Candida – Mucosal & Cutaneous

Last updated 26.09.12

 

Index

 

Definition

-  Candidiasis effecting skin & mucosal surfaces

 

Risk Factors

-  Broad spectrum Abx

-  DM

-  Immunosupression

-  Obesity & Immobilisation

-  Macerated & heated skin

 

Features

-  May superimpose other dermatoses esp in genital & flexures

-  Moist, erythematous papules/pustules

-  +/- vesicles +/- satellite lesions/pustules

-  +/- whitish curd like material

-  Minimal scaling

-  May coalesce into plaques

-  Sites

-  Usually in flexures, submamary area

-  Groin, axilla, glans penis (uncircumcised)

 

 

Ix

-  Swab MCS

-  Skin scaping: microscopy & culture

-  +/- BSL for DM

 

Mx

-  Cease Abx if possible

-  Keep moist areas dry

-  Mx of underlying risk factors

-  Topical antifungals 2/52

-  Topical Imidazole cream ie: Clotrimazole 1%

-  OR Nystatin 100,000 units/gram Topical BD

-  +/- Hydrocortisone 1% cream Topical BD if significant inflammation

-  Combination Hydrocortisone 1% + Clotrimazole 1% available

-  If poor response or topical impractical: PO antifungals ($$$)

-  Fluconazole 50mg PO Daily 2/52+

-  OR Itraconazole 200mg PO Daily 1/52