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Vaginal Yeast Infections (for Parents)

What Are Vaginal Yeast Infections?

Yeast infections (also known as candidiasis) are common infections caused by Candida albicans yeast, which is a type of fungus Yeast infections usually happen in warm, moist parts of the body, such as the mouth, and moist areas of skin.

A yeast infection in the vagina is known as vulvovaginal candidiasis (can-dih-DYE-uh-sis). Vaginal yeast infections are common, and many girls will have one at some point. Treatment can clear up the symptoms in a couple of days and cure the infection within a week..

What Are the Signs & Symptoms of Vaginal Yeast Infections?

Vaginal yeast infections can cause:

  • redness, swelling, or itching of the vulva (the folds of skin outside the vagina)
  • a thick, white discharge that can look like cottage cheese
  • pain or burning when urinating (peeing)

What Causes Vaginal Yeast Infections?

Having small amounts of Candida on the skin and inside the mouth, digestive tract, and vagina is normal. A healthy immune system and some “good” bacteria keep the amount in a person’s body under control.

But yeast in the vagina can sometimes “overgrow” and lead to symptoms of a yeast infection. This can happen if a girl:

  • has a weak immune system from an illness or medicines like chemotherapy
  • takes antibiotics for a bacterial infection (such as strep throat). The antibiotics can kill off the “good” bacteria that keep the Candida in check.
  • has high blood sugar. Girls whose diabetes isn’t well-controlled are more likely to get yeast infections.
  • wears clothing (especially underwear) that is too tight or made of materials like nylon that trap heat and moisture

As girls mature and go through puberty, hormonal changes can make them more likely to get yeast infections. Sometimes, girls get yeast infections right before their menstrual periods. Pregnant women are also more likely to get them. Yeast infections are not an STD (sexually transmitted disease).

Young girls who haven’t gone through puberty yet are less likely to get yeast infections, but they can happen. So if your young daughter complains of itching or discomfort in her vaginal area, it’s important to talk with her doctor.

How Are Vaginal Yeast Infections Diagnosed?

If your daughter has any symptoms of a yeast infection — like itchiness or abnormal vaginal discharge — she should see her doctor or gynecologist. Other infections can cause similar symptoms but require different treatments.

The doctor might take a urine sample to rule out a urinary tract infection (UTI) and swab some vaginal discharge to examine under a microscope.

How Are Vaginal Yeast Infections Treated?

If your daughter does have a yeast infection, her doctor can prescribe a medicine to take by mouth or a vaginal cream, tablet, or suppository that will quickly clear up the symptoms in a few days and get rid of the infection within a week. It’s important that your daughter takes the medicine for the whole time that her doctor prescribes. If she stops taking it too soon, the infection could come back.

Anyone using a vaginal treatment should not have sex until the infection is completely cleared — these medicines can weaken condoms and diaphragms.

If your daughter is not feeling better within a few days of finishing treatment, call the doctor.

Can Vaginal Yeast Infections Be Prevented?

For most girls, there’s no way to prevent yeast infections. Girls may feel more comfortable and have less irritation if they wear breathable cotton underwear and loose clothes and avoid vaginal sprays and douches. Wearing cotton underwear may also help prevent yeast infections. If your daughter has diabetes, keeping her blood sugar levels under control will help her avoid getting yeast infections.

If you think your daughter has an infection, call your doctor for advice. Don’t give her leftover antibiotics or someone else’s antibiotics or medicine because they be the wrong choice for her condition. And taking antibiotics when they are not needed can make a girl more likely to get yeast infections.

What Is a Yeast Infection? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Vulvovaginal Candidiasis and Pregnancy

Candida yeast colonizes the vagina of at least 20 percent of all women — and 30 percent of all pregnant women.

Research suggests that vulvovaginal candidiasis is especially common among pregnant women; because of this, the infection is sometimes considered a complication of pregnancy.

Both the increased candida colonization and yeast infection rates during pregnancy appear to be caused by several pregnancy-related factors, including increased estrogen levels, reduced immunity, and increased concentrations of sugar (a food source for yeast) in vaginal secretions. (18)

The symptoms and severity of yeast infections are no different during pregnancy, but treatment varies slightly.

Applying a topical azole for seven days is the recommended treatment for yeast infections during pregnancy; oral azoles have not been proved safe for pregnant women.

In fact, research published in January 2016 in the Journal of the American Medical Association (JAMA) suggests oral azoles increase a pregnant woman’s risk of spontaneous abortion. (19)

Diabetes and Vaginal Yeast Infections

Vaginal yeast infections are also considered a complication of type 2 diabetes, as the metabolic disease makes you more susceptible to the infection.

Diabetes mellitus also makes you more prone to infections by the azole-resistant species of yeast C. glabrata.

If your diabetes is uncontrolled, you’ll have high levels of sugar in your blood, which also affects the levels of sugar in other areas of your body. Specifically, the mucous membrane in the vagina and vulva becomes saturated with sugar, allowing Candida to rapidly reproduce.

A diet high in refined sugars may contribute to a diabetic woman’s risk of yeast infection. (6)

Nongenital Yeast Infections

Though the term “yeast infection” is most often used to refer to a vaginal infection, it also applies to other types of candidiasis.

A yeast infection of the mouth and throat is called thrush, or oropharyngeal candidiasis. (20)

When a yeast infection affects the esophagus (tube connecting the throat and stomach), it’s called esophageal candidiasis, or Candida esophagitis. (5)

A yeast infection of the skin — which typically occurs in warm, moist areas, such as the armpits and groin — is called cutaneous candidiasis. (21)

And if candida gets into the bloodstream, such as from using a contaminated intravenous catheter or as a complication of thrush, the yeast can cause a deadly infection called invasive candidiasis. Here, it enters your bloodstream and travels to other parts of your body, including your lungs, liver, and heart valves.

It can cause infection or inflammation in various body parts, such as meningitis (infection of the membranes of the brain), esophagitis (esophagus), endophthalmitis (eyes), endocarditis (heart), urinary tract infections (UTIs), and arthritis (joints). (7,22)

Candida can cause an infection of the bloodstream itself, called candidemia. (23)

Invasive candidiasis most frequently affects people who are critically ill and in intensive care units, such as from yeast that travels to the bloodstream from the gut, or leakage after abdominal surgery. (24)

Doctors typically treat the infection with antifungal medication, but up to 40 percent of people with invasive candidiasis die regardless of treatment. (25)

Additionally, men can get yeast infections in their genitals (candidal balanitis), mouths, and other areas.

Yeast Infections in Dogs | Small Door Veterinary

Itchy, irritated skin with a distinct odor can be an indication of a yeast infection, a common skin concern for dogs. A dog will typically develop a yeast infection on the skin or in the ears. Regardless of location, a yeast infection can cause extreme discomfort and can be an indication of a more serious issue.

In This Article

What are yeast infections in dogs?

A yeast infection occurs when there is an overabundance of yeast found on the body of a dog. Yeasts are budding, spore-like forms of fungi that typically live on the body without causing illness. It is only when their numbers grow that they cause issues.

Signs & symptoms of yeast infections in dogs

Yeast thrives in a moist environment, so for dogs, that can be in places such as the ears, paws, armpit, groin, and even the folds of their face in certain breeds. A veterinarian will be able to make a definitive diagnosis, but as an owner, watch for these certain signs.

  • Changes in skin color and texture. In the early stages of a yeast infection, the skin begins to turn pink or red. When dealing with chronic yeast infections, the skin may become leathery, thick, and gray or black.

  • Greasy skin. The skin can become greasy or excessively oily.

  • Scaly skin. Some dogs may develop scaling, crusting, or flakiness of the skin, similar to dandruff.

  • Head shaking and tilting. Because the ears are the most common place for a dog to develop a yeast infection, pay close attention if your dog starts exhibiting these movements.

  • Scratching and rubbing. Yeast infections are incredibly itchy, and some dogs will try and scratch the infected area or rub up against the floor, furniture, or another surface to get relief.

  • Licking. Incessant licking of the infected area is another way a dog might try and find relief.

  • Swelling and warmth. Redness and swelling are the first signs of a yeast infection, but a dog’s symptoms can progress to swelling, warmth, and pain in the infected area.

  • Odor. Another common sign of yeast infection is a distinct smell, which will likely be your first indicator that your dog has this condition. The smell has been described by dog owners to mimic a musty or cheesy scent.

  • Hair loss. For yeast infections in the ear, which can be associated with inflammation, hair loss will occur around the ears.

  • Drooling. Although extremely rare, a yeast infection can occur inside the mouth, leading to drooling, discomfort, and problems eating. These signs can also be indicators of other oral issues that can be determined by your veterinarian.

How to tell the difference between ear mites and yeast infection

Yeast infections in dogs’ ears typically result in head shaking and rubbing, itching, odor, redness, and brown discharge. Ear mites in dogs have many of the same symptoms, however, there are a few slight differences. Ear mites cause a dark discharge from the ear that can be waxy or crusty. Ear mites are also barely visible to the naked eye, extremely itchy, and very contagious to other animals. If your dog is experiencing any of these symptoms, contact your vet so they can determine whether it’s a yeast infection or ear mites and the best option for treatment.

What dog breeds are prone to yeast infections?

Although it’s possible for all dogs to contract a yeast infection, it’s more common for specific breeds. Breeds with excess skin folds, floppy ears, hair growing in the inner ear canal, and those with allergies have a higher chance of getting a yeast infection.

Susceptible breeds include:

What causes yeast infections in dogs?

Yeast infections can develop for many reasons. A dog with an underactive immune system can develop yeast overgrowth and infection. An overactive immune system, meanwhile, can trigger allergic reactions, which also leads to yeast infections.

When a dog develops allergies, it can be a sign of an overactive immune system. If the allergy is severe, a veterinarian will prescribe medication to help alleviate those symptoms, although certain medications can alter the natural balance of good bacteria, and can lead to yeast overgrowth.

Allergens such as pollens, mold, dust, cigarette smoke, cleaning products, and even certain foods, especially if they’re high in sugar and carbs, can also lead to yeast infections. For some dogs, yeast problems are seasonal, and when the temperature and humidity are high, problems with yeast can occur.

Since yeast thrives in a moist environment, dogs that are bathed or in water often are prone to yeast infections in the ear. If the ear is not kept dry, water and debris can become trapped inside the ear canal. Other causes for yeast infections in a dog’s ear include wax or discharge, a trapped foreign object inside the ear, poor hygiene, hot, humid weather, and the use of products or ear drops that alter the natural environment of the ear.

Too much exercise and spending time in the hot sun (which can be dangerous for other reasons as well) can also contribute to the overgrowth of yeast.

Diagnosing yeast infection in dogs

A veterinarian can confirm a definitive diagnosis through cytology or by culturing. Hair and skin samples can be taken from around the affected area and tested under a microscope to determine a yeast infection.

If the yeast infection is believed to be inside the ear, the veterinarian will use a device called an otoscope to look inside the ear canal. A sample may also be taken from in and around the ear to be examined under a microscope. This will help further determine if the infection is caused by yeast, bacteria, or even both.

