SKIN DISEASES: candidiasis
Oral Thrush (Oral Candidiasis)
Location: Oral thrush affects mucous membranes of the mouth.
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Symptoms: Small white, cream coloured, or yellow slightly raised spots in the mouth, throat, and tongue usually accompanied by fever, colic, and diarrhea. Commonly there is no pain in the area underneath the spots.
If scraped off, spots leave small slightly-bleeding wounds. In adults, thrush can cause an uncomfortable burning sensation in the mouth and throat.
Oral candidiasis commonly occurs as only a temporary candida infection in the mouths of infants. However, the term is sometimes expanded to include candida
infections occurring in the mouth and throat of adult, mainly immunocompromised patients.
At special risk are people with diabetes, other metabolic disturbance or an immune deficiency (AIDS/HIV), drug users, people with poor nutrition, denture users,
patients undergoing antibiotic or chemotherapy treatment and patients after a tonsillectomy. This infection has a great variety of clinical
acute or chronic pseudomembranous oral candidiasis - is characterized by an erythematous base beneath the creamy white pseudomembrane;
acute or chronic erythematous form of oral candidiasis - is characterized by reddened painful lesions;
hyperplastic or nodular candidiasis - is characterized by irregular white plaques that cannot be removed and loss of tongue papillae;
medial rhomboid glossitis - is characterized by a diamond-shaped plaque on the dorsum of the tongue.
Treatments: Oral thrush can be treated either with home remedies including the consumption or direct application of yogurt, which contains
yeast-killing bacteria (lactobacillus), acidophilus tablets or salves, and even lightly crushed cloves of garlic which yields allicin, topical imidazole
creams or troches, in the case of a more severe infection - anti-fungal drugs, such as nystatin, ketoconazole, itraconazole or amphotericin B.
Location: vaginal and anal regions
Symptoms: itching and irritation of the vagina and/or vulva, often with whitish or whitish-gray discharge that may have a "yeasty" smell and consistence resembling cream to cottage cheese. These simpthoms may be accompanied by dysuria and pain during coitus.
Treatments: topical imidazoles are effective in the treatment of this infection.
Location: head (glans) and shaft of the penis
Symptoms: inflammation of the skin on the head (glans) and shaft of the penis or under the foreskin (balanitis involving
the foreskin or prepuce is termed balanoposthitis) which may have a dry glazed appearance, with eroded white papules and grayish-white deposits.
In diabetic patients the presentation may be more severe with oedema and fissuring of the foreskin, resulting in phimosis, or inability to
retract the foreskin from the glans penis.
Prevention and Treatments: Thorough cleansing along with topical medications (for example clotrimazole) generally eradicate the infection,
although systemic treatment (such as with fluconazole) may be required, particularly if secondary infection occurs.
Location: Candidal Intertrigo most commonly occurs in overweight patients with redundant, moist and overlapping skinfolds in the areas of the inner thighs and genitalia, the armpits, under the breasts, the underside of the belly, behind the ears, and the web spaces between the toes and fingers.
Symptoms: An intertrigo usually appears red and raw-looking, macerated and reddened areas are found under the skinfolds, with surrounding scaling and,
often, satellite lesions and may also itch, ooze, and be sore. Intertrigo occur more often among obese individuals, immunocompromised patients (suffering from diabetes), people
restricted to bed rest and those who use such medical devices as artifical limbs, trapping moisture against the skin.
Prevention and Treatments: Keeping the area of the intertrigo clean, dry and exposed to the air along with use of topical imidazoles, can help clear the lesions and prevent recurrences.
If the individual is overweight, losing weight can help. Using antibacterial soap, absorbent body powders or a band of cotton fabric will help prevent future occurances.
Diaper Rash (Nappy Rash, Diaper Dermatitis)
Location: groin area, thighs and buttocks
Symptoms: is an irritating and often painful condition characterized by scattered small, reddish lesions with a scaly surrounding "collarette". The inflammation is localized to the diaper area
in infants and adults restricted to diaper use. Diaper rash occurs when poorly absorbent, moisture-trapping diapers are used: the enclosed nature of diapers produces a hot and humid environment
promoting a continuous assault on the skin in the groin area, caused by prolonged exposure to feces and urine and possibly by the ammonia produced by decomposing urine. Secondary infections by
bacteria living on the infant's skin or yeast (Candida) may further complicate the situation.
Treatments: the most effective treatment for the Diaper Rash is to discontinue use of diapers, or at least to allow the affected area to be exposed to air regularly.
Other remedies commonly recommended by dermatologists include oil-based protectants, zinc oxide based ointments, and, in extreme cases, antifungal cremes.
Long-term use of imidazole and steroid creams is discouraged, it exposes the infant to the risk of getting adverse topical effects and suppression of the adrenal axis from steroids.
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