Candidiasis (Yeast Infection) – Skin Disorders

By

Denise M. Aaron

, MD, Dartmouth Geisel School of Medicine

Reviewed/Revised Sep 2021 | Modified Sep 2022

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Candidiasis is infection with the yeast Candida.

• Candidiasis tends to occur in moist areas of the skin.

• Candidiasis may cause rashes, scaling, itching, and swelling.

• Doctors examine the affected areas and view skin samples under a microscope or in a culture.

• Antifungal creams or antifungal drugs given by mouth usually cure candidiasis.

(See also Overview of Fungal Skin Infections Overview of Fungal Skin Infections Fungi usually make their homes in moist areas of the body where skin surfaces meet: between the toes, in the genital area, and under the breasts. Common fungal skin infections are caused by… read more .)

Candida is a yeast that normally resides on the skin and in the mouth, digestive tract, and vagina and usually causes no harm. Under certain conditions, however, Candida can overgrow on mucous membranes and moist areas of the skin. Typical areas affected are the lining of the mouth, the groin, the armpits, the spaces between fingers and toes, on an uncircumcised penis, the skinfold under the breasts, the nails, and the skinfolds of the stomach. Yeast is a type of fungus.

Conditions that enable Candida to infect the skin include the following:

• Hot, humid weather

• Tight, synthetic underclothing

• Poor hygiene

• Infrequent diaper or undergarment changes, particularly in children and older people

• A weakened immune system resulting from diabetes, HIV infection/AIDS, or use of corticosteroids and other drugs that suppress the immune system

• Pregnancy, obesity, or use of antibiotics

• Other skin disorders such as intertrigo Intertrigo Intertrigo is irritation and breakdown of skin (maceration) in areas where two skin surfaces rub together. Sometimes bacterial or yeast infections develop. The diagnosis is based on the location… read more and psoriasis Psoriasis Psoriasis is a chronic, recurring disease that causes one or more raised, red patches that have silvery scales and a distinct border between the patch and normal skin. A problem with the immune… read more

People taking antibiotics may develop candidiasis because the antibiotics kill the bacteria that normally reside on the body, allowing Candida to grow unchecked. Corticosteroids or immunosuppressive therapy after organ transplantation can also lower the body’s defenses against candidiasis. Inhaled corticosteroids, often used by people with asthma, sometimes cause candidiasis of the mouth. Pregnant women, people receiving cancer therapy drugs, obese people, and people with diabetes also are more likely to be infected by Candida.

In some people (usually people with a weakened immune system), Candida may invade deeper tissues as well as the blood, causing life-threatening systemic candidiasis Candidiasis Candidiasis is a fungal infection caused by several species of the yeast Candida, especially Candida albicans. The most common type of candidiasis is a superficial infection of… read more .

Symptoms of candidiasis vary, depending on the location of the infection.

Infections in skinfolds (intertriginous infections) or in the navel usually cause a bright red rash, sometimes with breakdown of skin. Small pustules may appear, especially at the edges of the rash, and the rash may itch intensely or burn. A candidal rash around the anus may be raw, white or red, and itchy. Infants may develop a candidal diaper rash Diaper rash (diaper dermatitis) A rash is an abnormal change in the texture or color of the skin. Known causes of rashes include irritation, allergies, drugs, and bacterial, fungal, or viral infections. Rashes include redness… read more in the diaper area.

Vaginal candidiasis (vulvovaginitis, yeast infection— see Overview of Vaginitis (Vaginal Infection or Inflammation) Overview of Vaginitis (Vaginal Infection or Inflammation) Vaginal infections are one of the most common reasons women see their doctor, accounting for millions of visits each year. Vaginal infections are caused by infectious organisms (such as bacteria… read more ) is common, especially among women who are pregnant, have diabetes, or are taking antibiotics. Symptoms of these infections include a white or yellow cheeselike discharge from the vagina and burning, itching, and redness along the walls and external area of the vagina.

