Candida

Question 1

Superficial candidiasis

Answer 1

Candida species.
■ Malassezia species.
■ Dermatophytes

Question 2

Deeper, cutaneous, fungal infection

Answer 2

■ Phaeohyphomycosis (eumycetoma, chromoblastomycosis).

■ Sporotrichosis

Question 3

Where or what type of envt does

Malassezia, candida and dermatophytes grow?

Answer 3

Candida Species. Require a warm humid environment.
■ Malassezia Species. Require lipids or growth.
■ Dermatophytes. Infect keratinized epithelium,hair follicles,and nail apparatus.Trichosporon,Micros-
porum, and Epidermophyton species.
■ Hortaea werneckii. Causes tinea nigra

Question 4

Ecology and host factors

Answer 4

Candida spp. requently colonize the GI tract and can be transmitted via the birth canal.Approximately20% of healthy individuals are colonized. Antibiotic therapy increases the incidence of colonization.
Ten percent of women are colonized vaginally; antibiotic therapy, pregnancy,
oral contraception, and intrauterine devices increase incidence. C. albicans may transiently be present on the skin and infection is usually endogenous. Candida balanitis may be transmitted from sexual partner. The young and old are more likely to be colonized.
HOSTFACTORS Host defense defects,diabetes mellitus, and obesity; hyperhidrosis, warm climate, and maceration; polyendocrinopathies; glucocorticoids; chronic debilitation.

Question 5

KOH result

Answer 5

KOH preparation visualizes pseudo hyphae and yeast f orms

Question 6

Minifestation candida intertrigo

Answer 6

Pruritus, tenderness, and pain. Initial pustules on erythematous base become eroded and confluent.Subsequently,
fairly sharply demarcated, polycyclic, ery- thematous, eroded patches with small pustular lesions at the periphery (satellite pustulosis). Distribution: Inframammary or submammary axillae, groins, perineal, and interglutealcle .

Question 7

Manifestation candida interdigital

Answer 7

INTERDIGITAL Most common in obese elderly. Initial pustule becomes eroded,with forma tion of superficial erosion or fissure (. May be associated with Candida paronychia. Distribution: Webspace usually between third and fourth fingers feet: Maceration in webspace.

Question 8

Manifestation of diaper candidiasis

Answer 8

DIAPERDERMATITIS Irritability, discom ort with urination, de ecation, and changing diapers. Bee y-red plaques with papular and pustular lesions; erosions, collarette-like scaling at the margins o lesions. Distribution: Genital and perianal skin, inner aspects o thighs and buttocks, involves intertriginous areas, unlike irritant dermatitis (Fig. 26-5).
OCCLUDED SKIN Under occlusive dressing, under cast, on back in hospitalized patient. FOLLICULARCANDIDIASIS Small, discrete pustulesinostiao hair ollicles.Usuallyin occluded skin.

Question 9

Treatment

Answer 9

PREVENTION Keep intertriginous areas dry, wash with benzoyl peroxide bar, and use anti-
ungal powder.
TOPICALANTIFUNGALS Nystatin,azole,orimid- azole cream or powder.
ORALANTIFUNGALS Nystatin (suspension, tablet)eradicatesbowelcolonization.Maybe e ective in recurrent cutaneous candidiasis. SYSTEMICANTIFUNGALAGENTS Fluconazole tablets, oral suspension, and IV in usion. Itra- conazole capsules, oral solution; voriconazole; amphotericinBIV orseveredisease.