Candidiasis is skin infection with Candida sp, most commonly Candida albicans. Infections can occur anywhere and are most common in skin folds and web spaces, on the genitals, cuticles, and oral mucosa. Candidiasis occurs most commonly in intertriginous areas such as the axillae, groin, and gluteal folds (eg, diaper rash), in digital web spaces, in the glans penis, and beneath the breasts. But invasive candidiasis is common in immunosuppressed patients and can be life threatening.

Risk factors for candidiasis

 

• Hot weather

• Restrictive clothing

• Poor hygiene

• Infrequent diaper or undergarment changes in children and elderly patients

• Altered flora from antibiotic therapy

• Inflammatory diseases (such as psoriasis) that occur in skin folds

• Immunosuppression resulting from corticosteroids and immunosuppressive drugs, pregnancy, diabetes, other endocrinopathies (eg, Cushing's disease, hypoadrenalism, hypothyroidism), blood dyscrasias, or T-cell defects

• Oropharyngeal candidiasis causes white plaques on oral mucous membranes that may bleed when scraped

 

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

 

Diagnosis

• Clinical appearance
• Potassium hydroxide wet mounts- identification of yeast and pseudohypha in potassium hydroxide wet mounts of scrapings from a lesion.

 

Treatment

• Sometimes drying agents- gentian violet for toe web spaces
• Topical or oral antifungal like Flucanazole, Itracanazole

 

Candidal diaper rash is treated with more frequent change of diapers, avoidance of disposable diapers with plastic coverings

Oral nystatin is an option for infants with coexisting oropharyngeal candidiasis; 1 mL of suspension is placed in each buccal pouch 4 times a day