How to treat yeast infection in dogs

The first step in treatment is to identify and address the underlying cause of the yeast infection. Along with medication, at-home remedies can not only offer relief, but can also be a preventable measure.

At-home treatments can include the following:

  • Medicated baths. As long as there aren’t any secondary infections, an antifungal medicated shampoo can help to get the yeast infection under control. Wash your dog every 3-5 days for 2-12 weeks (or as long as directed by your veterinarian) for maximum effect.

  • Topical cream. If the infection is in a small area, you can apply an antifungal cream directly to the spot and cover. The medicated cream should come with specific instructions so follow carefully.

  • Clean your dog’s ears. Since the ears are one of the most common areas for a yeast infection, it’s important to keep them clear and clean. Using a dog-ear cleaning solution designed to lower pH levels, gently clean the ear with a soft tissue or cotton ball (do not put Q-tips down into the ear canal), and if necessary, apply a yeast infection cream inside the ear as directed.

  • If the infection is deeper inside the ear canal, oral medication and possibly surgery might be required; only your veterinarian can determine the course of action in this situation. Serious yeast infections inside the ear can take up to six weeks to heal.

  • Keep paws clean and dry. A dog’s sweat glands are primarily located in the paws, so it’s smart to wipe down after long or vigorous exercise. Plus, the paws come into contact with dirt frequently, especially when outside for walks or playtime, so it’s another reason to keep them clean.

  • Examine your dog’s diet. A healthy diet is key and the foundation for good health. Yeast loves sugar so avoid foods and treats loaded with refined carbohydrates like potatoes, corn, wheat, rice, honey, and high-fructose corn syrup should be cut out of your dog’s diet. You should also avoid giving your dog any table food.

Are there home remedies for yeast infections in dogs?

The only home remedy for yeast infections in dogs that has any scientific data to support it is a vinegar rinse. A vinegar rinse is able to help change the pH of the skin to make it less desirable for yeast. The proper dilution is essential to avoid irritation. You should only attempt this after speaking with your veterinarian for guidance and direction.

Is there a cure for yeast infection in dogs?

While yeast infections can be cured, some dogs are prone to recurrent infections. The best way to prevent a possible occurrence is to take care of your dog’s immune system properly. When you treat the root of the problem, you are not only taking care of the possible yeast infection but other potential skin issues that are a result of problems that originate in the digestive tract.

Are yeast infections in dogs contagious for humans or other pets?

If your dog has a yeast infection, the yeast cells cannot be transmitted to another pet even if they come in direct contact with the infected dog’s skin. What should be noted is that a yeast infection can lead to a secondary bacterial or fungus infection, which may be contagious in some cases. This holds true for humans as well; secondary infections, such as ringworm, are contagious and owners should take precaution when directly handling their dog.

What is the cost of treating yeast infection in dogs?

To treat a yeast infection in your dog, take into consideration the type of treatment needed (oral vs. topical medications), the area in which you live in (certain cities have a higher cost of living), and the type of veterinarian (general practitioner vs. veterinary dermatologist) you plan to visit. Prescription medications tend to cost more than over-the-counter medicine, while home remedies, if recommended, might be a bit lower. Also take into consideration how long and how much medicine your dog will need and whether the treatment is only for a yeast infection or whether medication is needed for an extended period to alleviate an underlying issue. These issues all play a role in determining the actual cost.

Recovery and management of yeast infection in dogs

Recovery depends on the severity of the infection. If it’s mild and caught in the early stages, it can clear up in a few days. If it’s a severe infection, it can take up to a few weeks to completely heal.

Managing a yeast infection requires continuous monitoring of your dog’s immune system. Frequent baths with antifungal shampoo and sprays will help soothe the skin, although you should check with your veterinarian before beginning any at-home treatments.

How to prevent yeast infections in dogs

Although yeast infections in dogs are mostly unpredictable, certain triggers can lead to an overgrowth of yeast. Being aware of those stressors will help keep your dog’s health under control.

A few tips to help prevent yeast infections:

  • Keep your pup indoors during extreme heat and humidity.

  • Feed a good quality food and be aware of any food allergies.

  • Keep the ears clean and healthy with regular checks.

  • Ensure your dog is completely dry, including paws and ears after a bath or swim.

  • If your dog has hair at the opening of his ears, have your groomer trim or tweeze it.

  • Use flea and tick preventatives as directed by your veterinarian.

Is there a vaccine for yeast infections in dogs?

There is no vaccine to prevent a yeast infection, but there are precautions owners can take to lower the risk of one.

Summary of yeast infections in dogs

Yeast infections are a common skin concern for dogs, causing itching and irritation. They typically occur in moist environments, like on the skin or in the ears or even the folds of their face. Often caused by allergies, yeast infections should be treated promptly, to avoid secondary infections and alleviate your dog’s discomfort. As some dogs can be prone to recurrent yeast infections, it’s important to identify the root cause and take precautions ahead of time to protect their immune system.

Yeast Infection | Women’s Health

Yeast infection: hearing those two words together is enough to make many women feel all kinds of itchy down there. But it turns out the same type of infection, caused by a fungus called candida, can make other places in your body itch and burn as well. Great. Luckily, Kathleen Green, M.D., ob-gyn, says that yeast infections—no matter where they turn up—can usually be treated with oral prescription medication or the same cream used to treat a vaginal yeast infection. 

The fungus alone isn’t the culprit, Green says, but when the yeast outgrows the other “good bacteria” in the body, that’s when an infection can form. Things that add moisture like sweating, having sex, or sitting too long in a wet bathing suit are known to create the perfect environment for yeast to thrive in the vagina. Extra moisture in other already damp, dark places in the body can cause the fungus to grow, too.

Here are some of the other random places in the body that could be affected. 

Alyssa Zolna

Yeast infections can pop up in virtually any place on the skin that gets constant moisture, but Green says her diabetic and immunocompromised patients are typically the ones who see this happen. Because the body can’t fight off infection as quickly, doctors prescribe a prescription medication that may be stronger and have a longer course than a drugstore cream.

Yeast infections can also develop under skin folds, Green says, and a cream like Monistat will help clear up the fungus if it is only on one small part of the skin. For systemic infections that spread to larger areas, a prescription medication is usually the go-to solution.

Related: Why You Should Always Shower Before Going to Bed

Alyssa Zolna

Much like athlete’s foot, an infection caused by another type of fungus (called trichophyton mentagrophytes), Green says yeast can turn up on feet, too. Sweaty socks or shoes could be to blame, so keep your feet clean and free of extra moisture to prevent yeast from growing between your toes. These are best treated with an antifungal over-the-counter cream. 

Watch a hot doctor explain whether you have to treat yeast infections or not:

Alyssa Zolna

This yeast infection is common, but it’s usually only found in babies who are breast- or bottle-feeding, Green says. If they haven’t mastered swallowing yet, the milk can sit on their tongues, causing an infection. Doctors will prescribe an oral antifungal treatment to clear up the infection and white patches on the tongue that may come with it. 

Alyssa Zolna

Breastfeeding moms are more prone to get yeast infections on their breasts, Green says. A baby’s mouth can change the pH balance and add moisture that helps yeast grow. The infection can also occur under the breasts, caused by extra sweat. To keep the fungus from causing problems, keep the area clean and avoid staying in a sweaty sports bra too long after a workout. Like with other yeast infections on the skin, an antifungal cream will clear this up if it stays in a concentrated area. If the infection spreads, it’s time to see an M.D. to see if you need an oral prescription, Green says.

Related: 11 Nipple Facts You Need in Your Life

Alyssa Zolna

Certain oral medications used to treat other problems in the esophagus can cause yeast to grow there. Thrush, the layman’s term for a yeast infection in the throat, typically affects immunocompromised patients, whether they are undergoing chemotherapy or have an autoimmune disease. Green says if this happens to you, see your M.D., who might prescribe an oral solution to treat the yeast quickly.

Alyssa Zolna

Vaginal yeast infections can spread to the butt, Green says. When women itch their vaginas and then the skin on their butts or between the cheeks, the infection can be transferred by their hands. For a yeast infection here, applying a cream like Monistat on to the skin will treat the infection. For both vaginal and anal infections, Green recommends the three-day or seven-day treatments to kill as much yeast as possible.

Related: Must-Know Facts About the Most Common Cause of Stinky Hoo-Ha

Alyssa Zolna

Green says about 15 to 20 percent of penises are colonized with yeast, and while the yeast may not always cause symptoms, sometimes itching and burning can happen because of it. Like on any part of the skin, penile yeast infections can form as added moisture from bodily fluids, like sweat, that help create a friendly environment for yeast.  Working out and infrequently changing underwear ramps up chances of contracting one, and the treatment is an antifungal cream.

Carly Breit
Web Editorial Fellow
Carly Breit is a freelance writer who loves to write about health, wellness, and strong women.

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Antifungal Safety Guide


Treatment Products
MONISTAT® 1, 3, & 7 should only be used for the treatment of vaginal yeast infections.

Safety First
If you have never had a vaginal yeast infection before, see your healthcare professional before using any MONISTAT® antifungal product. Do not use MONISTAT® 1, 3, or 7 day products for external vaginal (vulvar) itching due to causes other than a yeast infection. Before using a MONISTAT® product, make sure to read the safety information provided below, or in the product insert.

Some do’s and don’ts when using MONISTAT® products:

  • Do not use tampons, douches, spermicides or other vaginal products.
  • Do not rely on condoms or diaphragms for contraception and disease prevention, as they may be damaged and fail to prevent pregnancy or sexually transmitted diseases (STDs).
  • Do not have vaginal intercourse.
  • Do not scratch the skin outside the vagina. Scratching can cause more irritation and can spread the infection.
  • Be aware that a mild increase in vaginal burning, itching or irritation may occur.
  • Do use during your menstrual period.
  • If pregnant or breast-feeding, ask a healthcare professional before use.
  • Tell your healthcare professional about any drugs you are currently taking.
  • Keep out of reach of children. If swallowed, get medical help or contact a Poison Control Center (1-800-222-1222) right away.

Stop use and ask your healthcare professional if:

  • Symptoms do not improve in three days.
  • Symptoms last more than seven days.
  • You get a rash or hives, abdominal pain, fever, chills, nausea, vomiting or foul-smelling vaginal discharge. These may be signs that you have a different kind of vaginal infection. There may be a more serious condition present or you could be experiencing an allergic reaction.

What side effects may occur with MONISTAT® antifungal products?

  • A mild increase in vaginal burning, itching, irritation or headache may occur when the product is used. Abdominal cramping has also been reported.

Stop use and ask your healthcare professional if you have any of the following symptoms while using MONISTAT® antifungal products:

  • Abdominal pain
  • Hives
  • Skin rash
  • Severe vaginal burning
  • Vaginal itching
  • Vaginal irritation
  • Vaginal swelling
  • Headache

Warning: It’s important to know that MONISTAT® antifungal products:

  • Are for vaginal use only.
  • Are not intended to be used by anyone under the age of 12.

