper rash is manifested by the following symptoms:

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

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

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

When to see a doctor

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

Show the child to the doctor if:

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

Reasons for the development of diaper rash

Skin irritation from prolonged contact with faeces or urine.Prolonged exposure to urine or feces can irritate a baby’s sensitive skin. Your child may be more prone to diaper rash if he defecates frequently, because feces is more irritating than urine.

Introducing new foods into the diet. The introduction of complementary foods in a child’s diet can provoke diaper dermatitis, since this changes the composition and properties of feces. In addition, complementary foods increase the frequency of bowel movements. If your baby is breastfeeding, he may develop diaper rash in response to food eaten by the mother, although this is rare.

Contact with a new chemical. Disposable wipes, changing brands of diapers, diaper cream, laundry detergent, bleach or fabric softener can all irritate the delicate skin of your baby’s crotch.

A bacterial or fungal infection (candidiasis). Fecal irritated skin is the gateway for infection. In addition, it is always warm and humid under the diaper, which is very convenient for the growth of bacteria and fungi.Secondary skin lesions can be located in folds (bacterial lesions), or be scattered all over the surrounding skin (candidal diaper dermatitis).

Photo 3. Changes characteristic of candidal diaper dermatitis

Sensitive skin. Children with pre-existing chronic skin lesions such as atopic dermatitis or eczema may be more prone to developing diaper rash.

Tightness and friction Tight clothing or diapers – greatly increase the risk of developing diaper rash.

Antibiotic use. Antibiotics kill bacteria, both good and bad. The good bacteria that held back the development of fungi die – therefore the growth of the yeast infection is activated. This also applies to breastfed babies whose mothers are taking antibiotics.

Preparing for a doctor’s visit

As a rule, diaper rash can be successfully treated at home without medical supervision. But if the symptoms do not respond to treatment for more than 2-3 days or are accompanied by fever and other dangerous symptoms, you should make an appointment with your pediatrician.

It will be good if you prepare a list of the most important points in advance:

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

Write down questions to ask your doctor:

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

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

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

What can you do while waiting for your doctor’s appointment?

First of all, you should often wash your baby with cool water, keep the crotch in the air more often, change diapers more often, avoid food and local remedies that could cause diaper dermatitis. You should often wash your child with running water as soon as possible after each urination and bowel movement. You should also avoid contact of the perineum with soap and wet wipes until complete recovery from diaper rash.

Keep your baby without diapers for as long as possible. If your baby has loose stools, remember to use a barrier cream in the perianal area (around the anus). The barrier cream is not applied to the rest of the skin!

Diaper dermatitis treatment

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

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

Photo 4: intertrigo with secondary GABHS infection

Photo 5: Erosive diaper dermatitis caused by diarrhea

Photo 6: erosive diaper dermatitis

Do not use steroid, antifungal and antibacterial creams without first talking to your doctor, even if your child has previously been prescribed them by the doctor. Frequent and unreasonable use of these drugs can cause complications and worsen the condition of the child.

Recovering from diaper dermatitis usually takes several days. If the rash persists despite the treatment prescribed by your doctor, you should return to your doctor and / or seek the advice of a dermatologist.

Home remedies for diaper rash

Again, the most effective way to cure diaper dermatitis is to keep your crotch as clean as possible in the open air.To do this, either keep the baby naked or change diapers very often

In addition, you can apply some topical creams before visiting your doctor: for example, zinc cream (Desitin or others)

Zinc oxide is the active ingredient in many diaper rash creams. Apply a thick layer of zinc oxide cream to irritated skin to soothe, heal and protect your baby’s skin. Zinc oxide can also be used to prevent diaper rash on healthy skin (like a regular diaper cream).

Until the baby’s diaper rash heals, avoid: washing with soap, using disposable wipes, and any irritating topical products. Alcohol and perfumes in these products can irritate your baby’s skin and worsen and prolong the course of diaper dermatitis.

