DOCSLIB.ORG

Recurrent Candidal Intertrigo Open Access to Scientific and Medical Research DOI

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Recurrent Candidal Intertrigo Open Access to Scientific and Medical Research DOI Journal name: Clinical, Cosmetic and Investigational Dermatology Article Designation: REVIEW Year: 2018 Volume: 11 Clinical, Cosmetic and Investigational Dermatology Dovepress Running head verso: Metin et al Running head recto: Recurrent candidal intertrigo open access to scientific and medical research DOI: http://dx.doi.org/10.2147/CCID.S127841 Open Access Full Text Article REVIEW Recurrent candidal intertrigo: challenges and solutions Ahmet Metin1 Abstract: Intertrigo is a common inflammatory dermatosis of opposing skin surfaces that can Nursel Dilek2 be caused by a variety of infectious agents, most notably candida, under the effect of mechanical Serap Gunes Bilgili3 and environmental factors. Symptoms such as pain and itching significantly decrease quality of life, leading to high morbidity. A multitude of predisposing factors, particularly obesity, diabetes 1Department of Dermatology and Venereology, Medical School of mellitus, and immunosuppressive conditions facilitate both the occurrence and recurrence of Ankara, Yildirim Beyazit University, the disease. The diagnosis of candidal intertrigo is usually based on clinical appearance. How- 2 Ankara, Turkey; Department of ever, a range of laboratory studies from simple tests to advanced methods can be carried out to Dermatology and Venereology, Medical School of Recep, Tayyip confirm the diagnosis. Such tests are especially useful in treatment-resistant or recurrent cases Erdoğan University, Rize, Turkey; for establishing a differential diagnosis. The first and key step of management is identification 3Department of Dermatology and and correction of predisposing factors. Patients should be encouraged to lose weight, followed Venereology, Medical School of Yuzuncu, Yil University, Van, Turkey up properly after endocrinologic treatment and intestinal colonization or peri-orificial infections should be medically managed, especially in recurrent and resistant cases. Medical treatment of candidal intertrigo usually requires topical administration of nystatin and azole group antifun- gals. In this context, it is also possible to use magistral remedies safely and effectively. In case of predisposing immunosuppressive conditions or generalized infections, novel systemic agents with higher potency may be required. Keywords: Candida, intertrigo, recurrent candidal intertrigo, candidiasis, candidosis, candidal predisposals Background Intertrigo (intertriginous dermatitis) is a clinical inflammatory condition that develops in opposing skin surfaces in response to friction, humidity, maceration, or reduced air circulation.1 This common skin disorder may be localized in a small area or involve larger surfaces. Lesions mostly develop in the neck, axilla, sub-mammary fold, and perineum, while other sites may also be involved including antecubital, umbilical, perianal, and interdigital areas as well as abdominal folds, eyelids, and the retroauricular area.1–3 The main factor in the development of the lesions is the mechanical friction on the skin that initially appears as a minimal erythema of the folds. Heat, reduced aeration, humidity, and maceration facilitate intertrigo. Although the condition may Correspondence: Ahmet Metin occur in both genders and all races, it is more common in diabetic obese individuals Ankara Ataturk Egitim ve Arastirma residing in hot and humid climates and in bed-ridden or elderly subjects. Urinary or Hastanesi, Deri ve Zuhrevi Hastaliklar Kliniği, Üniversiteler Mahallesi, Bilkent fecal incontinence, inadequate personal hygiene, malnutrition, immunosuppression, Caddesi No:1, Çankaya, Ankara, Turkey and occlusive clothing are among other predisposing factors. Infants are also more Tel +90 312 291 2525 ext 3154 Email [email protected] likely to develop intertrigo due to drooling and short neck structure with prominent submit your manuscript | www.dovepress.com Clinical, Cosmetic and Investigational Dermatology 2018:11 175–185 175 Dovepress © 2018 Metin