Monistat® should not be used without seeing your healthcare professional if you are having vaginal itching and discomfort for the first time. Ask a healthcare professional before use if you have:

  • Vaginal itching, burning and discomfort for the first time.
  • Lower abdominal, back or shoulder pain, fever, chills, nausea, vomiting or foul-smelling vaginal discharge. You could have a more serious medical condition.
  • Vaginal yeast infections often (such as once a month or three in six months). You could be pregnant or have a serious underlying cause for your symptoms, including diabetes or a weakened immune system.
  • Been exposed to the human immunodeficiency virus (HIV) that causes AIDS
  • Consult a healthcare professional before use if you are taking the prescription blood-thinning medicine warfarin (i.e., Coumadin), because bleeding or bruising may occur.  

What is warfarin?
Warfarin is a drug that causes an anticoagulant effect (prevents clotting). It is often used in people at risk for a stroke. Those on warfarin should be continuously monitored. There are many drugs that interact with warfarin to increase or decrease the anticoagulant action. If a drug interaction occurs, causing circulatory levels of warfarin to increase, you become at risk for bleeding.

Why do miconazole nitrate and warfarin interact?
The liver metabolizes both drugs, so taking them together may increase the levels of warfarin in the blood. Such an interaction with warfarin occurs with many drugs that are metabolized by the liver.

Do warfarin interactions occur with all miconazole nitrate products? 
Warfarin may interact with all miconazole nitrate products from all suppliers.

What are the chances of an interaction with warfarin occurring?
The risk in each individual is variable. You should follow the instructions on the package and consult a healthcare professional before using both products together.*

*If you are using MONISTAT® 1-Day Treatment Prefilled Tioconazole Ointment, you do not need to see a healthcare professional about potential interactions with the prescription warfarin because such interactions are not expected.

Does the “Interaction with warfarin” warning appear on all MONISTAT® products?
Our company placed the following warning on all topical miconazole nitrate-based MONISTAT® products: Ask a healthcare professional before use if you are taking the prescription blood-thinning medicine warfarin, because bleeding or bruising may occur.*

If you have any other questions or need more information about MONISTAT® products, call our STAFFED ANSWER LINE: 1-877-MONISTAT® (1-877-666-4782), between 8:00 A.M. and 5:00 P.M. EST, Monday through Friday. It’s toll-free. And anything discussed is strictly confidential.

Oral Thrush. Causes, Symptoms & Treatment of oral thrush

What is oral thrush?

Thrush is an infection caused by a yeast germ called Candida. The mouth is a common site where Candida causes infection. Candidal infection in the mouth is called oral thrush. Other common sites for thrush to develop are the vagina, nappy area, and nail folds. See separate leaflets called Vaginal Thrush (Yeast Infection), Candidal Skin Infection and Nappy Rash for more details about these other types of thrush.

Who develops oral thrush?

Small numbers of Candida commonly live on healthy skin and in a healthy mouth. They are usually harmless. Healthy people do not normally develop oral thrush. However, certain situations or conditions may cause an overgrowth of Candida which can lead to a bout of oral thrush. These include:

  • Being a baby. Oral thrush is quite common in young babies.
  • Wearing dentures, especially if they are not taken out at night, not kept clean, or do not fit well and rub on the gums.
  • A course of antibiotic medicine. Antibiotics will kill harmless germs (bacteria) which live in the mouth. They do not kill Candida which may multiply more easily if there are fewer bacteria around.
  • Excessive use of antibacterial mouthwash (for similar reasons to above).
  • Taking steroid tablets or inhalers.
  • Having a dry mouth due to a lack of saliva. This may occur as a side-effect from certain medicines (such as antidepressants, antipsychotics, chemotherapy medicines). It may also occur following radiotherapy to the head or neck, or as a symptom of Sjögren’s syndrome.
  • Having diabetes.
  • Having severe anaemia.
  • Lacking iron, folate or vitamin B12.
  • Having a poor immune system. For example, if you are taking medicines that suppress your immune system, if you have certain cancers, or if you have HIV/AIDS.
  • Being frail or in generally poor health.
  • Smoking. Smokers are more likely to develop oral thrush.

Oral thrush is not usually contagious. You cannot usually pass on oral thrush to other people.

What are the symptoms of oral thrush?

  • The classical symptom is white spots that develop in your mouth. The spots may join together to form larger spots called plaques. They may become yellow or grey. If you wipe off a spot, the underlying tissue may be red but it is not usually sore or painful.
  • Often there are no white spots. Areas in your mouth may just become red and sore. This more typically occurs if you develop thrush after taking antibiotics or steroids.
  • Denture wearers may develop an area of persistent redness under a denture.
  • You may develop sore, cracked, red areas just outside your mouth. This mainly affects the angle where the upper and lower lips meet (angular stomatitis).
  • Some mild oral thrush infections are painless. However, sometimes oral thrush is quite sore and can make eating and drinking uncomfortable. Some babies with oral thrush may drool saliva, or not be able to feed properly because of soreness.
  • Taste can be affected in some people with oral thrush.

How is oral thrush diagnosed?

Your doctor will usually diagnose oral thrush by your typical symptoms and the typical appearance in your mouth. No investigations are usually needed to diagnose oral thrush.

However, your doctor may sometimes suggest a blood test to look for certain conditions that may make you more likely to develop oral thrush. For example, a blood test to see if you are lacking iron, vitamin B12 or folate.

If oral thrush does not respond to treatment (see below), your doctor may suggest that they take a sample (swab) from inside your mouth. The swab is then sent to the laboratory to be examined under a microscope. They can also try to grow the Candida in the laboratory.

Occasionally, a biopsy is needed to confirm a diagnosis of oral thrush. A small sample is taken from the white patches inside your mouth and this can be examined under a microscope.

What is the treatment for oral thrush?

Locally applied treatment

For mild oral thrush, the usual treatment that is tried first is miconazole mouth gel for seven days. Sometimes a two-week course is needed. Nystatin drops are another option if miconazole gel cannot be used (for example, if you are known to be allergic to it).

Follow the instructions in the packet:

  • The gel or drops should be used after you have eaten or drunk.
  • Smear a small amount of gel on to the affected areas, with a clean finger, four times a day.
  • With the drops, you use a dropper to place the liquid inside your mouth on to the affected areas four times a day.
  • Ideally, you should not eat or drink for about 30 minutes after using either the gel or the drops. This helps to prevent the medicine from being washed out of your mouth too soon.

Anti-thrush tablets

Tablets that contain a medicine called fluconazole can also help to clear fungal and thrush infections from the body. Tablets tend to be used in more severe or serious cases. For example, for people with a poor immune system who develop extensive oral thrush. Tablets are usually prescribed for seven days and this will usually clear oral thrush.

Adjustment of other medication

If you are taking other medication that may have caused oral thrush, such as steroids or antibiotics, your doctor may need to change this medication or reduce the dose to help clear up your thrush.

Referral to a specialist

Your doctor may suggest that he or she refer you to (or ask the advice of) a specialist if:

  • The above measures do not help to clear your oral thrush infection.
  • You have particularly severe infection or other health problems (for example, you are undergoing chemotherapy or are taking other medicines that weaken your immune system).

Can oral thrush be prevented?

It may be possible to alter one or more of the situations mentioned above to help prevent further bouts of oral thrush. For example:

  • If you have diabetes – good control of your blood sugar level reduces the risk of thrush and other infections.
  • If you use steroid inhalers – having a good inhaler technique and using a spacer device may reduce the risk of thrush. Also, rinse your mouth after using the inhaler, to help remove any medicine particles left in your mouth. Ask your doctor about reducing your dose of steroid in your inhaler to the lowest level needed to control your asthma.
  • If you wear dentures:
    • Leave your dentures out overnight, or for at least six hours daily. Constant wearing of dentures, and not taking them out at night, is thought to be one of the most common causes of oral thrush.
    • Clean and disinfect dentures daily. To clean, use soapy water and scrub the dentures with a soft nailbrush on the fitting surface – that is, the non-polished side. Then soak them in a disinfecting solution. The type of solution and the time they should be soaked for will be advised by your dentist. Rinse the dentures after disinfecting them, and then allow the dentures to air dry before wearing them again. Drying like this helps to kill any Candida that might be stuck to the dentures.
    • Clean the inside of your mouth (where the dentures sit) with a soft brush.
    • See a dentist if the dentures do not fit well.
  • If you take medication which causes a dry mouth – take frequent sips of water. See separate leaflet called Dry Mouth for more details.
  • Tips to prevent oral thrush in babies are included in the separate leaflet called Oral Thrush in Babies.
  • If you are found to have anaemia or low levels of vitamin B12, folate or iron, treating this may help to prevent oral thrush in the future.
  • If you are a smoker, quitting smoking may help to prevent further bouts of oral thrush. See separate leaflet called Tips to Help You Stop Smoking for more details.
  • Certain groups of people may be given anti-thrush tablets to help to prevent oral thrush. For example, people who are on medication to suppress their immune system or who are receiving chemotherapy for cancer.

Yeast Infections | My Alfred University

Vaginal yeast infections are most often caused by a fungus called Candida albicans. This is a common fungus normally found in small amounts in the vagina, mouth, digestive tract, and skin. Most often it leads to no symptoms, but if for some reason the number of Candida fungi increases and the balance is disturbed, a yeast infection can occur. This balance is known to be disrupted under the following conditions: antibiotic use, pregnancy, obesity, high sugar diet, or diabetes.

Symptoms of a vaginal yeast infection

  • Vaginal discharge (range from watery to thick and white)
  • Itching/burning of vagina/labia
  • Painful intercourse
  • Painful urination
  • Redness/swelling of the skin in the genital area

Is a vaginal yeast infection an STI?

Vaginal yeast infections are not spread through sexual contact. It is possible for men to develop itching/rash on the penis after sexual contact, but it isn’t an infection that is passed on. With vaginal discharge, though, it is important to rule out other causes, such as STIs. A pelvic exam can assess for symptoms, and a microscopic examination of the discharge can help provide an accurate diagnosis.

How is a vaginal yeast infection treated?

If this is the first time experiencing these symptoms, it is important to see a healthcare provider for an accurate diagnosis. Some women, however, are comfortable treating the infection themselves. Self-care is only advised, however, when the woman is not worried about any STIs. There are over the counter treatments available in the form of creams, ointments, vaginal tablets/suppositories, and oral tablets. Treatments last from 1 to 7 days, depending on which medication is chosen. As with any medication, follow package directions, and take the complete course even if symptoms disappear. Most often, treatments are effective, but occasionally they aren’t and require a healthcare provider to prescribe a more effective treatment. If the soreness and itching lead to open sores, skin infection is a possibility and should be monitored for.

How can I treat/prevent vaginal discharge?

