What is it?

Although a common commensal yeast, candida can cause an infection, typically when predisposing conditions are present such as moist areas of skin or when the patient is immunosuppressed with diabetes or HIV.

Candida in the folds of skin such as the inner thighs, under the breasts or intergluteal folds is called candidal intertrigo.

Risk factors include:

  • recent antibiotic use
  • warm climate
  • occlusion (such as nylon underwear)
  • diabetes
  • immunodeficiencies (such as HIV, transplant patients, other immunosuppressive therapy)

Clinical presentation

The candidal rash is typically well circumscribed and erythematous, with a possible overlying white appearance.

The skin may be moist and peeling and have an odour. There may be satellite pustules at the periphery of the rash.

Candidal proctitis

Warning

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Candidal proctitis

Management 

  • Keep the area dry and clean
  • Topical azoles (such as clotrimazole) or oral antifungals may be necessary depending on severity
  • Hydrocortisone 1% cream or ointment may help if there is severe itch