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CANDIDIASIS OF INTERTRIGINOUS SKIN (Moniliasis)

DESCRIPTION

Candidiasis of intertriginous skin is a yeast infection in skin folds or areas of adjacent skin that come in contact with each other, such as in the diaper area of an infant, the groin or under the breasts. This is contagious from person to person and from place to place on the same person. Body parts involved include the skin of the scrotum, vagina and vaginal lips, underarm area, spaces between fingers and toes, inner thighs, under the breasts, and over the base of the spine (sacrum). Candidiasis of intertriginous skin can affect older children and adolescents.
Appropriate health care includes: self-care after diagnosis; physician's monitoring of general condition and medications (sometimes).

SIGNS & SYMPTOMS
Plaques (patches or flat areas) with the following characteristics:

  • Bright red patches with poorly defined borders. They are often 6cm to 12cm in diameter or larger.
  • Some plaques appear to have pus.
  • Skin appears moist and crusted.
  • Itching is usually severe.
  • Smaller plaques sometimes surround larger plaques. Smaller plaques are less than 1mm in size. They form small pustules (small white blisters with pus inside).

    CAUSES
    Yeast infection of the skin caused by candida fungus (usually candida albicans). The spore form of this organism normally grows in the intestinal tract and the vagina. Skin signs do not begin until yeast changes from its spore form to another growth phase, the mycelial phase. Damaged skin, moisture, and warmth are all necessary for the infection to take over.

    RISK FACTORS
    Use of oral antibiotics; use of steroids (oral, injectable or topical); diabetes; obesity; poor nutrition; excessive sweating; crowded or unsanitary living conditions.

    PREVENTING COMPLICATIONS OR RECURRENCE

  • If your child must take antibiotics, consult your doctor about eating yogurt, buttermilk, or sour cream, or taking acidophilus tablets. These help prevent yeast infections that may result as an adverse effect of the drugs.
  • Keep the child's skin cool and dry.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory culture to identify the yeast organism.

    POSSIBLE COMPLICATIONS

  • Secondary bacterial infections.
  • Id reactions (in Illnesses section).
  • Blood poisoning.

    PROBABLE OUTCOME
    Usually curable in 2 weeks with treatment. Without treatment, healing may be slow (4 to 5 years). Recurrence is common.

    TREATMENT

    HOME CARE

  • Keep your child's skin cool and dry. Expose affected areas to sunlight as much as possible.
  • Let the child wear loose cotton clothing. Avoid synthetic or wool fabrics.
  • Protect skin from injury.
  • If your daughter has a vaginal infection as well as infection of the surrounding skin, obtain treatment for the vaginitis (see Vaginitis, Monilial).

    MEDICATION

  • Your doctor may prescribe anti-fungal topical medications such as nystatin, haloprigin, miconazole, or clotrimazole. Gently massage a small amount into the affected area 3 or 4 times a day. Use only enough to cover. Larger amounts don't help.
  • Continue to use the medication on your child for 1 week after symptoms and signs disappear, to prevent further recurrences.
  • See Medications section for information regarding medicines your doctor may prescribe.

    ACTIVITY
    No restrictions, except for the child to avoid heat and sweating.

    DIET & FLUIDS
    No special diet.

    OK TO GO TO SCHOOL?

    Yes.

    CALL YOUR DOCTOR IF

  • Your child has symptoms of candidiasis.
  • The following occurs during treatment: -- Infection continues to spread, despite treatment. -- Your child develops signs of secondary bacterial infection (pain, tenderness, redness, warmth, oozing).
  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects. ‡
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