  • Keep genital area clean and dry. When bathing, use water only. A warm bath may help with symptoms.
  • Don’t douche as it can disturb a healthy bacterial lining and disturb the balance of Candida in the vagina
  • Eat yogurt with live cultures or take a probiotic tablet when on antibiotics to help prevent the bacterial imbalance in the vagina
  • Use condoms to prevent the spread of other infections
  • Avoid sprays, fragrances, or powders in the genital area
  • Avoid tight-fitting pants or shorts, and choose underwear that are cotton and/or use cotton-crotch pantyhose. Avoid underwear made of silk or nylon as they lead to sweating and moisture containment, a good environment for yeast growth.
  • If diabetic, keep your blood sugar level under good control
  • Change out of bathing suits and sweaty work-out clothes soon after use as moisture build up can lead to an imbalance in the Candida growth

When should I see a health care provider?

There are certain situations when a provider should be consulted. If it is your first experience with a yeast infection or you aren’t sure if it is a yeast infection, see a provider to confirm the diagnosis. Also, if symptoms don’t improve with treatment, worsen, or if new symptoms develop, it’s important to see a provider. Finally, if it’s possible that there was exposure to an STI, diagnosis and appropriate treatment are crucial. If concerned, call the health center to make an appointment for an assessment.

MedlinePlus Vaginal Yeast Infection

90,000 Foot fungus – what you need to know

Foot fungus is the most common fungal infection. It develops when a favorable environment for dermatophytes appears – fungi that can parasitize on our skin.

Fungal infection is a consequence of excessive skin damage by these fungi. Their growth and reproduction can be due to the presence of a beneficial environment that can arise right inside our shoes.

Excessive reproduction of dermatophytes causes infection, and the development of the disease occurs due to the fact that the fungus begins to feed on dead cells of our skin and multiply.

Most often, the fungus appears between the toes, less often on the back of the foot or on the sole. The characteristic symptoms of the fungus are redness and stratification of the skin.

Foot fungus spreads on the skin quite easily and quickly, and is also quickly transmitted from person to person: it survives well in a humid environment, especially in showers, swimming pools, as well as in our shoes.

If you catch the fungus, you may have contracted it in a public place. Walking barefoot in locker rooms and shared showers, using someone else’s towels, clothes, and lack of hygiene – all these factors can cause infection.

What are the symptoms of spreading infection?

Most common symptoms of foot fungus:

  • Itching
  • Swelling
  • Skin redness and exfoliation
  • Dry skin
  • In more advanced cases, the foot may become inflamed, blistering or blistering, which can cause cracks in the foot. When walking, they deliver hellish pain.
  • Over time, fungus in a specific part of the foot can spread to the entire foot, causing redness.
  • If the symptoms are severe enough and the skin on the legs is cracked, the infection can spread to the inner tissues of the leg. 1

It is recommended to wash contaminated clothes and shoes in hot water using disinfectants, such as soda, hydrogen peroxide and various kinds of bleaching agents 2 – since just warm soapy water is not capable of killing the fungus.

In conclusion

If you start treatment, make sure you complete the entire course.The fungus may remain in your skin long after the underlying symptoms have disappeared.

The chances of permanently getting rid of the fungus are higher if the treatment lasts as long as indicated in the instructions.

Quite often people stop treatment as soon as symptoms disappear. However, the fungus can re-enter the skin at any opportunity, and start bothering you again.


Prostate adenoma

Benign hyperplasia (increase in volume) of the glandular tissue of the prostate gland.According to statistics, it prevails in patients over the age of 50. It is characterized by an urinary disorder, impaired function of the bladder and kidneys, and sexual dysfunctions. In the initial stages of the disease, an asymptomatic course is possible, the final stages are manifested by severe pain syndrome, the inability to urinate independently.


Absence of sperm in the ejaculate.It is one of the causes of infertility in men.

Acne (acne)

Pustular skin lesions, with the most frequent localization in the face, chest and back, associated with a violation of the sebaceous glands. The patients have a feeling of inferiority, depression, shyness, irritability. The disease is accompanied by inflammatory changes around acne (acne) with possible regional lymph node involvement.

Allergic contact dermatitis

Itchy rashes on the skin in places of contact with allergens. When combing, infection is possible with the subsequent spread of the inflammatory process in the skin.

Allergy to drugs

The type of adverse reactions to taking medications from the skin is manifested by itching, rashes, hives, areas of redness, blistering, etc.The most formidable complication is the development of toxic epidermal necrolysis – rejection of large areas of the skin (from 20 to 100%), sometimes incompatible with life.


A cyclical pathological process, consisting of pain in the lower abdomen, which may be accompanied by nausea, vomiting, headache, lack of appetite, fever, fainting and other vegetative manifestations during menstruation.Hypersensitivity to certain hormones during the menstrual cycle, endometriosis, or pelvic inflammatory disease can be the cause.


Pathological absence of menstruation in women for 6 months or more. The cause of the disease can be a brain tumor, psychosis, inflammatory diseases of the ovaries, uterus, malformations of the genital organs, diseases of the adrenal glands, thyroid gland, nutritional disorders.

Anal itching

A pathological condition characterized by persistent itching in the anus. The disease is characterized by a persistent course. It can be primary (true) and secondary, accompanying many diseases (hemorrhoids, anal fissure, helminthic invasions, inflammation of the sigmoid and rectum, constipation, diarrhea, inflammation of the genital organs, diabetes mellitus, fungal skin lesions, etc.).). Anal itching is always dangerous by the development of perianal purulent-inflammatory processes and inflammatory changes in the sigmoid and rectum.

Ovarian apoplexy

Hemorrhage into the ovary, accompanied by its rupture and bleeding into the abdominal cavity. It occurs against the background of a previous inflammatory process. Lifting weights and violent intercourse play a provoking role. It is manifested by severe pain syndrome and signs of internal bleeding.


Absence of sperm in the semen. One of the causes of male infertility.


Reducing the number of mobile forms, as well as the speed of movement of sperm in the semen (more than 30%). One of the causes of male infertility.

Bacterial infections

Purulent-inflammatory lesions of the skin and hair follicles caused by various bacterial flora (the most common are staphylococcal and streptococcal infections).Manifested by the formation of boils, carbuncles, vesicles with serous or purulent contents, inflammation of the hair follicle bulb. Purulent areas of the skin can become necrotic; when a large amount of infectious agents enter the blood, bacteremia develops, which can be fatal.

Bacterial vaginosis

Inflammatory changes in the vagina, accompanied by discharge from the genital tract.Bacterial vaginosis is one of the causes of severe pathology of the female genital organs and complications of pregnancy and childbirth.


Inflammation of the large gland of the vestibule of the vagina. The causative agents are various microbes: staphylococci, gonococci, etc. It is manifested by swelling, pain in the vaginal area.


A symptom of gynecological diseases associated with a change in the secretion of the genital organs.The reasons may be inflammatory processes, tumors of various localization.


Absence for 2 years or more of pregnancy in a woman who has a regular sex life and does not use contraceptives. In 60% of cases, infertility is caused by disorders in a woman’s body, in 40% – in a man’s body. The most common cause of infertility in a woman is anatomical and functional changes in the genitals: infantilism; inflammation of the disease of the fallopian tubes, ovaries, uterus, vagina; dysfunction of the ovaries and pituitary gland, adrenal glands, thyroid gland; tumors of the uterus; endometriosis; ovarian tumors.An important cause of secondary infertility is abortion.

Painful intercourse (dyspareunia)

Possible in both men and women. Pain can appear at the beginning, in the middle of intercourse, after completion, during or after orgasm. Usually pain is felt in the form of cramps, tingling, burning. The pain can be external, in the pelvic region, felt in the penis or vagina, in the abdomen. The reasons can be divided into organic (the presence of diseases of the genitourinary organs), psychogenic and infectious-inflammatory.


Growths on the epidermis (surface layer of the skin) or mucous membranes caused by the human papillomavirus. May appear on the skin of the limbs, palms, soles, scalp, mucous membranes of the mouth, larynx, genitals and rectum. They tend to grow over large areas of the skin or mucous membranes. When warts are traumatized, it is possible to introduce an infection with the development of inflammation.They cause a pronounced cosmetic defect that greatly disturbs patients. The most formidable complication is malignancy (malignancy) of the process with the development and progression of malignant tumors.


Inflammation of the vaginal mucosa. The causative agents are: streptococci and staphylococci, Escherichia, Trichomonas, mushrooms. In acute inflammation, complaints of a feeling of heaviness in the vagina, burning, itching in the external genital area.

Vesicular viral rash

Blistering eruptions on the skin or mucous membranes caused by various viruses, including the herpes simplex virus. They are contagious (infectious) diseases. The classic manifestation is grouped vesicles on a red background, open vesicles crusty, accompanied by soreness or itching. Suppression of the immune system is noted, so the rash spreads, covering new surfaces, fever is possible.When a secondary pathogenic flora is attached, purulent skin lesions develop.

Vesicular-bullous dermatoses

Limited lesions of the skin and mucous membranes, manifested by the development of vesicles (vesicles) up to 5 mm in diameter and bubbles (bulls) over 5 mm. The reasons are varied, including infections (bacterial, viral and fungal), external agents (allergic contact dermatitis, bites, burns, radiation, photodrug reactions), inflammatory dermatoses, genetic defects.Large surfaces of the skin or mucous membranes can be affected, patients are worried about soreness and itching in places where blisters develop. Perhaps the addition of purulent skin lesions with severe intoxication, fever.

Herpes simplex virus

Blistering eruptions on the skin or mucous membranes caused by various viruses, including the herpes simplex virus. They are contagious (infectious) diseases.The classic manifestation is grouped vesicles on a red background, open vesicles crusty, accompanied by soreness or itching. Suppression of the immune system is noted, so the rash spreads, covering new surfaces, fever is possible. When a secondary pathogenic flora is attached, purulent skin lesions develop.

Viral exanthema

Any skin rash associated only with a viral infection.Most often appears with measles, rubella, herpes, intestinal viruses, chickenpox, etc. The spread of the rash can be in the form of spots and nodules, blisters, redness, etc. Treatment of the underlying disease is always indicated.

Human papillomaviruses

Growths on the epidermis (surface layer of the skin) or mucous membranes caused by the human papillomavirus. May appear on the skin of the limbs, palms, soles, scalp, mucous membranes of the mouth, larynx, genitals and rectum.They tend to grow over large areas of the skin or mucous membranes. When warts are traumatized, it is possible to introduce an infection with the development of inflammation. They cause a pronounced cosmetic defect that greatly disturbs patients. The most formidable complication is malignancy (malignancy) of the process with the development and progression of malignant tumors.

Pubic louse

Parasitic infection with a characteristic localization of the process in the pubic region.It can also be found on short hairs in the occiput, torso, eyebrows, eyelashes and armpits. The most common route of infection is through sexual contact. Bites cause itching, discomfort, scratching is dangerous by introducing a secondary infection into the wound.


Inflammation of the external genitalia, often associated with vaginitis. It occurs as a result of mechanical, chemical influences and the development of infection.It is manifested by pain and itching in the genital area.


