Cutaneous candidiasis

Alternative names
Skin infection - fungal; Fungal infection - skin; Skin infection - yeast; Yeast infection - skin; Intertriginous candidiasis; Intertrigo

Definition
Cutaneous candidiasis is an infection of the skin caused by the fungus candida.

Causes, incidence, and risk factors

The body normally hosts a variety of microorganisms including bacteria and fungi. Some of these are useful to the body, some produce no harm or benefits, while others may cause harmful infections.

Fungal infections are caused by microscopic organisms (fungi) that can live on the skin. They can live on the dead tissues of the hair, nails and outer skin layers. Fungal infections include mold-like fungi (dermatophytes, which cause tinea infections) and yeast-like fungi (such as candida).

Cutaneous candidiasis involves infection of the skin with candida. It may involve almost any skin surface on the body, but usually occurs in warm, moist, creased areas (such as armpits and groins). Cutaneous candidiasis is fairly common.

Candida is the most common cause of diaper rash in infants, where it takes advantage of the warm moist conditions inside the diaper. The most common fungus to cause these infections is Candida albicans.

Candida infection is particularly common in individuals with diabetes and in people who are obese. Antibiotics and oral contraceptives increase the risk of cutaneous candidiasis. Candida can also cause infections of the nail, referred to as onychomycosis, and infections around the corners of the mouth, called angular cheilitis.

Oral thrush, a form of candida infection found on the mucous membranes of the mouth, may be a sign of HIV infection or other immunodeficiency disorders when it occurs in adults. Infected individuals are not usually considered infectious to others, though in some settings transmission to immunocompromised people can occur.

Candida is also the most frequent cause of vaginal yeast infections, which are extremely common.

Symptoms

     
  • itching (may be intense)  
  • skin lesion or rash       o skin redness or inflammation       o enlarging patch       o macule or papule       o may have satellite lesions       o located on the skin folds, genitals, trunk, buttocks, under the breasts or other skin areas       o infection of hair follicles (“folliculitis”) may have a pimple-like appearance

Signs and tests
Diagnosis is primarily based on the appearance of the skin, particularly if risk factors are present. A skin scraping can show typical yeast forms, suggestive of candida.

Treatment
General hygiene is vital to the treatment of cutaneous candidiasis; keeping the skin dry and exposed to air is helpful. Weight loss may eliminate the problem in obese people, and good sugar control in diabetics may also be helpful. Topical antifungal medications may be used to treat infection of the skin; systemic antifungal medications may be necessary for folliculitis or nail infection.

Expectations (prognosis)
Cutaneous candidiasis is usually treatable, but occasionally is difficult to eradicate. Recurrence is common.

Complications

     
  • Recurrence of candida skin infection  
  • Infection of nails may cause nails to become oddly shaped and may cause paronychia (infection around the nail)  
  • Disseminated candidiasis may occur in immunocompromised individuals

Calling your health care provider
Call for an appointment with your health care provider if symptoms indicate cutaneous candidiasis.

Prevention

Good general health and hygiene help prevent candida infections. Keep the skin clean and dry. Drying powders may help prevent fungal infections in people who are susceptible to them. Weight loss and good sugar control in diabetics may help prevent these infections.

Johns Hopkins patient information

Last revised: December 6, 2012
by Simon D. Mitin, M.D.

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