Penile candidiasis most often affects men with diabetes, uncircumcised men, or men whose female sex partners have vaginal candidiasis. Sometimes the rash may not cause any symptoms, but usually the infection causes a red, raw, itching, burning, or sometimes painful rash on the head of the penis.

Thrush is candidiasis inside the mouth Candidiasis Candidiasis is a fungal infection caused by several species of the yeast Candida, especially Candida albicans. The most common type of candidiasis is a superficial infection of… read more . The creamy white patches typical of thrush cling to the tongue and sides of the mouth and may be painful. The patches can be scraped off with a finger or blunt object and may bleed when scraped. Thrush in otherwise healthy children is not unusual, but in adults it may signal a weakened immune system, possibly caused by cancer, diabetes, or human immunodeficiency virus (HIV) infection. The use of antibiotics that kill off competing bacteria increases the risk of developing thrush.

Perlèche is candidiasis at the corners of the mouth, which causes cracks and tiny fissures. It may stem from chronic lip licking, thumb sucking, ill-fitting dentures, or other conditions that make the corners of the mouth moist enough that yeast can grow.

Candidal paronychia Chronic Paronychia Chronic paronychia is recurring or persistent inflammation of the nail fold, typically of the fingernails. (See also Acute Paronychia.) Chronic paronychia occurs almost always in people whose… read more is candidiasis in the nail folds or cuticles, which causes painful redness and swelling ( see Onychomycosis Onychomycosis Onychomycosis is a fungal infection of the nails. (See also Overview of Nail Disorders.) About 10% of people have onychomycosis, which most often affects the toenails rather than the fingernails… read more ) around the nail. In longstanding infection, the area underneath the nail may turn white or yellow, and the nail plate may separate from the nail bed (onycholysis Onycholysis The terms deformities and dystrophies are often used interchangeably, sometimes even by doctors. However, their meanings are slightly different. Deformities: Changes in nail shape… read more ). This disorder typically occurs in people with diabetes or a weakened immune system or in otherwise healthy people whose hands are subjected to frequent wetting or washing.

Chronic mucocutaneous candidiasis Chronic Mucocutaneous Candidiasis Chronic mucocutaneous candidiasis, a hereditary immunodeficiency disorder, is persistent or recurring infection with Candida (a fungus) due to malfunction of T cells (a type of white. .. read more causes red, pus-filled, crusted, and thickened areas that resemble psoriasis Psoriasis Psoriasis is a chronic, recurring disease that causes one or more raised, red patches that have silvery scales and a distinct border between the patch and normal skin. A problem with the immune… read more , especially on the nose and forehead. People who have this condition are also prone to thrush.

Usually, doctors can identify candidiasis by observing its distinctive rash or the thick, white, pasty residue it generates.

To confirm the diagnosis of candidiasis, doctors may scrape off some of the skin or residue with a scalpel or tongue depressor. The scraping Scrapings Doctors can identify many skin disorders simply by looking at the skin. A full skin examination includes examination of the scalp, nails, and mucous membranes. Sometimes the doctor uses a hand-held… read more sample is then examined under a microscope or placed in a culture medium Culture Doctors can identify many skin disorders simply by looking at the skin. A full skin examination includes examination of the scalp, nails, and mucous membranes. Sometimes the doctor uses a hand-held… read more (a substance that allows microorganisms to grow) to identify the specific fungus.

Treatment of candidiasis typically depends on the location of the infection. (See also table Some Antifungal Drugs Applied to the Skin (Topical Drugs) Some Antifungal Drugs Applied to the Skin (Topical Drugs) .)

Infections in skinfolds are treated with antifungal creams, powders, solutions, or other products that are applied directly to the skin (topical). Examples include miconazole, clotrimazole, oxiconazole, ketoconazole, econazole, ciclopirox, and nystatin. In healthy people, skinfold infections are usually easily cured. Keeping the skin dry helps clear up the infection and prevents it from returning. Solutions that dry out the skin (such as Burow solution) or topical antiperspirants help keep the surface area dry. Keeping the area dry may also help prevent a recurrence. People who have many infected skinfolds may be given drugs by mouth (such as fluconazole).