et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms. php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work http://dx.doi.org/10.2147/CCID.S127841 you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Metin et al Dovepress skin folds and a flexed position.2 Many yeasts (particularly respiratory system, in addition to the soil and a variety of Candida) and molds, bacteria, and viral infectious agents foods.31 Human colonization starts on the first day after birth may aggravate intertrigo by colonizing on the skin (Table 1). and continues throughout the life-cycle as an opportunistic Intertrigo may transform into a life-long chronic condi- pathogen. Candida albicans is responsible for the majority of tion. It generally has an insidious onset with symptoms such Candida-related noninvasive skin and mucosal candidiasis. as itching, pain, burning, or prickling sensations in skin fold However, a more than 50% increase in the incidence of non- areas.7 Initially it presents itself as mildly erythematous papil- albicans Candida species have recently been reported includ- lae or plaques, quickly developing into an exudative erosion, ing C. glabrata, C. parapsilosis, C. tropicalis, C. krusei, C. fissures, macerations, and crusts. Erythema due to secondary lusitaniae, C. dubliniensis, and C. guilliermondii.33 Each of infections, increased inflammation, papullo-pustules, and bad these organisms exhibits characteristic virulence potential, odor may develop.1,2,7 antifungal susceptibility, and epidemiology.34 Diagnosis of intertrigo and its complications are generally based on clinical manifestations and basic microbiological Pathogenesis of candidal infection investigations. Microbiological cultures, potassium hydrox- C. albicans is a part of the normal flora in skin and genital ide (KOH) preparation, and Gram’s staining may guide the and/or intestinal mucosa in 70% of healthy individuals.35 therapy when used for differentiating primary and secondary Similar to many other opportunistic microorganisms of the infections. Wood’s light examination can be used to identify skin, it exists as a commensal yeast in individuals with an a Pseudomonas, Malassezia, or erythrasma infection more intact immune system. It may lead to mucocutaneous or quickly than would a culture. Despite the absence of a charac- systemic infections under appropriate conditions. teristic histopathological appearance, biopsy may be required Many Candida species are known to produce virulence in treatment-resistant cases of intertrigo in order to exclude factors like proteases. Species lacking these virulence fac- other skin disorders such as psoriasis or lichen planus.1,2 tors are considered less pathogenic.36–39 Mechanisms of Treatment of intertrigo should generally focus on the pathogenicity for Candida albicans may be summarized removal of predisposing factors, followed by appropriate as below: secretion of hydrolases, molecules that mediate use of topical or systemic antimicrobial agents as well as adhesion to with concomitant invasion into host cells, the low-potency corticosteroids, if required. yeast-to-hypha transition, biofilm formation, contact sensing and thigmotropism, phenotypic switching, and a variety of Candida species fitness attributes.37 Taxonomically, Candida belongs to the phylum Ascomy- As is the case with all pathogens, the innate immunity of cetes, class Blastomycetes, order Cryptococcales, family the skin represents the first step of the host defense against Cryptococcaceae, and genus Candida.31 These microorgan- Candida.40 Pathogenic invasion is a rather complex process isms have a diameter of 3–5 μm with a two-layered cell wall. and is initiated through disruption of the physical barrier by Among more than 200 Candida species identified, only 15 the transformation of Candida on the skin from yeast to hypha may be associated with primary Candida infections.32 Yeasts form. The capability of the yeasts to adhere to epithelium is a associated with Candida species can be found in the normal strong stimulant for the hyphal transformation and represents flora of human skin as well as in the mucosal covering of the most important step in tissue penetration.37,39-41 Hyphae of the gastrointestinal system, genito-urinary system, and C. albicans exhibit stronger