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Saturday, March 04, 2006

Infection of the skin by Candida albicans (cutaneous candidiasis)

Infection of the skin by Candida albicans (cutaneous candidiasis): "Infection of the skin by Candida albicans (cutaneous candidiasis)"


What is it? An infection of the skin by the yeast-like fungus Candida albicans. What causes it? The human body contains a vast number of different micro-organisms, including fungi, both on the inside and on the outside. Some of these micro-organisms are beneficial. Others have no effect until either there is a change in their nature or there is a decrease in the body's resistance to them. This allows one type to grow excessively and leads to an infection - a fungal infection of the skin. In principle, Candida albicans can infect all areas of the skin as well as the mucous membranes but it prefers warm moist places. Infections by Candida albicans, especially the variants that are found in the mucous membranes or the genitals, are contagious. They can be spread from person to person by direct contact, by sexual contact and indirectly by damp towels or flannels. What are the symptoms? The fungus is, typically, found in skin folds, under women's breasts, in the groin, on the genitals and in the area around the anal orifice. The symptoms are:
itchy, purple patches on the skin that resemble eczema. The itching in these patches is highest near the edge.
a small degree of scaling.
blisters resembling spots are often seen around the itchy patches. Who is at increased risk?
Babies with a nappy rash.
People with a metabolic disorder, including diabetics.
Overweight people.
Pregnant women, and women who take high-dose contraceptive pills, eg Ovran.
People who work in wet conditions.
People who are HIV-positive or suffer from another type of immunodeficiency. What can be done at home? A high standard of hygiene and good general health are vital in the prevention of an infection by this fungus. An infection is more likely when a person has other skin problems or has become unhealthy for other reasons.
Wash regularly and dry the skin carefully afterwards. Overweight people should be careful to dry all skin folds.
Avoid using other people's towels.
Wear clothes that are made of cotton or wool. These will allow the skin to breathe and rid itself of surplus moisture. Change clothes and socks regularly so that you are always wearing dry ones.
Wear sandals or leather shoes instead of trainers.
Wash the hands very carefully after touching an infected area and after applying an antifungal cream. How is it diagnosed? The diagnosis is made on the basis of the skin's appearance and a skin scrape. It is important, if possible, to pinpoint the cause. What happens if it gets worse? For people who work in wet conditions, the fungus may cause some highly unpleasant eczema-like changes. In addition, the fungus may also lead to an infection of the nails, causing them to crumble away.In people who have some form of immunodeficiency, the fungus may spread over the entire body creating a very serious and potentially dangerous condition - generalised mucocutaneous candidiasis. Future prospects If the cause of the infection can be brought under control, the infection will disappear after an antifungal treatment. However, like other fungal infections, this condition may return if a favourable environment is created again. What is the treatment? Bringing the cause of the infection under control may mean losing weight, better hygiene or regulation of a person's diabetes. The doctor may also offer a local treatment of the fungus with some of the medications shown below. The doctor will often choose a combined treatment consisting of an antifungal cream and a corticosteroid (an anti-inflammatory hormone), which makes the red itchy patches go away. In difficult cases, or where the infection is spreading, the doctor will offer a systemic treatment, possibly by injection. What medication can be used?
Antifungal agents against yeast fungus - as creams, liniments and shampoos.
Antifungal medication against yeast fungus, for injection or in tablet form.
Based on a text by Dr Flemming Andersen and Ulla Soderburg, specialist

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