In the recent past, talcum powder was often used to prevent and treat diaper rash. The absorption of excess moisture was believed to have a beneficial effect on the skin of the perineum.However, at present, these recommendations are considered inappropriate: talc acts as an abrasive, leading to traumatic friction when the child moves, and inhalation of talc can irritate the child’s lungs.

Prevention of diaper dermatitis

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

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

Which diapers to choose?

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

Thrush in women

This disease affects not only women of childbearing age who are sexually active, but also young girls and those who have reached venerable years.The reason is simple: candidiasis occurs not only after contact with a sick sexual partner. It can be the result of active reproduction of Candide, which were previously part of the normal microflora. With candidiasis, women complain of copious cheesy discharge from the vagina and itching in the genital area.

Causes of thrush

Why does thrush occur? is one of the most common questions among women. After all, this problem is very common.Unpleasant sensations arise at the most inopportune moment. This fungal disease negates intimate relationships and ruins everyday life.
Candidiasis can be contracted from a sexual partner. Especially if a man has clear signs of this disease or he is a carrier of fungi. However, this reason is far from the most common. Much more often thrush occurs as a result of a decrease in immunity and a violation of the natural balance of the microflora of the genital organs.

There are many factors that trigger the development of vaginal candidiasis in women.

• Decrease in the body’s defenses as a result of chronic diseases or after infections.
• Hormonal changes during pregnancy and before menstruation.
• Changes in hormonal levels during menopause.
• Use of hormonal contraceptives .
• Long-term use of antibiotics , corticosteroids and cytostatic drugs.
• Intestinal dysbiosis , while fungi can enter the vagina.
• Climate change , which entails adaptation to new conditions, water composition.
• Use of intimate hygiene products : intimate gels, soaps, shower gels containing a lot of alkali and fragrances.
• Use of panty liners . They disrupt the access of air to the genitals, and the humidity rises.
• Deodorized tampons and pads cause allergic reactions and disrupt the mucous membrane.
• Wearing synthetic underwear, tight and tight . The most common culprits for thrush are thongs.
• Food rich in pastries and carbohydrate dishes, strong coffee, carbonated drinks, yeast baked goods, spicy and fatty delicacies, ketchup and mayonnaise.
• Avitaminosis entails a decrease in the body’s resistance and deterioration of the skin and mucous membranes.
• Obesity – favorable conditions for the growth of fungi are created in the folds of the body.
• Metabolic disorders . Diabetes mellitus is a prime example. It not only weakens local immunity, but also increases the amount of carbohydrates in cells, which is a good breeding ground for microorganisms.
• Smoking causes vasospasm and interferes with blood circulation, including in the genitals.
• Sexual intercourse with a dry vagina and other actions that can lead to the appearance of microtrauma on the genital mucosa. Through them, Candida can penetrate deep into the tissues.
• Chronic stress , strong mental and physical stress, overwork, lack of sleep.

What are the symptoms of thrush and what are they associated with?