epithelial adhesion than yeasts. Table 1 Infectious agents commonly found in intertrigo Microorganisms Species References Candida C. albicans, C. glabrata, C. tropicalis, C. krusei, C. parapsilosis, C. dubliniensis, C. famata 4–11 Fusarium F. oxysporum, F. solani 12–18 Dermatophytes Trichophyton spp., Microsporum spp., and Epidermophyton floccosum 2,8,9,15,19,20 Malassezia Mostly M. furfur, M. globosa or M. sympodialis 9,21–23 Bacteria S. aureus, S. agalactiae, S. haemolyticus, S. pyogenes, or other streptococcal species Pseudomonas spp., 2,11,24–26 Proteus spp., E. coli, Peptostreptococcus spp., Corynebacterium spp., Acinetobacter spp., etc. Viruses Poxviridae, Papillomaviridea (HPVs), Picornaviridae, Retroviridae (HIV), Herpesvirdae, Togaviridae, 27–30 Parvoviridae, Abbreviation: HPV, human papillomavirus. 176 submit
Load more

Recommended publications
  • An Overview of the Management of the Most Important Invasive Fungal Infections in Patients with Blood Malignancies
    Infection and Drug Resistance Dovepress open access to scientific and medical research Open Access Full Text Article REVIEW An Overview of the Management of the Most Important Invasive Fungal Infections in Patients with Blood Malignancies This article was published in the following Dove Press journal: Infection and Drug Resistance Aref Shariati 1 Abstract: In patients with hematologic malignancies due to immune system disorders, espe- Alireza Moradabadi2 cially persistent febrile neutropenia, invasive fungal infections (IFI) occur with high mortality. Zahra Chegini3 Aspergillosis, candidiasis, fusariosis, mucormycosis, cryptococcosis and trichosporonosis are Amin Khoshbayan 4 the most important infections reported in patients with hematologic malignancies that undergo Mojtaba Didehdar2 hematopoietic stem cell transplantation. These infections are caused by opportunistic fungal pathogens that do not cause severe issues in healthy individuals, but in patients with hematologic 1 Department of Microbiology, School of malignancies lead to disseminated infection with different clinical manifestations. Prophylaxis Medicine, Shahid Beheshti University of fi Medical Sciences, Tehran, Iran; and creating a safe environment with proper lters and air pressure for patients to avoid contact 2Department of Medical Parasitology and with the pathogens in the surrounding environment can prevent IFI. Furthermore, due to the Mycology, Arak University of Medical fi For personal use only. absence of speci c symptoms in IFI, rapid and accurate diagnosis reduces
    [Show full text]
  • Hyperhidrosis: Sweating out the Details
    Focus on CME at the Université de Montréal Hyperhidrosis: Sweating Out the Details Antranik Benohanian, MD, FRCPC; and Nowell Solish, MD, FRCPC Presented at the 250th meeting of the Montreal Dermatological Society, April 2003 yperhidrosis (HH) remains a relatively Table 1 Hunknown disorder to the general public Most commonly affected sites and health-care professionals. According to the literature, 0.5% to 1% of the population is Site Prevalence affected by HH. However, a recent survey held Facial 68.9% in the U.S. places that figure at 2.8%; thus, Axillary 50.8% revealing that the prevalence is underrated. Plantar 28.7% Among those affected, only 38% had discussed Palmar 24.8% the problem with a health professional.1 HH may be classified as primary or sec- ondary; either type can be localized or gen- Besides affecting quality of life, HH predis- eralized. Table 1 lists the most commonly poses its victims to a host of dermatologic dis- affected sites. orders (Table 2).3 The control of HH would also control the associated disease condition, as has Impact on quality of life been recently reported with the treatment of dyshidrotic hand dermatitis with intradermal HH is known to be a socially embarrassing and botulinum toxin.4 occupationally disabling disorder. Many patients suffer in silence. Figure 1 illustrates the How is HH treated? impact HH has on quality of life.2 Those with axillary HH often have to change Systemic approach clothing several times a day and throw out Minor sedatives, such as amitriptyline and clothing because of the damage caused to fabric hydroxyzine, produce an anticholinergic, as and leather.