A benign vascular tumor that can develop at any age and anywhere in the body. Available in various sizes and shapes. On the skin, hemangiomas are raised formations of red, dark blue or cherry color. Sometimes there is a reverse development of the hemangioma. At this site, hypopigmentation, excess skin, fibrous fat deposits or scars develop.The most formidable complication of hemangiomas are violations of vital functions (vision, breathing, nutrition, defecation or urination), ulceration followed by bleeding and the development of infection, heart failure, etc.

Genital herpes

Sexually transmitted infection. The causative agent is most often the herpes simplex virus II. Asymptomatic viral shedding can occur in the following cases: the rash is located in places inaccessible to patients, due to their anatomical location; lesions are misinterpreted by the doctor or patient (eg, candidiasis, fissures).

Deep trichophytosis

Damage to the scalp (scalp, ringworm) caused by a fungal pathogen. It manifests itself as inflammatory plaques, abscesses, sometimes accompanied by an increase in regional lymph nodes and fever. In some patients, residual scarring and persistent baldness are observed.

Deep mycoses

Certain fungal infections that can penetrate deep into the skin and cause damage to mucous membranes, lymph nodes and internal organs.Clinical manifestations on the skin are varied, depending on the type of pathogen. The most formidable complications are the drift of a fungal infection through the blood vessels to the tissues of the joints, bones, eyes, meninges, etc.

Gonorrheal proctitis

Damage to the rectal mucosa. It is observed when infected discharge from the genital tract flows. It is manifested by a burning sensation in the rectum and an urge to defecate.

Gonorrheal urethritis

Lesion of the mucous membrane of the urethra. Complaints of pain and pain when urinating.

Gonorrheal endometritis

Damage to the mucous membrane of the body of the uterus. The ascent of infection is facilitated by menstruation, abortion, childbirth, intrauterine interventions. The acute stage is accompanied by pain in the lower abdomen, low-grade fever, and serous-purulent discharge.

Gonorrheal endocervicitis

Damage to the mucous membrane of the cervical canal. Complaints of slight pain in the lower abdomen, mucopurulent leucorrhoea.


Disease of the urogenital tract caused by gonococcus, which has a tropism for the mucous membranes covered with columnar epithelium. The disease is caused by a pathogenic microorganism and is sexually transmitted, leading to infertility.

Fungal lesions of the feet

Interdigital or plantar infection with characteristic inflammation. It appears as peeling, maceration, cracks or redness in the interdigital folds. Damage to the feet according to the “moccasin” type is manifested in the form of diffuse hyperkeratosis (excessive keratinization) and desquamation in the area of ​​the soles of the foot. This form of infection is usually accompanied by nail damage. The inflammatory type of infection is manifested by the rash of blisters on the arch or lateral surfaces of the foot.Blisters and cracks in the foot interfere with normal walking, causing pain. It is always possible to attach a secondary infection with the development of purulent-inflammatory complications.


Inflammation of the skin, manifested by outlined erythema with itching. The lesions pass through 3 stages: acute (with the manifestation of a vascular reaction), subacute (with the formation of crusts and scales in the affected area) and chronic (with a pronounced thickening of the outer skin).Depending on the stage of the disease, skin manifestations can occur in the form of spots, vesicles, plaques, edema, crusts, scales, cracks, etc. , seborrheic, autosensitive, etc. Any areas of the skin are affected, the disease often takes on chronic forms with periodic exacerbations.


Fungal skin lesions.

Diabetes mellitus

a chronic increase in blood sugar levels, which develops as a result of exposure to many factors, including genetic ones. The first signs are thirst, frequent urination, and changes in body weight. In the future, the pathology of the retina of the eye develops with deterioration of vision, impaired renal function, damage to the nervous and cardiovascular systems. The most formidable are acute complications of diabetes mellitus – various types of coma.

Dysplasia of the cervix, vagina

A precancerous condition, which means a change in the epithelium (mucous membrane) of the cervix and vagina of various origins. It can occur both on the unchanged cervix and with concomitant diseases (infectious and inflammatory processes, including sexually transmitted diseases). It does not have a clear clinical picture, most often it is asymptomatic.With severe dysplasia, surgical treatment is indicated (in order to avoid the development of malignant oncology) and constant dispensary observation.

Sexually transmitted diseases

Inflammatory diseases of the genitourinary system in men and women. Includes chlamydia, ureaplasmosis, mycoplasmosis, gardnerellosis, gonorrhea, trichomoniasis, viral diseases (herpes, hepatitis, HPV). Depending on the main localization of the inflammatory focus, the clinic of diseases is diverse – urethritis, prostatitis, cystitis, adnexitis, endometritis, colpitis, vaginitis, etc.The most common consequences are chronic inflammatory processes of the genitourinary organs (sluggish or with frequent exacerbations), all kinds of sexual disorders, infertility.

Itching of the vulva

Belong to precancerous diseases of the external genital organs. It occurs in women during menopause or postmenopause.


Superficial pyoderma (purulent skin lesions).It is caused by group a streptococcus or Staphylococcus aureus. The disease is promoted by non-observance of hygiene rules, vitamin deficiency, inadequate protein nutrition. Primarily, a vesicular element appears on the inflamed skin, which turns into a bubble with a yellowish content. When opened, the contents shrink into yellowish crusts. With a long course, the development of glomerulonephritis (damage to the glomeruli of the kidney) is possible.


A skin disease characterized by excessive dryness of the skin, flaking.The most common are hereditary forms, but it is possible that this condition may occur secondarily in relation to other diseases (malignant tumors, eating disorders, metabolic disorders, etc.). Vulgar ichthyosis begins in childhood, palms, soles, extensor surfaces, thin scales are affected, hair follicles can be affected. Lamellar ichthyosis manifests itself from birth, lamellar scales, dark against the background of reddened skin. The process is generalized, flexion surfaces, palms and soles are affected.

Vulvovaginal candidiasis

Infectious lesion of the vagina and the entrance to the vagina with yeast-like fungi of the genus Candida. The predisposing factors for the development of the disease are the impact of various external factors on a person, prolonged use of antibiotics, hormonal drugs, cytostatics, oral contraceptives, diabetes mellitus, pregnancy, etc. skin and mucous membranes of the vulva and vagina, copious or moderate cheesy discharge from the genital tract, itching and burning, an unpleasant odor that intensifies during sexual intercourse.

Ovarian cyst

Formation resulting from the accumulation of secretions in the preexisting ovarian cavity. Torsion or hemorrhage of cysts with the development of a pronounced pain symptom is possible.

Pathological male climax

A decrease in the level of male sex hormones due to the extinction of the hormonal and reproductive activity of the reproductive system.It manifests itself in the form of sexual dysfunction, increased blood pressure, heart pain, weakness.

Menopause syndrome in women

Disorder of the functions of various organs and systems of the body against the background of the extinction of the hormonal and reproductive activity of the reproductive system. Possible neuropsychiatric disorders (fatigue, depression, tearfulness, sleep disturbances, fears), autonomic disturbances (hot flashes, tachycardia, increased blood pressure, migraine, pain in the heart, etc.)), trophic disorders (vaginitis, dry mucous membranes, increased fragility of bones, pain in the bladder). It is often accompanied by an increase in body weight.

Kraurosis vulva

Precancerous disease of the external genital organs. Usually observed in women during menopause or postmenopause. Complaints of itching and dryness of the mucous membrane of the external genital organs.

Uterine bleeding dysfunctional

It occurs as a result of a violation of the production of ovarian hormones.It is characterized by an alternation of delayed menstruation and bleeding. With prolonged and heavy bleeding, post-hemorrhagic anemia develops.

Lichen planus

A common disease that occurs in middle age in men and women; non-infectious origin. It is characterized by itchy nodular rashes with clear boundaries of a purple hue on the skin (flexors of the wrists and forearms, sides of the neck, buttocks, penis, ankles, sacrum).Lesions of the mucous membranes of the oral cavity differs from the skin by the absence of nodules in the presence of a white lace mesh. Severe itching in places of skin lesions provokes scratching with the addition of a secondary infection. Against this background, the development of purulent-inflammatory complications is possible.

Leukoplakia of the vulva, cervix

Precancerous disease, manifested by the development of the sclerosing process, the appearance of whitish spots on the external genitals and the vaginal part of the cervix that cannot be removed with a cotton swab.Itching of the vagina is possible. A transition to a malignant formation (cancer) is possible.

Uterine fibroids

A benign tumor originating from the smooth muscle tissue of the uterus. The disease manifests itself in cyclic or acyclic bleeding, symptoms of compression of the bladder and rectum are possible. Development of necrosis or torsion of the leg of the node is possible.


Acute skin inflammation after thermal or chemical exposure.One of the causes of burns is photodermatitis (sunburn), especially in people with lightly pigmented or white skin (blondes, albinos, redheads). Burns are manifested by redness, blistering, and the development of necrosis in severe cases. May be accompanied by headaches, vomiting, fever, fainting.


Fungal infection of the nail bed and nail.It is accompanied by whitening, yellowing and loosening of the nail plate, or detachment of the nail with the formation of subungual crumbling masses and discoloration of the nail. Tends to spread with the defeat of new nail plates. One of the varieties is candidal onychomycosis, noted in patients with chronic candidiasis of the skin and mucous membranes.


Infection caused by the VZ virus parasitizing the nerve ganglia (nodes).Has a periodically repeating flow. A skin rash consists of painful and / or itchy blisters that tend to appear on one side. The development of visible lesions is often preceded by pain. The entire cycle of the disease is usually 2-3 weeks. Most often, the skin of the trunk is affected (in accordance with the zone of innervation of the intercostal nerves), less often – the skin of the face. Shingles can appear in people of any age, especially with reduced immunity. The most common complication is neuralgia with severe and debilitating pain that can last for years.Sometimes lesions of the eyeball develop.

Human papillomavirus infection

The disease, caused by both low- and high-oncogenic types of human papillomavirus, is sexually transmitted, can be latent (without clinical manifestations), subclinical (with a dull clinical picture) or have certain clinical symptoms. Manifested by genital warts, chronic inflammatory processes, dysplasias (precancerous conditions).It can lead to the development of a malignant process.

Papulosquamous rash

Inflammatory skin conditions characterized by red or pink nodules and scaly plaques. This group includes psoriasis, lichen planus, seborrheic dermatitis, lichen rosacea, acute parapsoriasis, lichen planus and filiformis. Large areas of the skin can be affected, the rash is sometimes accompanied by itching.After the disappearance of the rashes, zones of hypopigmentation are formed in their place, in rare cases, scars. Patients are worried about a pronounced cosmetic defect.


Purulent skin lesions. Gangrenous pyoderma can be a manifestation of Crohn’s disease (damage to the mucous membrane of the large intestine), lymphoma, leukemia, cardiovascular failure, rheumatism, etc. Bubbles appear suddenly on the buttocks, thighs, face, opening, turn into ulcers.The ulcers rapidly increase in size, within a few days they can reach 10–20 cm in diameter. Pus is secreted through the holes in the ulcers, regional lymph nodes increase. The course of the disease is severe. After the resolution and healing of the ulcerative process, scars are formed.