1. Pain during intercourse. Most often, the reproduction of Candide begins on the vaginal mucosa. They destroy the upper cells of the epithelium, gradually affecting the deeper layers. In this case, the smallest lesions are formed, resembling sores. The mucous membrane of the vaginal wall becomes inflamed and painful. Therefore, during intercourse, a woman experiences pain and other unpleasant sensations.
2. Swelling of the genitals. Inflammation causes the vaginal walls to swell.This is due to the fact that small vessels on the surface of the mucous membrane expand. Thus, the body tries to eliminate the toxins secreted by Candida. Blood circulation increases, and the tissue of the genital organs is saturated with fluid that has left through the walls of the capillaries.
3. White bloom and cheesy discharge. Gradually the number of fungi increases and the colonies grow. They look like a whitish plaque on the genitals. The inflammatory process begins, which is accompanied by abundant vaginal discharge. They look like white curdled masses or curdled milk. These are mainly mycelium of fungi, leukocytes and damaged cells of the mucous membrane.
4. Itching and burning. Candida feeds on glycogen stores in cells. When this carbohydrate is broken down, acids are formed. It is they that cause itching and burning in the vagina and irritate the skin of the genitals damaged by Candida, while the woman feels severe discomfort. These symptoms are worse after urinating or washing.Therefore, each time the skin in this area must be dried. It is advisable to use soft paper towels so as not to further injure.
5. Rash with thrush. The inflammatory process in thrush also extends to the vestibule of the vagina, labia majora and labia minora. On the skin of the genitals, the epidermis is stratified as a result of the activity of fungi, and small burgundy pimples-bubbles with liquid contents inside – vesicles are formed.After a day or two, they burst and small erosion and crusts form in their place.
6. Spread to nearby skin areas. Signs of candidiasis: redness, small rash, itching, the formation of white plaque can occur in the perineum, on the skin of the buttock and groin folds. More often, this form of the disease occurs in women who are overweight.
7. Deterioration of the general condition. Itching, persistent discomfort and discomfort cause nervousness, bouts of bad mood, and sleep disturbance.The latter is due to the fact that the burning sensation intensifies at night. The unpleasant symptoms increase after long walking and during menstruation.
8. Urethritis and cystitis with thrush. Frequent urination and the appearance of cuts indicate that Candida entered the urinary system and caused urethritis and cystitis. Another sign that the inflammatory process has spread to other organs is the appearance of aching pains in the lower abdomen. In this case, the temperature may rise.If you notice such symptoms, then be sure to consult a doctor and do not self-medicate.

Composition of normal microflora of the vagina and external genital organs

The genitals of girls begin to be colonized by microorganisms within a few hours after birth. This is the moment when microflora begins to form. From the first day of life, various types of bacteria constantly live in the vagina and on the external genitals. There are more than 60 of them.Usually these microorganisms do not cause disease or harm to the body. This set varies depending on the age of the woman, the phase of the menstrual cycle, pregnancy, and the presence of a permanent sexual partner. Periodically, pathogenic bacteria enter the vagina. But if their number is not large, then representatives of microflora and immune cells destroy these microorganisms. The vagina contains:

• lactobacilli
• bifidobacteria
• streptococci
• enterococci
• Clostridium
• coagulase-negative staphylococci
• coliform bacteria
• candida

The majority of microorganisms in the body of a healthy woman are various types of lactobacilli and bifidobacteria – up to 90%. They provide an optimal level of acidity, pH up to 3.8–4.5 (in adult women). If their number decreases, then the vaginal environment becomes slightly alkaline and the pH exceeds 6. This leads to the multiplication of pathogenic bacteria and the development of inflammatory processes.

In almost 80% of cases, Candida is present in the microflora of women. They are represented by single inactive rounded cells and do not form filaments of mycelium (pseudo-mycelium).

Normal microflora in a woman’s body performs important functions:

• Releases beneficial enzymes that provide the necessary acidity
• Promotes the formation of vitamins
• Supports local immunity tension
• Prevents the entry of foreign bacteria that can cause disease.

Vaginal microflora has a balanced composition. Moreover, some bacteria regulate the number of others. So lactic acid bacteria produce acid, which inhibits excessive multiplication of Candide. Therefore, normally, the fungi contained in the vagina do not cause thrush.

For more information call 8 (351) 200-33-10 or in one of our branches .

Skin candidiasis – a directory of diseases – HealthInfo

Symptoms vary depending on the location of the infection.

Lesions of the skin folds (intertriginous infections) or the skin of the navel are usually accompanied by the appearance of a red rash, often patchy. Small pustules may occur, especially around the periphery of the rash. The rash itself can cause itching or a burning sensation. A candidal rash around the anus is white or red, itchy, and often wet.

