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Cutaneous CandidiasisCutaneous Candidiasis – General InformationCutaneous Candidiasis is a form of persistent candidiasis, which is, in most of the cases, caused by Candida albicans. This fungus can be found inside the skin, nails or in the mucous membranes, and commonly develops in patients who suffer from some forms of metabolic conditions or cell mediated immunity. Disorders such as leukocyte dysfunction and any other type of endocrine conditions, including hypoparathyroidism, Addison's disease, hypothyroidism, diabetes or polyglandular autoimmune disorder, can also trigger the appearance of the disease. Candida granuloma is a severe form of the Cutaneous Candidiasis, and can develop with endocinopathy which can consist in severe hyperkeratic granulomatous lesions. This type of disease causes, in most of the cases, an infection on the surface of the skin, although the healthy skin is usually resistant to this medical condition. The disease is generally caused by a predisposing factor such as the high exposure to contaminated water. Generally, the disease is not considered life threatening, just irritating and can be present in many forms such as intertrigo, erosio interdigitalis blastomycetica, diaper rash, candidal balanitis, perianal candidiasis and candidal folliculitis. Although the moisture is the main cause of the disease, there are other possible causes which can include obesity. It is known that obese patients have a big difficulty in keeping the skin dry between the fat rolls. Diabetes or the abuse of corticosteroids can also enable this medical condition to appear. This type of infection is most encountered in young patients with the age between ten an twenty years old, but is more common in male patients.Cutaneous Candidiasis – SymptomsThe diagnosis of the Cutaneous Candidiasis disorder is based on medical tests of the surface of the skin. The risk factors to which the patient has been recently exposed must also be taken into consideration. There are, in most of the cases, some typical signs and symptoms that point to this disorder. They can include itching, which can vary from mild to intense, skin lesion or rash, which can appear such a skin redness or inflammation, enlarged patch, macule or papule. These lesions can present some smaller lesions surrounding the big ones. These are called satellite lesions, and are usually located in many areas on the body including the skin folds, genitals, trunk, buttocks, under the breasts, generally the areas covered with skin. Another symptom of the Cutaneous Candidiasis is considered the infection of the hair follicles called folliculitis, which can be present like pimples. In the rare cases of the disease, it can cause symptoms such as repeated appearance of the skin infection, infections located on the nails, and can make the nails have an oddly shape. Such a medical condition can also cause infection on the skin surrounding the nail. The disseminated form of the disease can appear in immuno-compromised persons. A patient must contact a doctor when he starts to experience one of the symptoms above in order to receive the early treatment, which is very important and effective for this type of disorder. The main way to prevent the disease is to have a good hygiene of the skin, by keeping it clean and dry.Cutaneous Candidiasis – TreatmentThe most important way to treat Cutaneous Candidiasis is the general hygiene of the patient, who has to maintain his skin dry and exposed to the air as much as possible. Obese patients can try to lose weight to clear the problems, and individuals suffering from diabetes can try to control their sugar levels. If the disease is caused by a fungus, the main treatment options are the antifungal drugs that effectively heal the skin infection. If the infection affects the nails, a condition known as folliculitis, the patient may need a systemic treatment trial with the antifungal drugs. This type of antifungal treatment is considered to be effective in almost all the cases, but the best improvement and symptom relief is acquired by one of the options below. Patient education is very important, and the average medical advice is to avoid occlusions, to favor dryness and keep a perfect hygiene of the affected part of the body. There are many medications that can be applied to treat the Cutaneous Candidiasis, and can consist in creams, such as Miconazole, which is especially effective in patient suffering of intertrigo. The doctor can prescribe a short term drug trial with topical corticosteroid agents, which can bring symptom relief in the chronic stages of the disease. In young patients doctors usually prescribe an oral nystatin treatment trial, who suffer with recurrent diaper rash. This type of medicine is considered to be effective in reducing the rate of bowel recolonization of the perianal skin. There are cases in which the doctor recommends a systemic treatment with azoles, but, in the end, it proves to be unnecessary. There are patients who develop a severe stage of the disease, in which the disease is hard to control and is especially widespread. In these cases, doctors prescribe short treatment trials which can include Fluconazole, ketoconazole, or Itraconazole. Because the Cutaneous Candidiasis disease, in some cases, is not possible to correct it and because the conditions which had caused the disease resist to the topical Imidazole treatment trial, another treatment trial can be applied. It generally includes Fluconazole in 100 to 400 mg/day doses that are administered orally for two weeks. This kind of medicine is also used to treat and control the oropharangeal form of the disease. But, there are cases in which the treatment with Fluconazole is required in 150 to 300 mg/week, depending on the existing symptoms. For the neutropenic patients who suffer from Cutaneous Candidiasis the doctor usually prescribes treatment trials with amphotericin B in high doses like 1.0 mg per day, in combination with another medicine called Flucytosine that is administered in 150 mg per day doses. During the treatment trial with these drugs, the doctor should monitor the patient’s blood levels and make tests to avoid the fungal infections to develop. This type of treatment can be also applied in patients suffering with the bacterial form of the Cutaneous Candidiasis. |
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