Candida Intertrigo and Candida Albicans

00:01 Okay now when you first hear candida, this may be the type of image you think of first.

00:06 This is classically thrush, right? Oropharyngeal thrush we'd commonly see in folks who are immunocompromised from using steroid inhalers or HIV, etcetera.

00:15 But we're gonna focus on another manifestation of candida called intertrigo.

00:19 Of note, candida can also manifest on the genitals, on the tip of the penis called balanitis or vaginal candidiasis as well.

00:26 Risk factors for candida include heat, immunosuppression as I mentioned, excess sweating.

00:32 Diabetes is a big risk factor.

00:34 If somebody's on steroids for whatever reason, recent antibiotic use cause that kills off a lot of the normal skin flora and obesity, with potentially some pannus which could contribute to the heat and hygiene issue.

00:47 But let's again, we're gonna focus on the skin today and look at intertrigo.

00:52 So this is a classic picture of candidal intertrigo under the breasts.

00:56 What you'll see in this condition is well-demarcated, itchy, beefy red, erythematous patches and sometimes you'll see large distribution of confluence underneath the breast or any inguinal folds and then what's called 'satellite lesions' which are smaller areas that are separated away from the primary confluent region.

01:18 It occurs in any moist skin fold, - maybe that's under the breast, so called submammary.

01:23 maybe it's in the groin or the gluteal cleft, maybe it's underneath pannus like I said in someone who's obese, or you might find it in the axilla.

01:31 Occasionally, you'll even find pustules though I will say that I don't see that very often.

01:36 The diagnosis, similar to many fungal infections is gonna be with the KOH prep.

01:41 And ultimately it's very readily treatable with a Nystatin cream or Nystatin powder.

01:47 Sometimes you'll need to use oral -azoles like fluconazole, ketoconazole, depending upon the extent of the infection.

01:56 Alright, again while the lesion that our patient has is somewhat itchy and erythematous, it's in an unusual locaiton on the arm, and a host that doesn't seem to have risk factors for intertrigo.

02:07 So I think, we can safely take candidal intertrigo also off our list, x-ing it out.