Vaginal candidiasis (vulvovaginitis) is common in women, especially during pregnancy, with diabetes or taking antibiotics.Symptoms of vulvovaginitis include whitish or yellow vaginal discharge, burning and itching, and redness of the walls and outer edges of the vagina.

Penile lesions caused by candidiasis, as a rule, occur in men with diabetes mellitus, as well as in men whose sexual partners have vaginal candidiasis. Usually, these conditions are accompanied by the appearance of a red, scaly, sometimes painful rash on the underside of the penis. However, lesions of the penis or vagina may not be accompanied by any symptoms.

Candidal stomatitis (thrush) is a candidal infection of the oral cavity. The curdled white patches, typical of candidal stomatitis, are usually located near the tongue and on the sides of the mouth and are often painful. Stains can be easily removed with your finger or spoon. Candidal stomatitis, even in healthy children, is not uncommon, but in adults it serves as a signal for a decrease in immunity, possibly associated with diabetes or AIDS. Using antibiotics that kill competing bacteria increases the likelihood of developing thrush.

Angular stomatitis (candidal seizure) – candidal lesion of the corners of the oral cavity. It is accompanied by the formation of tiny cracks and can be the result of a poorly executed denture, as a result of which the corners of the mouth become wet and candida infects the skin.

Candidal paronychia (growth of yeast fungi in the nail beds) is accompanied by painful swelling and the formation of pus. Infected nails may turn white or yellow and separate from the nail bed.

Not a terrible “mollusk” at all – SCCH

Recently, the disease molluscum contagiosum occurs frequently in children of all ages.In this article, I will answer the most common questions parents have regarding this condition.

The name “contagious” means “contagious” and was previously referred to as “contagious molluscum”. The word “mollusk” does not mean that the skin rash is associated with the entry of animals of the class Molluscs. The fact is that the shape of the viral particles, which are determined under a microscope, resembles the shape of mollusks, hence the name of this disease.

Molluscum contagiosum is a viral disease.The disease is transmitted by contact, i.e. with direct contact between the skin of a sick child and the skin of a healthy child, as well as with contact with toys and other common items. If earlier this disease occurred in children, starting from 3 years old, i.e. those who lead an active contact lifestyle, attend kindergarten, but now molluscum contagiosum is often found in children of the first year of life, who for the most part do not contact other children. Thus, our personal assumptions regarding the ways of transmission of viral infection in children of the first year of life are as follows: infection can occur during a massage, visiting a pool, or a clinic.

Molluscum contagiosum is a disease that is not harmful to a child’s health. In the overwhelming majority of cases, it is not evidence of a reduced child’s immunity, but appears precisely in children because the child’s immunity is more vulnerable and immature and, in this regard, the molluscum contagiosum virus easily multiplies in the child’s body.

Rashes with molluscum contagiosum can be located on any part of the body, but the preferred localization is the trunk, especially its lateral surfaces, axillary regions, and also the surfaces of the hands in contact with the trunk.But we also often see rashes on the skin of the face, including around the eyes, nose, neck and other parts of the body.

So we come to the most troubling question for parents: how will the treatment be carried out?

According to our experience and the experience of foreign colleagues, the appointment of antiviral, immunomodulating drugs for molluscum contagiosum is inappropriate, because I repeat once again, the presence of molluscum contagiosum does not mean a decrease in the child’s immunity.But interfering with healthy immunity by prescribing various drugs inside can cause much more serious complications than the presence of molluscum contagiosum. From personal observations, we can note that in the overwhelming majority of cases, the use of various combinations of antiviral drugs prescribed by other doctors does not bring the desired relief from this disease.

In rare cases, spontaneous disappearance of elements is observed, while most often the rash spreads, and then 10 of 1-2 elements appear, then 20-30 appear out of 10, and so on.I think that none of the parents wants their healthy baby to communicate with a child who has similar rashes. In addition, the presence of such rashes is a contraindication for visiting kindergarten!