    [Show full text]
  • Oral Candidiasis: a Review
    International Journal of Pharmacy and Pharmaceutical Sciences ISSN- 0975-1491 Vol 2, Issue 4, 2010 Review Article ORAL CANDIDIASIS: A REVIEW YUVRAJ SINGH DANGI1, MURARI LAL SONI1, KAMTA PRASAD NAMDEO1 Institute of Pharmaceutical Sciences, Guru Ghasidas Central University, Bilaspur (C.G.) – 49500 Email: [email protected] Received: 13 Jun 2010, Revised and Accepted: 16 July 2010 ABSTRACT Candidiasis, a common opportunistic fungal infection of the oral cavity, may be a cause of discomfort in dental patients. The article reviews common clinical types of candidiasis, its diagnosis current treatment modalities with emphasis on the role of prevention of recurrence in the susceptible dental patient. The dental hygienist can play an important role in education of patients to prevent recurrence. The frequency of invasive fungal infections (IFIs) has increased over the last decade with the rise in at‐risk populations of patients. The morbidity and mortality of IFIs are high and management of these conditions is a great challenge. With the widespread adoption of antifungal prophylaxis, the epidemiology of invasive fungal pathogens has changed. Non‐albicans Candida, non‐fumigatus Aspergillus and moulds other than Aspergillus have become increasingly recognised causes of invasive diseases. These emerging fungi are characterised by resistance or lower susceptibility to standard antifungal agents. Oral candidiasis is a common fungal infection in patients with an impaired immune system, such as those undergoing chemotherapy for cancer and patients with AIDS. It has a high morbidity amongst the latter group with approximately 85% of patients being infected at some point during the course of their illness. A major predisposing factor in HIV‐infected patients is a decreased CD4 T‐cell count.
    [Show full text]
  • Fundamentals of Dermatology Describing Rashes and Lesions
    Dermatology for the Non-Dermatologist May 30 – June 3, 2018 - 1 - Fundamentals of Dermatology Describing Rashes and Lesions History remains ESSENTIAL to establish diagnosis – duration, treatments, prior history of skin conditions, drug use, systemic illness, etc., etc. Historical characteristics of lesions and rashes are also key elements of the description. Painful vs. painless? Pruritic? Burning sensation? Key descriptive elements – 1- definition and morphology of the lesion, 2- location and the extent of the disease. DEFINITIONS: Atrophy: Thinning of the epidermis and/or dermis causing a shiny appearance or fine wrinkling and/or depression of the skin (common causes: steroids, sudden weight gain, “stretch marks”) Bulla: Circumscribed superficial collection of fluid below or within the epidermis > 5mm (if <5mm vesicle), may be formed by the coalescence of vesicles (blister) Burrow: A linear, “threadlike” elevation of the skin, typically a few millimeters long. (scabies) Comedo: A plugged sebaceous follicle, such as closed (whitehead) & open comedones (blackhead) in acne Crust: Dried residue of serum, blood or pus (scab) Cyst: A circumscribed, usually slightly compressible, round, walled lesion, below the epidermis, may be filled with fluid or semi-solid material (sebaceous cyst, cystic acne) Dermatitis: nonspecific term for inflammation of the skin (many possible causes); may be a specific condition, e.g. atopic dermatitis Eczema: a generic term for acute or chronic inflammatory conditions of the skin. Typically appears erythematous,
    [Show full text]
  • Epidemiology of Invasive Fungal Diseases in Patients With
    Journal of Fungi Article Epidemiology of Invasive Fungal Diseases in Patients with Hematologic Malignancies and Hematopoietic Cell Transplantation Recipients Managed with an Antifungal Diagnostic Driven Approach Maria Daniela Bergamasco 1 , Carlos Alberto P. Pereira 1, Celso Arrais-Rodrigues 2, Diogo B. Ferreira 1 , Otavio Baiocchi 2, Fabio Kerbauy 2, Marcio Nucci 3 and Arnaldo Lopes Colombo 1,* 1 Division of Infectious Diseases, Hospital São Paulo-University Hospital, Universidade Federal de São Paulo, São Paulo 04024-002, Brazil; [email protected] (M.D.B.); [email protected] (C.A.P.P.); [email protected] (D.B.F.) 2 Division of Hematology, Hospital São Paulo-University Hospital, Universidade Federal de São Paulo, São Paulo 04024-002, Brazil; [email protected] (C.A.