Vaginal candidiasis is treated with antifungal drugs that may be applied as a cream to the affected area, inserted into the vagina as a suppository, or taken by mouth (such as fluconazole).

Diaper rash is treated with more frequent changes of diapers, use of super-absorbent or ultra-absorbent disposable diapers, and a cream that contains an antifungal drug (for example, butoconazole, clotrimazole, fluconazole, ketoconazole, or miconazole).

Candidal paronychia is treated by protecting the area from wetness. Doctors give antifungal drugs that are taken by mouth or applied to the skin. These infections are often difficult to treat.

Thrush in adults is treated with drugs that go directly in the mouth. An antifungal drug (such as clotrimazole) may be given as a tablet or lozenge that dissolves in the mouth. Doctors may also have people gargle with liquid nystatin for as long as possible and then spit it out or swallow it. Doctors may also give drugs in pill form that are swallowed (such as fluconazole).

Thrush in infants may be treated with liquid nystatin. The liquid can be applied with a finger or cotton swab to the cheek pouches inside the mouth.

Chronic mucocutaneous candidiasis is treated with fluconazole taken by mouth. This drug is taken for a long time.

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Candida infection of the skin Information | Mount Sinai

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

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

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

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

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

Causes

The body normally hosts a variety of germs, including bacteria and fungi. Some of these are useful to the body, some produce no harm or benefit, and some can cause harmful infections.

Some fungal infections are caused by fungi that often live on the hair, nails, and outer skin layers. They include yeast-like fungi such as candida. Sometimes, these yeast penetrate beneath the surface of the skin and cause infection.

In cutaneous candidiasis, the skin is infected with candida fungi. This type of infection is fairly common. It can involve almost any skin on the body, but most often it occurs in warm, moist, creased areas such as the armpits and groin. The fungus that most often causes cutaneous candidiasis is Candida albicans.

Candida is the most common cause of diaper rash in infants. The fungi take advantage of the warm, moist conditions inside the diaper. Candida infection is also particularly common in people with diabetes and in those who are obese. Antibiotics, steroid therapy, and chemotherapy increase the risk of cutaneous candidiasis. Candida can also cause infections of the nails, edges of the nails, and corners of the mouth.

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

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

Symptoms

Candida infection of the skin can cause intense itching.

Symptoms also include:

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

Exams and Tests

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

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

Treatment

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

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

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

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

Outlook (Prognosis)

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

Possible Complications

These complications may occur:

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

When to Contact a Medical Professional

Contact your provider if you develop symptoms of cutaneous candidiasis.

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

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

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

Last reviewed on: 12/4/2022

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

Candidiasis, thrush – causes, symptoms, diagnosis and treatment in Astrakhan | Diseases

Causes

• Mushrooms of the Candida group

Triggers

• Hot and humid weather
• Tight synthetic underwear
• Non-observance of personal hygiene
• Irregular diaper and underwear changes, especially in children and the elderly
• Weakened immune system due to diabetes, HIV infection/AIDS
• Use of corticosteroids and other drugs that suppress the immune system
• Pregnancy, obesity
• Antibiotic use

Symptoms

Symptoms of candidiasis can vary depending on where the infection is located.

• Rashes on the skin of a bright red color
• Itching and burning
• White creamy spots on the oral mucosa
• Curdled discharge

Infections in the skin folds (intertriginous infections) or in the umbilical region are usually accompanied by a bright red rash, sometimes with destruction of the skin. Small pustules may appear, especially along the edges of the rash, severe itching and burning.

Vaginal candidiasis is a common infection, especially among pregnant women, women with diabetes, or women taking antibiotics. The symptoms of these infections are cheesy discharge from the vagina of white or yellow color, as well as burning, itching and redness of the walls and the outer area of ​​the vagina.