Treatment of molluscum contagiosum in our Center consists in removing elements mechanically, i.e. tweezers. For example, in most European countries, removal is also carried out with tweezers or a Volkmann spoon, and in the USA, the United Arab Emirates, they do not treat at all, but I have already said about the rate of spread of rashes.

For a long time this procedure was carried out without any anesthesia, which had a traumatic effect on the psyche of the child and his parents. Therefore, the doctors of our Center were among the first, 10 years ago, to actively use the anesthetic cream “EMLA”.

The deletion procedure consists of several steps:

• We apply EMLA cream on the rashes, on top we stick the supplied films so that the cream can penetrate the skin and have an analgesic effect.After that, the child walks for 40 minutes.
• Then you come back, we remove the films and carry out the removal with sterile tweezers (see the video).
• Then the skin is treated with a brilliant green solution (brilliant green) or fucorcin immediately after the removal of the elements and for the next 5 days at home. Water procedures during this period are limited, these areas should not be wetted.

In 90% of cases, the removal procedure itself is painless and calm, taking about 10-20 minutes.But there are individual rare cases when the cream did not completely anesthetize the skin, and the child may receive unpleasant, but not painful, sensations.

Also, the course and duration of the procedure depends on the age of the child. For example, very young children under one year old and adult conscious children after 7 years old calmly respond to the procedure, but babies from 2 to 5 years old may be capricious because of fear of any medical procedures.

One last thing: removing molluscum contagiosum rashes is not a guarantee that the rashes will not reappear.Most often this disease recurs, i.e. elements appear again 2-3 more times, but then disappear without a trace.

Dysbacteriosis: intestinal battles

Photo is illustrative. From the archive “MV”.

There is hardly a person who has never had heartburn, belching, nausea, abdominal pain, flatulence or stool problems. However, people seek medical help only if the symptoms regularly make themselves felt or are acutely manifested. Most for the time being are treated on their own, using common “gastric” means at their discretion.

Goal – balance

The alimentary tract is a heterogeneous bacterial ecosystem. Due to its low pH, the stomach of a healthy person can be considered a sterile environment.

In the intestine, conditions for the growth of microorganisms are better. In the thin one there are few bacteria – 104-106 / ml (high pH value and fast transit do not contribute to an increase in their number), and in the thick one – 100,000 times more.

The intestine is a strictly anaerobic system, rich in nutrients, with a neutral to slightly alkaline acidity.Its bacterial ecosystem includes 400 to 500 types of microorganisms that interact. Many are compensators, helping to break down indigestible compounds in food.

In practically healthy people, about 96% of the intestinal microflora are representatives of the obligate (i.e. constantly occurring) microflora: bifidobacteria and lactobacilli, bacteroids, non-pathogenic E. coli, etc.

The second group, which includes optional (non-permanent) and opportunistic microflora, occupies only 2–4% of the total number of microorganisms.Under certain conditions (a decrease in local, and even more so general immunity), it causes intra-intestinal and general disorders. The optional group is represented by micrococci, proteus, staphylococci, clostridia, citrobacters, etc.

The third group consists of transient (random) pathogenic microflora: clostridia, Pseudomonas aeruginosa, fungi of the genus Candida. It accounts for 0.001-0.01%.

In the process of constant interaction of macro- and microorganisms, a unique ecosystem is formed, which is in a state of dynamic balance.An essential role is played by obligate and facultative anaerobes: bifido-, lacto- and enterobacteria, as well as enterococci. Bifidobacteria create an acidic environment and thereby prevent the reproduction of harmful microflora. In addition, they have a pronounced antagonism against pathogens, improve digestion processes, maintain vitamin balance and immune status, and participate in the synthesis of essential amino acids.

Violation of bacterioecological balance in the gastrointestinal tract leads to the formation of intestinal dysbiosis (dysbiosis).