Subcutaneous fungal infections

Lesions of the skin and subcutaneous tissue, often developing after an injury or cut with the introduction of a fungal infection into the wound.Nodules form on the skin, rapidly enlarging and ulcerating. Without treatment, blockage of the lymphatic vessels and edema of the elephantiasis type occur. Damage to deep-lying tissues – muscles and bones is possible.

Premenstrual Syndrome

Disorder of the function of the nervous, cardiovascular and endocrine systems in the second half of the menstrual cycle. Complaints about headaches, insomnia, depression, irritability, edema, tachycardia, arrhythmia, and dyspnea that appear 7-10 days before the onset of menstruation.


Inflammatory process of the prostate gland. It is caused by a number of reasons: infectious diseases, stagnant processes of the pelvic organs, microcirculation disorders. The disease can occur in acute, subacute and chronic forms. The most often manifested by the following symptoms: pain, urinary disorder, sexual dysfunctions. Long-term presence of a focus of infection leads to the formation of a chronic inflammatory process with periodic exacerbations and persistent disorders in the sexual sphere.

Occupational diseases

A group of skin diseases caused by harmful production factors. The most common are acne (caused by, for example, fats or oils), depigmentation (caused by certain chemicals), lichen planus (caused by developers), infectious lesions (when working on contaminated surfaces), photodermatosis, contact dermatitis (for example, from rubber gloves at the medical staff), etc.etc.

Versicolor versicolor

Caused by a yeast-like fungus, infection occurs through close contact with patients, when wearing someone else’s clothes, through the sand on the beach. Hormonal imbalances contribute to the development of the disease. It manifests itself in spots of various sizes, brown or yellow, merging into large foci. The spots are slightly scaly, located in the upper part of the body, less often on the neck, scalp or other areas.Without treatment, the process progresses to cover new skin surfaces.


A type of cellulite usually caused by hemolytic streptococcus. Begins with fever, malaise, headache. A red infiltrated plaque with a sharply delineated border appears on the skin. In severe cases, the surface layer of the skin becomes blistered or necrotic. Without treatment, erysipelas leads to death, caused by vascular thrombosis, intoxication and bacteremia (infection in the blood).


Acne rosacea. The cause of the disease is unclear, but it is known that patients experience increased blood flow to the skin. Acne rosacea predominantly affects the forehead, cheeks, nose, and chin. There are three main manifestations of the disease – telangiectasia (spider veins), enlargement of the sebaceous glands, acne-like nodules.

Pink lichen

Acute benign disease affecting young adults and adolescents.It begins with a single, well-defined oval-shaped spot 2–4 cm in diameter with characteristic peeling. After a few days or weeks, similar rashes appear on the trunk and limbs. Trunk lesions are arranged in parallel lines in the form of a “Christmas tree”. The cause of pink lichen is unknown, but the infectious nature of the disease is not excluded.

Hypertrophic scar

Pathological feature of connective tissue to excessive regeneration (proliferation).Scars appear at the sites of cuts, wounds, and other skin defects. Large scars disfigure the skin surfaces, impair the functions of flexion / extension of the limbs. Patients suffer from a pronounced cosmetic defect.


Inflammation of the fallopian tube. It is accompanied by recurrent pain in the lower abdomen, a rise in temperature. Often occurs as a result of the spread of a sexually transmitted infection.The chronic process leads to the development of infertility.

Seborrheic dermatitis

It develops as a result of increased function of the sebaceous glands under the influence of androgens. A certain role is given to the lack of vitamins B6 and H. It is manifested by the formation of fatty yellowish scales located on the reddened scalp, the hair is glued together. Often the skin of the buttocks, genitals, and large folds is affected.It may be accompanied by excruciating itching, the addition of a secondary infection with the development of purulent-inflammatory complications.

Seborrheic keratosis

Benign epidermal skin formation, observed in elderly patients. The reason is unclear. Clinically, seborrheic keratosis presents as well-defined, prominent brown, gray, black, or tan nodules that appear to be “stuck” to the skin.Their surface is often uneven, but sometimes it is warty or smooth. In some cases, seborrheic keratosis is associated with malignant tumors of the internal organs. With frequent trauma to areas of keratosis, malignancy of the process is possible.

Polycystic ovary syndrome

Pathology, which is based on changes in the function of the hypothalamic-pituitary-ovarian system, leading to cystic and degenerative changes in the ovaries.It can manifest itself as menstrual irregularities or amenorrhea, infertility, hirsutism, vegetative manifestations.

Systemic fungal infections

Deep fungal skin lesions involving internal organs (lungs, bone marrow, gastrointestinal tract, spleen, adrenal glands, central nervous system, bones, joints, etc.). They are accompanied by symptoms of a cold, fever, chills, headache, muscle pain, cough.On the skin, the manifestations of fungal infections are variable. The most common are warts or nodules, painful sores on the mucous membranes of the mouth and nose.


Subcutaneous fungal infection. People who practice floriculture, horticulture and caring for animals are at risk of infection. Distinguish between the skin-lymphatic form of the disease (the formation of an ulcerating nodule with the spread of infection along the lymphatic vessels), skin (nodules with ulceration on the skin) and disseminated (damage to the lungs, joints, bones, eyes, meninges).With the spread of the process to the internal organs, a severe clinical course of the disease with impaired function of the affected organ is observed.

Staphylococcal impetigo

Purulent skin lesions caused by staphylococcus. Thin flabby blisters with cloudy contents or layers of pus form on the skin. At the base of the bladder, redness of varying degrees of severity may be observed. Bubbles quickly fall off, and the lesion can take on the appearance of a shiny varnished surface.Older lesions have yellowish crusts. The disease may be accompanied by fever, malaise. It is possible to attach a secondary infection with the development of a severe clinical picture.

Medicinal rash

Skin manifestation of drug allergy. Extensive skin surfaces can be affected. The clinic is diverse – from a benign course of the process to the development of urgent dermatological conditions (acute urticaria, angioedema, toxic epidermal necrolysis – rejection of the superficial skin layer).


Expansion of skin vessels in the form of spider veins. The reason is unknown, family cases are possible. There are several types of telangiectasias, including dermal-ocular, generalized, nevoid. Skin and eye telangiectasias are located on the auricles, behind the ear, on the neck, on the face, eyeballs, conjunctiva, eyelids, in the ulnar, popliteal fossa, the back of the hands and feet.On the skin of the body, areas of skin atrophy, spots of the color “coffee with milk” can be found. Dystrophy of hair, nails, a tendency to various types of infection are noted. When telangiectasias are located on the cerebellum, cerebellar symptoms are manifested – decreased reflexes, convulsions, etc. Generalized telangiectasias spread throughout the body, often accompanied by varicose veins. Nonvoid telangiectasias tend to become malignant.

Urogenital mycoplasmosis

A group of inflammatory diseases caused by pathogenic bacteria – mycoplasmas.Infection occurs primarily through sexual contact. Mycoplasmosis in a woman can cause premature birth, early discharge of amniotic fluid, the development of pneumonia, meningitis in children.


Inflammation of hair follicles in the form of a common rash on the body. The main cause of folliculitis is an infection, sometimes folliculitis appears after hair removal. Abscesses, inflammation of the lymphatic vessels, etc. may occur.Without treatment, the disease becomes chronic with periodic exacerbations.

Photocontact dermatitis

Damage to sun-irradiated skin areas to which photoallergen has been applied (tar derivatives, psoralen, some sunscreens and fragrances). Some plants (fig, celery, parsnips, fennel, rose hips, meadow grasses, clover, lemon, and other citrus fruits) cause phytophotodermatitis.

Photosensitive dermatitis

Sunburn-like skin reactions caused by exposure to sunlight on the skin while taking certain medications.


Painful swelling around the hair shaft, in the center of which a yellow abscess, infiltration appears. The central part is compacted, opened with rejection of the necrotic rod.The disease may be accompanied by a temperature reaction. It is caused by Staphylococcus aureus, diabetes mellitus and decreased immunity contribute to the development of the disease.


Sexually transmitted urogenital infection. In women, chlamydia causes urethritis, cervicitis, then endometritis, inflammation of the uterine appendages, infertility can develop. Often the onset of the disease is accompanied by frequent painful urination.Transmission of the causative agent to a child is possible in 40-60% of cases, both in the presence and in the absence of obvious clinical manifestations of infection in the mother.

Chronic proctitis, proctosigmoiditis

Chronic inflammation of the rectum and sigmoid colon. It is a consequence of an untreated acute disease or has a specific nature – tuberculous, syphilitic, gonorrheal, due to helminthic invasion, etc.Clinically manifests itself as a recurrent feeling of discomfort in the rectum, a feeling of incomplete emptying, periodic exacerbations, accompanied by increased stool with an admixture of mucus and sometimes blood, painful urge to defecate. Chronic inflammatory processes can lead to the development of ulcers on the intestinal mucosa, the formation of fistulas.


Inflammatory process of the cervix, which can be caused by the causative agents of sexually transmitted infections (chlamydia, gonococcus, Trichomonas, etc.)Etc.). The disease is accompanied by profuse mucous or purulent discharge, itching, burning, pain in the lower abdomen.


The appearance of painful urge to urinate with normal urine tests. It is caused by gynecological diseases, ovarian dysfunction.


An infectious disease caused by a scabies mite.Infection occurs through contact with a sick person or through infected linen. Patients are worried about severe itching, aggravated at night, swelling in the axillary areas, individual blister rashes on the body. Possible complication of the disease by the development of purulent-inflammatory changes in the skin, eczema.


Inflammation of the skin, manifested by outlined erythema with itching. The lesions pass through 3 stages: acute (with the manifestation of a vascular reaction), subacute (with the formation of crusts and scales in the affected area) and chronic (with a pronounced thickening of the outer skin).Depending on the stage of the disease, skin manifestations can occur in the form of spots, vesicles, plaques, edema, crusts, scales, cracks, etc. Any areas of the skin are affected, the disease often takes on chronic forms with periodic exacerbations.


Inflammation of the mucous membrane of the vaginal part of the cervix. Causes of the disease, clinical picture, complications – see.Endocervicitis.


An infectious disease caused by group A streptococcus or Staphylococcus aureus. Emaciated people with altered immunity, emaciated by the infection, are more often sick. First, a bubble with cloudy contents appears on the skin, upon opening which a purulent thick crust quickly forms. A rounded ulcer with a peripheral inflammatory corolla is exposed under the crust. Ectymes can be single or multiple, the favorite localization is the lower limbs.


A hormone-dependent disease that develops against the background of a violation of the immune processes in the body, characterized by the penetration of the endometrium into the tissues, where it normally does not exist.


Inflammation of the lining of the uterus due to its infection. Often associated with previous abortions and complicated childbirth.