Thrush is oral candidiasis. The tongue and cheeks are covered with white creamy spots characteristic of thrush, which may be accompanied by pain. The spots can be scraped off with a finger or blunt object and may bleed.

Angular cheilitis is candidiasis at the corners of the mouth, causing large and small fissures. Angular cheilitis can be caused by chronic lip-licking, thumb sucking, poor fitting dentures, and other factors that cause the corners of the mouth to become wet enough for fungus to grow.

Paronychia candidiasis is candidiasis that affects the nail fold and cuticle, causing painful redness and swelling around the nail. With prolonged infection, the area of ​​skin under the nail may turn white or yellow, and the nail plate may separate from the nail bed. This disorder usually occurs in people who have a weakened immune system, have diabetes, or healthy people who wet or wash their hands frequently.

With chronic mucocutaneous candidiasis , red, pus-filled and crusty patches resembling psoriasis appear on the skin, especially in the nose and forehead. Patients with these diseases are also predisposed to thrush.

Candidiasis – causes, symptoms, diagnosis and treatment – St.

Petersburg State Budgetary Institution of Health “Dermatovenerological Dispensary No. 4”

Candidiasis is an infectious disease affecting the skin, mucous membranes and / or internal organs, caused by yeast-like fungi of the genus Candida. The term “candidiasis” implies a pathological process, which is based on the overgrowth of Candida, primarily in the gastrointestinal tract and secondarily in other areas (on the mucous membrane of the genitals, bronchi, in parenchymal organs).

Causes

Candidiasis (thrush) affects not only external but also internal organs. The cause of the disease are yeast-like fungi that live in the body of every person.

1. Many factors can provoke intensive reproduction of the fungus. For example, hypothermia, illness, stress, hormonal changes (during pregnancy or taking hormonal drugs).
2. When taking antibiotics, along with pathogenic bacteria, the beneficial microflora of the intestine and vagina, which controls the growth and development of Candida fungi, also dies. The presence of a chronic disease that reduces the activity of the immune system (HIV, sexually transmitted diseases, infections) very often causes candidiasis.
3. Candidiasis may be accompanied by endocrine diseases (diabetes, obesity, dysfunction of the thyroid gland).
4. Finally, hot climates or wearing uncomfortable, tight or synthetic underwear can be causes of candidiasis.

The source of infection with candidiasis, as a rule, is the body’s own flora (autoinfection), but infection from the outside can occur. Causing a disease, the fungus does not change its properties – the body changes its properties (local protection decreases). Attaching to the cells of the epithelium, the pathogenic fungus begins to parasitize in them, penetrating deep into the tissues.

In the body’s struggle with candidiasis, a dynamic balance often occurs when the fungus seeks to penetrate deeper into the tissues, but cannot, and the body tries to reject it and also cannot. In this case, the process can last for years, a shift in the balance in one direction or another will either lead to recovery or exacerbate the process.

Candidiasis occurs in several forms, depending on certain features.

1. Carriage. The person is a carrier of the disease. Symptoms of candidiasis are absent, there is no need to treat.
2. Sharp. Accompanied by itching, rashes, discharge. It is necessary to treat comprehensively and qualitatively. Most often, young children are susceptible to infection.
3. Chronic. Characterized by the remission and manifestation of symptoms, relapses are possible. It develops if it is incorrect to treat with antibiotics for a long time, use hormonal contraceptives.

This disease has several varieties, since it does not have an exact localization in the body:

• Urogenital candidiasis
  • female.
  • male.
• Oral candidiasis
  • Lip thrush
  • Thrush of the tongue
  • Stomatitis, as well as oropharyngeal candidiasis – thrush of the oral mucosa, tonsils, gums.
• Skin and nail candidiasis
  • On the folds of the skin (armpits, area between the buttocks, inguinal folds).
  • Candidiasis of exposed (or smooth) parts of the skin. Rarely seen.
  • Candidiasis on the palms.
  • Candidiasis on the nail plates.
  • Candidiasis of the feet.
• Candidiasis of internal organs
  • GIT (stomach, esophagus, intestines, anus).
  • Lungs and bronchi.
  • Hearts.
  • Meninges.
  • Eyes and ears.
• Neonatal candidiasis (e.g. pseudomembranous)

Symptoms of candidiasis

The disease is ubiquitous. The causative agents of candidiasis are found in the air, soil, vegetables, fruits, confectionery products. Yeast-like fungi are found as saprophytes on healthy skin and mucous membranes.

