Candidiasis Cutis

Fungal infection of the skin caused by Candida species

Aetiology

  • Candida albicans (most common)
  • Other species: Candida tropicalis, Candida parapsilosis, Candida glabrata

Predisposing Factors

  • Warm, humid environment
  • Poor hygiene
  • Occlusive clothing
  • Obesity (skin folds)
  • Diabetes mellitus
  • Immunosuppression (HIV, corticosteroids, chemotherapy)
  • Prolonged antibiotic use
  • Infant/elderly (skin barrier vulnerability)
  • Pregnancy

Common Sites

  • Intertriginous areas (skin folds)
    • axillae, inframammary folds, inguinal region
    • intergluteal cleft, neck folds (infants)
  • Perianal region
  • Finger/toe web spaces
  • Diaper area (diaper dermatitis candidiasis)

Clinical Presentation

Clinical Manifestations

  • Erythematous, macerated plaques
  • Moist, shiny appearance
  • Satellite pustules/vesicles (characteristic)
  • Scaling at periphery
  • Burning, itching, soreness
  • In chronic cases: fissuring, lichenification
notion image
Special forms:
  • Intertrigo candidiasis → in skin folds
  • Paronychia candidiasis → nail fold infection
  • Candidal diaper rash → bright red lesions with satellite pustules

Investigations

  • KOH 20% Examination
    • Shows budding yeast cells (blastospora) and pseudohyphae
      • notion image
  • Culture with Sabaroud agar for recurrent/atypical cases
  • Wood’s lamp → usually negative

Management

  • Topical
    • Clotrimazole 1%
    • Miconazole 2%
  • Systemic
    • Fluconazole 50 mg/day or 150 mg/week
    • Itraconazole 100-200 mg/day