Inflammation of the mucous membrane of the cervical canal caused by infectious agents (including sexually transmitted infections), mechanical damage and trauma (during abortion, diagnostic curettage, rupture of the cervix during childbirth, etc.). Clinically, it can manifest itself with profuse mucous or purulent discharge, itching, burning, pain in the lower abdomen. With the spread of the inflammatory process to other organs, a clinic of urethritis, endometritis, salpingo-oophoritis, etc. is possible.The chronic course of the disease can lead to complications during pregnancy and childbirth, infertility.


Change in the color of skin areas from bright pink to bluish-purple, accompanying various diseases of the skin and internal organs. The clinical manifestations of erythema are diverse, there are several types of erythema – nodular, heat, migrating necrolytic, pigmentary, exudative, gluteal, etc.Some of them have a tendency to generalization (extensive spread) of the process, ulceration and malignancy.

Cervical erosion

An acquired pathological process characterized by damage and subsequent exfoliation of the stratified squamous epithelium of the vaginal part of the cervix. As a result, a wound surface is formed with the development of an inflammatory reaction. The occurrence of erosion is facilitated by abortions, cervical ruptures during childbirth, chronic endocervicitis.

Therapy of onychomycosis using terbinafine according to the pulse therapy scheme

UDC 616.596-002.828

Etiopathogenesis of onychomycosis

According to the World Health Organization, nail fungus affects 5–25% of the world’s population. There are 3 groups of pathogens of onychomycosis: dermatophytes, yeast-like fungi and non-dermatophyte mold fungi. Up to 90% of nail lesions are caused by dermatophytes. In the development of dermatomycosis, mainly filamentous fungi play a role.These, for example, are trichophytosis, epidermophytosis, microsporia and favus, as well as mycoses of the feet and nails. The intensity of changes in these mycoses depends on the immune status of the patient, the virulence of the pathogen, the state of the affected areas, and the localization of the lesion.

Currently, the most common cause of onychomycosis is Trichophyton (Tr.) Rubrum , less often Tr. mentagrophytes . Much less often, onychomycosis can be caused by Tr. violaceum , Epidermophyton floccosum .In addition to dermatophytes, yeast-like fungi of the genus Candida are often the causative agents of onychomycosis. It is candidal lesion that prevails in onychomycosis of the hands. With candidiasis, changes in the skin around the nails are quite characteristic: it is paronychia that can be a sign of candidal onychomycosis. A feature of modern mycology is a significant increase in the prevalence of onychomycosis caused by molds. Non-dermatophytic molds are represented by different species of the families Moniliaceae and Dematiaceae .

Combined fungal infection of nails with dermatophytes, yeast-like fungi and molds is more common. The association of fungal and bacterial infections is also not excluded. If onychomycosis is suspected, it is imperative to obtain laboratory confirmation of the diagnosis and clarify the type of fungus based on the results of inoculation on nutrient media.

As a rule, the source of infection is a sick person. Onychomycosis mainly occurs as a result of autoinfection from the patient himself with a long-term fungal infection of the skin, and with candidiasis – and the mucous membrane.Often, infection occurs through contact with contaminated objects (the floor of the shower room, sauna, living quarters, through someone else’s shoes). Onychomycosis almost never affects children. The incidence increases with age and is highest in the elderly. Onychomycosis on the hands, caused by Candida albicans , is 3 times more likely to be diagnosed in women professionally associated with cooking and confectionery production.

Predispose to the development of onychomycosis: trauma, dystrophic processes, impaired innervation, endocrinopathies (diabetes mellitus, etc.)), ionizing radiation, chronic long-term infectious and non-infectious diseases against the background of immunodeficiency (including AIDS), long-term use of antibiotics, corticosteroids and cytostatics.

Vascular disorders are often caused by the prolonged influence of the metabolic products of the pathogenic fungus on the vessels, and mycotic sensitization becomes the trigger for the development of allergic vasculitis.

According to modern concepts, 4 forms of onychomycosis are distinguished: distal-lateral subungual, superficial white, proximal subungual, total dystrophic.

Features of mycotic lesion of the nail

In onychomycosis, the penetration of the pathogen into the nail usually occurs from the lower surface of the nail plate. However, in order to fully understand the essence of the process of infection of the nail plate in mycotic lesions and, accordingly, assess the penetration of systemic antifungal drugs into the nail, let us dwell on some of its anatomical and functional features.

The nail plate is formed as a result of the immersion of the epidermis into the dermis.Here, the formation of the nail occurs through the complete “death” of cells (onychocytes). Similar to the phylogenetic progenitor (claw, hooves), this visible part of the nail serves as a protection for the distal end of the digital phalanx, and nevertheless provides many additional functions. The close anatomical connection between the nail and the phalanx, which determines the shape of the nail, is also responsible for the condition of the bone in nail diseases.

An essential role in the formation and growth of the nail plate is played by its vascularization (Paus R.et al., 2008). The nails of the hands and feet are characterized by abundant vascular supply. The leading role is played by digital arteries that supply blood to the phalanges. They do not have an internal elastic plate and are covered with smooth muscles with a characteristic architecture of internal longitudinal and external circular fibers. These vessels ascend from two palmar and plantar arches, which create large anastomoses between the arteries of the extremities that supply blood to the fingers. These arches provide two independent sources of supply to the individual segments of the nail matrix, which support normal nail growth even during periods of temporary deficiency, such as injury.A unique anatomical feature is large arteriovenous anastomoses, noted in all areas of the nail, with the exception of its proximal part. These anastomoses differ from morphologically simple unmodified anastomoses by the presence of an original complex of vessels and glomus bodies.

The growth of the nail plate consists in its constant renewal at the proximal edge and the advancement of the already formed stratum corneum to the distal edge. The growth and formation of the nail plate involves not only the growth zones, but also the proximal and lateral ridges of the nail, the nail bed and the phalanx of the finger.

The nail plate on the hands for 1 month grows by 2-4.5 mm, or on average by 0.1 mm / day. Toenails grow 1.5 times slower – on average 1 mm / month.

Clinical manifestations of onychomycosis

Clinical manifestations of onychomycosis are very monotonous, but still have some distinctive features. At candidal onychomycosis yeast-like fungi are introduced at the place of transition of the cuticle to the plate, then the process passes to the nail plate, transverse grooves and bulges appear, thinning, dullness with a brownish-brown color, separation from the sides from the nail bed may be noted.In chronic generalized (granulomatous) candidiasis, onychogryphosis is characteristic, the nail skin can be preserved.

Onychomycosis, caused by red trichophyton ( Tr. Rubrum ), spreads along an extension or lymphogenous. The defeat of the nail plates of the fingers can occur from the proximal part of the nail. There are several types of damage to the nail plates of the feet and hands: normotrophic, hypertrophic and onycholytic. Tr. rubrum belongs to quite aggressive strains: it affects the nail deeply, several nails are involved in the process, penetration into the lymph nodes is possible.

Trichophytosis of nails is more often caused by anthropophilic fungi ( Tr. Violaceum , Tr. Mentagrophytes ) and is localized mainly on the fingers of the hands. Zoophilic trichophytos rarely affect nails. Onychomycosis caused by trichophytos usually occurs secondarily after a change in the area of ​​the skin surrounding the nail.The defeat of the nail plates occurs gradually. At the site of the introduction of trichophyton in the thickness of the nail, a whitish-gray spot is formed. The so-called trichophytosis leukonychia is also observed, when a white or grayish spot in the thickness of the nail plate remains the only clinical sign for a long time. Much later, the nail becomes dull, bumpy, dirty gray in color. Sometimes the nail fold is slightly swollen, reddish-bluish in color. Trichophytosis of the nails can last for many years.

Nail microsporia develops when the nail plate is infected with anthropophilic, zoophilic and geophilic microsporums from foci on smooth skin and scalp, or directly in contact with the soil. Microsporia of nails is noted extremely rarely.

Nail damage at epidermophytosis of the feet is caused by interdigital trichophyton ( Tr. Interdigitale ) and affects only the toes.In the thickness of the nail plate, spots of ocher-yellow color appear, accompanied by subungual hyperkeratosis, loosening of the nail plate.

Favus of nails is diagnosed extremely rarely, the nail plates of the fingers of the hands are mainly affected, the causative agent of the disease is Tr. schoenleinii . First of all, the skin of the nail ridges is affected, then grayish-yellow spots appear in the thickness of the nail, gradually becoming specifically yellow (the color of the scutula on the skin).After quite a long time, the nail dulls, becomes thinner, becomes brittle, can separate from the bed, with symptoms of subungual hyperkeratosis.

Mold onychomycosis cause various genera and certain types of molds Aspergillus scopulariopsis , Penicillium . More often, fungi are introduced into the nail plate a second time, when it has already been changed under the influence of dermatophytes or yeast-like fungi. The clinical manifestations of mold onychomycosis differ little from nail damage caused by dermatophytes.Subungual hyperkeratosis often develops. Molds most often affect the toenails, especially the first ones.

Diagnostics of onychomycosis

Laboratory diagnostics of mycosis of nails includes microscopic and cultural studies, during which attention should be paid to the technique of taking the material.

It should be remembered that various changes in nails in the overwhelming majority of cases are associated precisely with their fungal infection. Even symptomatic onychodystrophies (psoriasis, lichen planus, neurotrophic changes, etc.)) may well be complicated by the addition of mycosis. Various changes in nails in chronic diseases and conditions should convince the doctor of the mandatory need for a mycological study.

Systematic approach to the treatment of onychomycosis

Knowledge of the peculiarities of vascularization of the growing nail has now made it possible to shift the emphasis of specific antifungal therapy in onychomycosis to the use of systemic drugs. Systemic therapy ensures the penetration of antifungal drugs into the nails through the blood, while the flow of the drug into the nail bed is guaranteed.The limitation of systemic therapy is the risk of developing side, and sometimes toxic effects associated with many months of taking drugs. Many systemic drugs accumulate in the nail matrix at concentrations well above the minimum inhibitory concentration, and are able to persist there after the end of treatment.

Groups of antifungal drugs. Allylamines. Terbinafine

Treatment for mycosis is a complex problem. There are 4 main groups of antifungal drugs:

In addition, other drugs are used that are not linked by chemical structure (griseofulvin, ciclopirox, chloronitrophenol, undecylenic acid).The most promising in the treatment of mycoses are drugs of the allylamine group. One of the most famous representatives of this class is terbinafine, which meets the requirements for antifungal drugs. Terbinafine is keratotropic, provides a high cure rate with good tolerability, and causes a minimum number of side effects and complications. One of the modern generic antimycotics is Exifin ® (Dr. Reddy’s, India), 1 tablet of which contains 250 mg of terbinafine.Exifin ® has a pronounced fungistatic and fungicidal effect due to inhibition of the biosynthesis of fungal ergosterol, which determines the stability of cell membranes, and inhibition of enzyme systems – squalene epoxidase – in the cell membrane of the fungus, resulting in the accumulation of the poisonous substance squalene and death of the fungal cell. Terbinafine does not affect the metabolism of hormones or other drugs.