Bad changes

Intestinal dysbiosis is a clinical and laboratory syndrome that occurs in various pathological conditions. Changes in the quantitative and (or) qualitative composition of the normal flora, metabolic and immunological disorders are characteristic; in some patients, symptoms of intestinal lesions are added.

The intestinal microflora of an adult is quite resistant to changes in nutrition. Meanwhile, it is worth remembering that food rich in carbohydrates stimulates bifidoflora and leads to an increase in the bacterial mass of the large intestine.Protein dishes do not affect the spectrum and number of intestinal bacteria, and fats inhibit bifidobacteria and enterococci, but stimulate the reproduction of bacteroids. “Food” dysbiosis is often temporary and disappears with the transition to a healthy balanced diet.

In diseases of a local and general nature, the microbial landscape of the colon changes. Dysbacteriosis is recorded in most patients with gastrointestinal lesions of an infectious and non-infectious nature, after acute viral and bacterial infections of extraintestinal localization, in chronic inflammatory and allergic pathology, in those suffering from malignant diseases and leukemias, against the background of the use of cytostatics and especially antibiotics.Antibiotic-dependent dysbiosis is stable and requires active therapy.

Shifts in the intestinal microflora are secondary – they reflect the impact of factors that change the status of the intestine or the internal balance of the microbiocenosis itself. Microbial imbalance can complicate many pathological conditions, be an atherogenic phenomenon associated with antibacterial, hormonal and other therapy, unbalanced diet, etc.

One of the most frequent variants (the proportion sometimes reaches 31%) of intestinal dysbiosis is candidiasis, in which there is an overgrowth of fungi of the genus Candida.It is often associated with food allergies and allergic diseases in general, as well as with smoking.

Laboratory searches

The clinical picture of intestinal dysbiosis is variable, and the severity of symptoms does not always directly depend on the degree of dysbiotic disorders. The earliest and most specific symptoms can be considered increased gas production, impaired digestion of food (intestinal dyspepsia), a change in the nature of the stool; with the development of dysbiosis against the background of colitis – pain syndrome, pathological impurities in the feces (mucus).In more severe cases, intoxication, diarrhea and dehydration, weight loss are added.

In the diagnosis and treatment of intestinal dysbiosis, scatological research is of great importance, which makes it possible to characterize the digestive, enzyme-excreting, absorption and motor functions of the intestine. Recently, methods based on the identification of metabolites of microorganisms have become widespread – gas-liquid and ion chromatography. In laboratories, bacteriological studies of feces and sowing on nutrient media of scrapings from mucous membranes are carried out.

Intestinoscopy with aspiration of the contents of the small intestine and inoculation of the aspirate onto a nutrient medium is considered the gold standard for the diagnosis of bacterial overgrowth syndrome. But this technique is complicated, it requires general anesthesia and a good bacteriological base with the possibility of cultivating aerobes and anaerobes, and the result has to wait about 10 days.

The syndrome of bacterial overgrowth is also detected according to the breath test with labeled H2 – with lactulose or galactose.The bacteria break down lactulose, resulting in the release of labeled H2, the concentration of which can then be measured in the exhaled air. Normally, lactulose is broken down only by the microflora in the large intestine. With dysbiosis, the small intestine is also colonized by microorganisms that break down lactulose. In this case, the accelerated movement of the substrate through the small intestine should be excluded.

Inoculation of duodenal aspirate also confirms the syndrome of bacterial overgrowth: in pathology, the content of microorganisms is> 106 / ml (the total number of bacteria in the lumen of the jejunum does not exceed 104-106 / ml).

The microflora of various parts of the digestive tract differs significantly quantitatively and qualitatively. +

Microbiological examination of feces can only indirectly indicate microbial trouble, since the composition of fecal microflora reflects the situation only in the large intestine, or rather, in the distal section.