Manifestations of candidiasis, and therefore symptoms and signs, depend on the localization of the focus of the disease.

Oral candidiasis (oral candidiasis, childhood thrush) is most common in children, usually they become infected from the mother through the birth canal. Symptoms:

• buccal mucosa, pharynx, tongue and gums become red,
• puffiness appears,
• then foci of white cheesy plaque appear on the oral mucosa.

With candidiasis of the skin and its appendages, most often the foci are located in large folds:

• inguinal-femoral,
• intergluteal,
• armpits,
• under the mammary glands.

The skin in the interdigital folds may be affected, more often in children and adults suffering from severe diseases – on the skin of the palms, feet, smooth skin of the trunk and extremities. Foci in large folds look like small 1-2 mm bubbles, which soon open with the formation of erosion. Erosions increase in size, merge, forming large areas of damage.

Foci of candidiasis are irregular in shape, dark red in color, around the focus there is a strip of exfoliating epidermis. Outside the folds, the lesions look like red spots with peeling in the center; occasionally, small bubbles may appear around the focus.

Vaginal candidiasis (candidiasis, thrush) is an infectious disease of the vaginal mucosa that often spreads to the cervix and vulva. Almost every woman has experienced such a disease, and some signs of candidiasis are constantly disturbing. Most common in women of reproductive age, but can occur in girls

Intestinal candidiasis (dysbacteriosis) often accompanies vaginal candidiasis or develops in isolation. Usually intestinal candidiasis appears after taking antibiotics or past intestinal infections. Fungi of the genus Candida live in the small intestine. Symptoms characteristic of this type of candidiasis: in the stool of a patient suffering from intestinal candidiasis, white cheesy flakes are often found.

Esophageal candidiasis is a disease that is very difficult to define among all available in the field of gastroenterology. The disease is characterized by a discrepancy between the severity of the disease, the level of damage and the condition of the patient himself.

Complication

With timely treatment, candidiasis does not cause any particular harm to health. But the symptoms of candidiasis can cause a lot of discomfort. Long-term, it can lead to damage to other organs, most often the urethra, bladder and kidneys. In severe cases, the progressive disease can affect the reproductive organs, leading to infertility in both men and women. But the greatest danger of candidiasis is for pregnant women, because. very high risk of fetal harm.

How the disease is diagnosed

Visual methods for diagnosing candidiasis. On examination, inflammation of the skin areas is revealed, limited by a border of exfoliating, macerated epidermis, a whitish coating on the mucous membranes.

Laboratory diagnostics. Contrary to popular belief, the main method for diagnosing candidiasis is still smear microscopy from the affected areas of the mucosa. PCR (DNA – diagnostics), popular recently, as a rule, is poorly suited for the diagnosis of candidiasis.

Laboratory diagnosis of the disease includes:

• smear microscopy of secretions
• cultural diagnosis (inoculation)
• enzyme immunoassay (ELISA)
• polymerase chain reaction (PCR).

Treatment of candidiasis

Treatment of candidiasis is aimed at eliminating the factors that contribute to the development of candidiasis. In case of skin lesions, local treatment is carried out in an open way with the use of antifungal ointments.

The attending physician prescribes systemic and local medications for this disease. Local agents are not absorbed into the blood – they act only on the mucous membrane affected by the Candida fungus. They stop the reproduction and growth of fungi, relieve discomfort and restore affected tissues.

Prevention

Since candidiasis is a recurrent infectious process that occurs very often, there are some methods of prevention that lead to a decrease in the frequency of recurrence of the disease, and also prevent primary infection.