-R.); [email protected] (O.B.); [email protected] (F.K.) 3 Department of Internal Medicine, Hospital Universitário Clementino Frafa Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil; [email protected] * Correspondence: [email protected] or [email protected] Abstract: Patients with hematologic malignancies and hematopoietic cell transplant recipients (HCT) Citation: Bergamasco, M.D.; Pereira, are at high risk for invasive fungal disease (IFD). The practice of antifungal prophylaxis with mold- C.A.P.; Arrais-Rodrigues, C.; Ferreira, active azoles has been challenged recently because of drug–drug interactions with novel targeted D.B.; Baiocchi, O.; Kerbauy, F.; Nucci, therapies. This is a retrospective, single-center cohort study of consecutive cases of proven or probable M.; Colombo, A.L. Epidemiology of IFD, diagnosed between 2009 and 2019, in adult hematologic patients and HCT recipients managed Invasive Fungal Diseases in Patients with fluconazole prophylaxis and an antifungal diagnostic-driven approach for mold infection.
    [Show full text]
  • “The Red Face” and More Clinical Pearls
    “The Red Face” and More Clinical Pearls Courtney R. Schadt, MD, FAAD Assistant Professor Residency Program Director University of Louisville Associates in Dermatology I have no disclosures or conflicts of interest Part 1: The Red Face: Objectives • Distinguish and diagnose common eruptions of the face • Recognize those with potential implications for internal disease • Learn basic treatment options Which patient(s) has an increased risk of hypertension and hyperlipidemia? A B C Which patient(s) has an increased risk of hypertension and hyperlipidemia? A Seborrheic Dermatitis B C Psoriasis Seborrheic Dermatitis Goodheart HP. Goodheart's photoguide of common skin disorders, 2nd ed, Lippincott Williams & Wilkins, Philadelphia 2003. Copyright © 2003 Lippincott Williams & Wilkins. Seborrheic Dermatitis • Erythematous scaly eruption • Infants= “Cradle Cap” • Reappear in adolescence or later in life • Chronic, remissions and flares; worse with stress, cold weather • Occurs on areas of body with increased sebaceous glands • Unclear role of Malassezia; could be immune response; no evidence of overgrowth Seborrheic Dermatitis Severe Seb Derm: THINK: • HIV (can also be more diffuse on trunk) • Parkinson’s (seb derm improves with L-dopa therapy) • Other neurologic disorders • Neuroleptic agents • Unclear etiology 5MinuteClinicalConsult Clinical Exam • Erythema/fine scale • Scalp • Ears • Nasolabial folds • Beard/hair bearing areas Goodheart HP. Goodheart's photoguide of common skin disorders, 2nd ed, Lippincott • Ill-defined Williams & Wilkins, Philadelphia
    [Show full text]
  • Therapies for Common Cutaneous Fungal Infections
    MedicineToday 2014; 15(6): 35-47 PEER REVIEWED FEATURE 2 CPD POINTS Therapies for common cutaneous fungal infections KENG-EE THAI MB BS(Hons), BMedSci(Hons), FACD Key points A practical approach to the diagnosis and treatment of common fungal • Fungal infection should infections of the skin and hair is provided. Topical antifungal therapies always be in the differential are effective and usually used as first-line therapy, with oral antifungals diagnosis of any scaly rash. being saved for recalcitrant infections. Treatment should be for several • Topical antifungal agents are typically adequate treatment weeks at least. for simple tinea. • Oral antifungal therapy may inea and yeast infections are among the dermatophytoses (tinea) and yeast infections be required for extensive most common diagnoses found in general and their differential diagnoses and treatments disease, fungal folliculitis and practice and dermatology. Although are then discussed (Table). tinea involving the face, hair- antifungal therapies are effective in these bearing areas, palms and T infections, an accurate diagnosis is required to ANTIFUNGAL THERAPIES soles. avoid misuse of these or other topical agents. Topical antifungal preparations are the most • Tinea should be suspected if Furthermore, subsequent active prevention is commonly prescribed agents for dermatomy- there is unilateral hand just as important as the initial treatment of the coses, with systemic agents being used for dermatitis and rash on both fungal infection. complex, widespread tinea or when topical agents feet – ‘one hand and two feet’ This article provides a practical approach fail for tinea or yeast infections. The pharmacol- involvement. to antifungal therapy for common fungal infec- ogy of the systemic agents is discussed first here.