Mood for victory

Prevention and especially treatment of intestinal dysbiosis should be comprehensive and assume:

• elimination of excessive bacterial contamination of the small intestine;
• restoration of normal microbial flora of the colon;
• Improving intestinal digestion and absorption;
• restoration of normal intestinal motility;
• stimulation of the body’s reactivity.

The most important normal inhabitants of the human large intestine are bifidobacteria (a type of anaerobic rod-shaped gram-positive bacteria) – 3–7% of the total fecal microflora of adults. We also need lactobacilli.

The increase in pectins (soluble dietary fiber) in the diet contributes to the restoration of the quality and quantity of bifidobacteria, and fermented milk products are the best products for lactobacilli. The antibiotic activity of the latter is increased by adding niacin (6–8 mg per 1 liter), thiamine (4–6 mg), and tocopherol (1–3 mg).

Probiotics and prebiotics are widely used for the prevention and treatment of dysbiosis.

Probiotics are living microorganisms (lactic acid bacteria, more often bifidobacteria or lactobacilli), normal inhabitants of the intestines of a healthy person, which improve the microbial balance. They have antagonistic properties in relation to pathogens (third group): they compete for receptors on epithelial cells, nutrients; are able to release ingredients (cytokines, butyric acid) that inhibit the growth of pathogenic bacteria.A monoculture or a complex of living microorganisms is supplemented with a substance that stimulates their colonizing ability and reproduction.

Probiotics are found in dairy products with special sourdough, cornflakes, cereals, black bread.

In the presence of fermentation processes in the intestine, it is necessary to limit carbohydrates, dietary fiber (cellulose), with putrefactive – proteins and fats.

Anyone at high risk of developing dysbiosis should avoid whole milk, legumes, and foods rich in essential oils (garlic, green onions, turnips, radishes).

To stabilize the intestinal microflora, the diet includes carrot juice, soy, yeast, pumpkin, potato and rice extracts, whey and colostrum (have a bifidogenic effect).

Plant components are also used for staphylococcal dysbiosis. Useful wild strawberries, mountain ash, raspberries, blueberries, rose hips, black currants. With protean dysbiosis, apricots and black currants are needed; in the presence of putrefactive bacteria – cranberries and apricots. If there is an overgrowth of fungi of the genus Candida, it is worth leaning on lingonberries, peppers, carrots.

With torpid dysbacteriosis, it is recommended to supplement the treatment, connecting the effect of taking eucalyptus, calendula, calamus, St. John’s wort. When fungal dysbiosis with fermentative dyspepsia is confirmed, soluble chicory will have a positive effect.

In addition to probiotics, prebiotics are important in the prevention and treatment of intestinal dysbiosis (these mainly include soluble dietary fiber of the carbohydrate class: fructooligosaccharides, galactooligosaccharides). In the stomach and small intestine, they avoid hydrolysis by digestive enzymes and reach the large intestine unchanged.There they are fermented by bifidobacteria and lactobacilli, which leads to an increase in the amount of flora and the volume of feces. It is important to emphasize that fructooligosaccharides are an energy substrate for representatives of normal intestinal microflora (bifidobacteria and lactobacilli). In the process of fermentation, short-chain fatty acids (mainly acetic, propionic, butyric) are formed, which lower the pH in the intestine and stimulate peristalsis.

Stimulation of mucus production in the colon helps to strengthen the protective barrier of the large intestine when consuming prebiotics.Increased mucus production by enterocytes may result from a decrease in pH with an increased synthesis of short-chain fatty acids by the intestinal microflora in response to the administration of prebiotics. Inulin, lactulose, lactyl, oligosaccharides, lactooligosaccharides, hilak forte, etc.

Inulin is present in the cells of chicory, artichoke, dandelion roots, Jerusalem artichoke tubers, beans, parsley. It is best studied as a bifidogenic factor – selectively accelerates the growth and metabolism of bifidobacteria.Intake of 5 g / day of oligofructose or ≤8 g / day of inulin provides a significant change in the composition of the intestinal microflora, increasing the number of bifidobacteria and reducing the number of pathogens.

