Mild infections of the skin, hair and nails caused by fungi (Candida albicans and dermatophytes).
Clinical features and treatment:
Candidiasis:
– E rythème infant diaper erythema anogenital with peripheral desquamation and sometimes pustules. Secondary infections may develop.
• Clean the skin with water and plain soap, dry well and apply gentian violet 2 times / day for 2 to 3 weeks depending on the clinical course. Do not use Whitfield’s ointment.
• Avoid maceration: remove plastic pants and diapers; ass in the air.
• In the event of severe and persistent diaper rash despite local treatment, treat intestinal household (nystatin PO 400 000 IU in 4 divided doses for 20 days).
– Other candidiasis: large and small folds (same treatment); mouth; vaginal.
Ringworm:
– Dermatophytoses the scalp (tinea): mainly in children.
Depending on the species:
– One or more round erythematous, scaly plaques; short broken hair;
– Inflammation, discharge, and crusts lymphadenopathy satellites (kerion)
– Final scarring alopecia (ringworm).
• Shave the hair, clean with soap and water 2 times / day and apply Whitfield’s ointment 2 times / day for at least 15 days, and if needed, throughout the duration of treatment with griseofulvin.
• griseofulvin PO
Child: 10 to 20 mg / kg / day in one or two taken for 6 weeks
Adult: 500 mg to 1 g / maximum daily or in 2 divided doses for 6 weeks
The treatment can last up to 12 weeks in severe infections.
• In case of painful kerion: paracetamol PO.
• If infected ringworm: treat the secondary infection before applying Whitfield’s ointment.
• Some moths are contagious: examine simultaneously treat subjects symptomatic contacts.
– Ringworm of the hairless skin (vine herpes): macular erythematous, pruritic, scaly clearer to central and well-defined vesicular border.
• Clean with soap and water 2 times / day, dry well and apply Whitfield’s ointment 2 times / day for 3 weeks if the lesions are not extensive.
• Book griseofulvin PO for extended forms (at least 4 weeks of treatment).
– Dermatophytoses folds
– Intertrigo interorteil pruritus, crack and whitish scales in the 3rd and / or 4th interdigital space (different infectionsCandida albicans where the lesions are in the 1st and 2nd interdigital spaces).
– Tinea cruris: lupus closet edged, paler center periphery vesicular-pustular centrifugal extension around the groin;pruritus.
• Clean with soap and water 2 times / day, dry well and apply Whitfield’s ointment 2 times / day for 3 weeks.
• If oozing lesions, apply gentian violet 2 times / day before beginning Whitfield’s ointment.
Note: Candida albicans and dermatophytes are responsible for fungal nail infections requiring treatment PO 12 to 18 months, so difficult in practice.