Clinical observations and literature data indicate a high therapeutic efficacy of terbinafine in dermatophytosis of smooth skin, mycosis of feet and hands, onychomycosis (Sergeev Yu.V., Sergeev A.Yu., 1998). With a single oral administration in a dose of 250 mg, the maximum concentration of the drug in the blood plasma is reached within 2 hours and is 0.97 μg / ml. Stable concentrations of the drug in blood plasma are achieved after 10-14 days. The duration of treatment for onychomycosis of the hands is 6 weeks, for onychomycosis of the feet – 12-16 weeks. The effectiveness of monotherapy with terbinafine is 88–94%. In a double-blind, double-sham study, continuous use of terbinafine in patients with onychomycosis provides convincing long-term mycological and clinical efficacy and lower relapse rates compared to intermittent use of itraconazole (Sigurgeirsson B.et al., 2002).

Terbinafine quickly diffuses through the dermal layer of the skin and accumulates in the lipophilic stratum corneum. There is a high concentration of it in the hair follicles, hair and the secretion of the sebaceous glands. During the first few weeks of taking the drug inside, the active substance accumulates in the skin and nail plates in a concentration that provides a fungicidal effect. In the liver, the drug is converted into a pharmacologically inactive substance and is excreted mainly in the urine, mainly in the form of metabolites.Terbinafine enters the nail plate mainly through the matrix, but also through the nail bed. After discontinuation of treatment, terbinafine remains in the nails at a therapeutically effective concentration for 4–6 weeks.

In Europe and North America, the course of treatment with terbinafine is traditionally 250 mg / day for 3 months, in Japan – 125 mg / day for 5-6 months.

Pulse therapy of onychomycosis with terbinafine

The pharmacokinetics of terbinafine are similar to those of itraconazole, which has traditionally been used in a pulse therapy regimen.Assessment of the time of accumulation of terbinafine in the nail plate, the duration of its retention in it after the termination of administration, the duration of nail growth from the proximal to the distal part, as well as the need to reckon with the possible toxic effect of any systemic drug contributed to the development and in-depth analysis of pulse therapy for onychomycosis with the use of terbinafine. (Gupta AK et al., 2001; Warshaw EM et al., 2005; Paus R. et al., 2008).

Japanese dermatologists monitored the safety and efficacy of pulse therapy with terbinafine in 55 patients with onychomycosis.During pulse therapy in patients with onychomycosis using terbinafine, systemic antifungal drugs were not used for 6 months before the present course, the patients did not have severe systemic diseases, pregnancy and lactation, hematological abnormalities, and liver dysfunction. The course of treatment included oral administration of terbinafine at a dose of 500 mg / day for 1 week, followed by a 3-week break. This course was repeated twice. The clinical and mycological efficacy of the drug was assessed after 12 months.In addition, laboratory testing of the functional state of the liver was carried out. As a result, a sufficient therapeutic effect was achieved with good tolerability of the drug (Sanmano B. et al., 2004).

Further, other authors described pulse therapy with terbinafine for 7 days at a dose of 500 mg / day in 2 doses (Warshaw EM et al., 2005; Stelios K.M. et al., 2007; Paus R. et al., 2008).

The analysis of reports and our own experience convinces us that the method of treatment of onychomycosis with terbinafine in the pulse therapy mode meets all the requirements of clinical and evidence-based dermatology.

List of used literature

  • Sergeev Yu.V., Sergeev A.Yu. (1998) Onychomycosis. Fungal nail infections. Geotar medicine, Moscow, 126 p.
  • Stelios K.M., Kripitser O.A., Bogush I.G. (2007) Pulse therapy with oral terbinafine in combination with terbinafine cream in the treatment of dermatophytic onychomycosis. In the book: Yu.V. Sergeev (ed.) Advances in medical mycology. National Academy of Mycology, Moscow, p. 130.
  • Gupta A.K., Lynde C.W., Konnikov N. (2001) Single-blind, randomized, prospective study of sequential itraconazole and terbinafine pulse compared with terbinafine pulse for the treatment of toenail onychomycosis. J. Am. Acad. Dermatol., 44 (3): 485-491.
  • Paus R., Peker S., Sundberg J.P. (2008) Biology of Hair and Nails. In: Dermatology, 1: 965-1036.
  • Sanmano B., Hiruma M., Mizoguchi M., Ogawa H. (2004) Combination therapy consisting of week pulses of oral terbinafine plus topical application of terbinafine cream in the treatment of onychomycosis.J. Dermatolog. Treat., 15 (4): 245-251.
  • Sigurgeirsson B., Olafsson J.H., Steinsson J.B. et al. (2002) Long-term effectiveness of treatment with terbinafine vs itraconazole in onychomycosis: a 5-year blinded prospective follow-up study. Arch. Dermatol., 138 (3): 353-357.
  • Warshaw E.M., Fett D.D., Bloomfield H.E. et al. (2005) Pulse versus continuous terbinafine for onychomycosis: a randomized, double-blind, controlled trial. J. Am. Acad. Dermatol., 53 (4): 578-584.

Received 08/20/2013

Information for the professional activities of medical and pharmaceutical workers
Exifin ®
R.S. No. UA / 4720/01/01 of 10.08.2011, No. UA / 4720/02/01 of 28.01.2011
Composition: Exifin ® cream. 1 g cream contains 10 g terbinafine hydrochloride Exifin ® tablets. 1 tablet contains terbinafine hydrochloride 250 mg. Pharmacotherapeutic group. Antifungal agent for use in dermatology. ATC code. D01AE15. Pharmacological properties. Antifungal agent of the allylamine group with a broad spectrum of antifungal action. In low concentrations, it exhibits fungicidal activity against dermatophytes, molds and some dimorphic fungi. Activity against yeast fungi, depending on their type, can be fungicidal or fungistatic.Specifically inhibits the early stage of sterol biosynthesis in the cell membrane of the fungus, which leads to a deficiency of ergosterol, intracellular accumulation of squalene and, ultimately, the death of the fungal cell. Indications. Fungal infections of skin, hair, nails caused by dermatophytes. Side effects. From the blood and lymphatic system: neutropenia, agranulocytosis, thrombocytopenia, pancytopenia; from the nervous system: headache, taste disturbances, dizziness, paresthesia, hypesthesia; from the gastrointestinal tract: a feeling of fullness in the stomach, loss of appetite, dyspepsia, nausea, slight, abdominal pain, diarrhea; from the hepatobiliary system: increased levels of liver enzymes, jaundice, hepatitis, liver failure; on the part of the skin and subcutaneous tissues: rash, urticaria, pruritus, Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalized exanthematous pustulosis, psoriasis-like rashes or exacerbation of psoriasis, hair loss; from the immune system: anaphylactoid reactions, cutaneous and systemic manifestations of systemic lupus erythematosus; on the part of the musculoskeletal system: arthralgia, myalgia; general disorders: increased fatigue.

Full information about the medicinal product is contained in the instructions for medical use.
Manufacturer: LLC “Dr. Reddys Laboratories “
03131, Kiev, Stolichnoe shosse, 103
BC” Europe “, 11th floor, office 11B
Tel .: (044) 492-31-74
Fax: (044) 492-31-73

90,000 Skin redness: causes, diagnosis and treatment

What does skin redness indicate?

There are many factors that cause skin reddening, some of them are harmless, others speak of serious diseases.

  • Exercise or shame that causes the skin to turn red is called flushing.
  • Redness of the skin caused by, for example, itching or swelling is called erythema.
  • Allergic reactions are often accompanied by skin redness. Additional signs may vary, but the most common are: redness of the eyes, vomiting, diarrhea, difficulty breathing.

What does redness in the joint area say?

  • After a bruise or dislocation, there is a limitation of the mobility of the damaged part of the body, pain and redness.Sometimes bruising occurs.
  • All types of arthritis, regardless of localization, are accompanied by redness of the diseased joint, swelling and pain ranging from moderate and aching to acute and painful. Stiffness is observed in the damaged joint.
  • Infectious diseases sometimes also manifest themselves through skin redness and rashes. Fever and headache can be considered common to all infections. Dizziness, nausea and vomiting are often added to them.

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Redness of the skin on the legs

The reasons for the reddening of the skin can be both external and internal.And if the external ones can be easily avoided – by changing shoes or lubricating the bite site, then the internal ones should be taken extremely seriously.

External causes of skin redness include: uncomfortable shoes, clothing that is not breathable or made of fabric that irritates the skin, scratches, bruises and other injuries, insect bites due to scratching of the skin at the site of the bite. Redness and itching can occur as a result of exposure to chemicals.

  • Allergic reaction. Often against their background, in addition to redness, edema, blisters and a rash, causing itching, may appear.
  • Psoriasis. It is also characterized by skin rashes.
  • Fungal infections are another cause of skin redness. They appear as scaly patches between the toes and on the soles.
  • A consequence of diseases of the cardiovascular system is edema of the legs, which are accompanied by reddening of the skin.
  • Diabetes mellitus. Itching is one of the most striking symptoms of the disease. Sometimes it also manifests itself as a rash, both of which lead to scratching and redness.
  • Some joint diseases can be accompanied by redness of the skin. Often this is accompanied by edema, swelling and pain, sometimes quite strong.
  • Varicose veins cause swelling and redness of the skin along the vein. Palpation of the area is painful.
  • Thrombophlebitis. One of the most dangerous diseases, because can end in death, it is also accompanied by redness on the skin.

How is redness manifested in systemic diseases?

Autoimmune diseases can also cause skin redness.Later, depending on the pathology, itching, spots, blisters, coarseness of the skin, etc., may appear.

With endocrine diseases, the formation of dark red stretch marks on the skin is frequent. Places of their appearance: chest, abdomen, inner thighs. Another symptom is high blood pressure.

How is redness manifested in vascular diseases?

Varicose enlargement of the lower extremities is accompanied by edema, which increases in the evening. If redness appears, then (attention!) It may already be thrombophlebitis.With thrombophlebitis, redness on the legs is accompanied by chills and fever, the skin turns red along the course of the veins, and the veins themselves become denser.

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Infrared treatment with a wavelength of 0.8-0.9 microns affects the internal focus of the problem. This relieves inflammation, swelling and pain in the joint. Degenerative processes in the joint attenuate as metabolic processes inside the joint are accelerated many times. More details…

Nutrition and growth of cartilage cells by applying peloid dressings. The base comes from Lake Sivash, where mud is mined with a high concentration of Dunaliela Salina microalgae, which is rich in beta-carotene.

We strongly recommend that if redness is detected, seek the help of a specialist as soon as possible, especially if it is accompanied by pain and swelling.

The patient, when he goes to the doctor with redness, is absolutely the right step.It is very difficult to diversify redness on your own, only a specialist is able to find out the cause of redness and prescribe adequate treatment. We remind you that you can always get support in our clinic and make an appointment with an experienced specialist. Make an appointment with a doctor right now by calling 986-66-36. or in the form of the online registry. The “MEDICUS” clinic employs high-level specialists with over 15 years of experience.

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