Probiotics and prebiotics can be used for the prevention and treatment of intestinal dysbiosis, including when prescribing eradication regimens for the treatment of Helicobacter pylori in gastroesophageal reflux, gastric ulcer and duodenal ulcer, erosive gastro- and duodenopathies.

The use of antibiotics is undesirable, becausebecause they can aggravate intestinal dysbiosis. It is advisable to use drugs that have a minimal effect on the symbiotic flora and at the same time suppress the growth of pathogenic microorganisms. These include nitrofurans (nifuroxazide, intetrix) – the so-called. intestinal antiseptics.

Enzyme preparations are indicated for patients with intestinal dyspepsia. Pancreatin is used more often (mezim forte, trienzyme, creon). With steatorrhea and hypomotor dyskinesia of the intestine, bile acids (panzinorm) are added to pancreatin, with fermentation disorders – hemicellulose (festal, enzistal, digestal).To improve the absorption processes, membrane stabilizing drugs (Karsil, Essentiale) can be prescribed.

In case of dysbiosis, especially during the rehabilitation period, immunomodulators (sodium nucleinate, vitamins), herbal adaptogens (eleutherococcus, ginseng, echinacea) are indicated. When a tendency to leukopenia is noted and it is required to increase the epithelialization of the mucous membrane, methyluracil and pentoxil can be used (no more than two weeks).

Ivan Bronovets, Professor of the Department of Cardiology and Internal Diseases of the Belarusian State Medical University, Dr. med.Sciences
Medical Bulletin , September 12, 2016

Keratomas – St. Petersburg State Budgetary Healthcare Institution “Dermatovenerologic Dispensary No. 4”

Keratomas are predominantly benign skin tumors that form on the face and body of a person, as a reaction to irreversible aging processes. The disease is in most cases hereditary, however, the first tumors appear only after 30 years, and then new rashes may appear during the rest of life. Their number can be very different – from several tumors and up to several hundred in very old people.Men get sick more often, and they also have more tumors. The color of keratomas can be yellow-brown, brown, gray, black, or normal skin color. The shape of the keratomas is round or oval. They are located in the area of ​​the face and trunk. In most cases, there are no complaints with keratomas – occasionally itching. If an infection joins, soreness. One of the ruling factors affecting the formation of keratomas is excessive ultraviolet radiation. When the keratoma is reborn, it transforms into squamous cell carcinoma.In this regard, it is advisable to remove large and injured keratomas.

Types of keratoma:

• Senile keratoma

This type of keratoma is a multiple formation, usually gray or white in color, increasing in size over time, crusting over and prone to inflammation. As a rule, senile keratoma is found in people aged 30 and older. The affected areas are the neck, face and back of the hands, less often – the chest, abdomen, back, legs and forearms.

• Seborrheic keratoma

Seborrheic keratoma appears in the form of spots on the skin, yellow or brownish. Over time, it grows in size, darkens and becomes covered with cracks. Seborrheic keratoma is the most dangerous type of keratoma. In addition to the fact that it constantly peels off, itches and can cause pain, this keratoma is capable of falling off and bleeding from the place from which it fell off. If such a keratoma has disappeared, then you should immediately consult a doctor in order to prevent the penetration of infection and subsequent complications.

• Keratoma, horny

This species is able to develop linearly and occupy different areas of different shapes. In most cases, it can develop in the plural. This type of keratoma is most susceptible to malignant transformation, so they need to be removed at an early stage.

• Solar keratoma

Represents multiple lesions, which are covered with gray scales. It mainly manifests itself in men, on areas of the skin exposed to sunlight.

• Follicular keratoma

A very rare type of disease. As a rule, it manifests itself in women in the form of nodules of grayish or pinkish colors. Sizes – up to 1.5 cm. The formation zone is the head area covered with hair, the upper lip and the head.

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