    [Show full text]
  • Application to Add Itraconazole and Voriconazole to the Essential List of Medicines for Treatment of Fungal Diseases – Support Document
    Application to add itraconazole and voriconazole to the essential list of medicines for treatment of fungal diseases – Support document 1 | Page Contents Page number Summary 3 Centre details supporting the application 3 Information supporting the public health relevance and review of 4 benefits References 7 2 | Page 1. Summary statement of the proposal for inclusion, change or deletion As a growing trend of invasive fungal infections has been noticed worldwide, available few antifungal drugs requires to be used optimally. Invasive aspergillosis, systemic candidiasis, chronic pulmonary aspergillosis, fungal rhinosinusitis, allergic bronchopulmonary aspergillosis, phaeohyphomycosis, histoplasmosis, sporotrichosis, chromoblastomycosis, and relapsed cases of dermatophytosis are few important concern of southeast Asian regional area. Considering the high burden of fungal diseases in Asian countries and its associated high morbidity and mortality (often exceeding 50%), we support the application of including major antifungal drugs against filamentous fungi, itraconazole and voriconazole in the list of WHO Essential Medicines (both available in oral formulation). The inclusion of these oral effective antifungal drugs in the essential list of medicines (EML) would help in increased availability of these agents in this part of the world and better prompt management of patients thereby reducing mortality. The widespread availability of these drugs would also stimulate more research to facilitate the development of better combination therapies.
    [Show full text]
  • Identification of Culture-Negative Fungi in Blood and Respiratory Samples
    IDENTIFICATION OF CULTURE-NEGATIVE FUNGI IN BLOOD AND RESPIRATORY SAMPLES Farida P. Sidiq A Dissertation Submitted to the Graduate College of Bowling Green State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY May 2014 Committee: Scott O. Rogers, Advisor W. Robert Midden Graduate Faculty Representative George Bullerjahn Raymond Larsen Vipaporn Phuntumart © 2014 Farida P. Sidiq All Rights Reserved iii ABSTRACT Scott O. Rogers, Advisor Fungi were identified as early as the 1800’s as potential human pathogens, and have since been shown as being capable of causing disease in both immunocompetent and immunocompromised people. Clinical diagnosis of fungal infections has largely relied upon traditional microbiological culture techniques and examination of positive cultures and histopathological specimens utilizing microscopy. The first has been shown to be highly insensitive and prone to result in frequent false negatives. This is complicated by atypical phenotypes and organisms that are morphologically indistinguishable in tissues. Delays in diagnosis of fungal infections and inaccurate identification of infectious organisms contribute to increased morbidity and mortality in immunocompromised patients who exhibit increased vulnerability to opportunistic infection by normally nonpathogenic fungi. In this study we have retrospectively examined one-hundred culture negative whole blood samples and one-hundred culture negative respiratory samples obtained from the clinical microbiology lab at the University of Michigan Hospital in Ann Arbor, MI. Samples were obtained from randomized, heterogeneous patient populations collected between 2005 and 2006. Specimens were tested utilizing cetyltrimethylammonium bromide (CTAB) DNA extraction and polymerase chain reaction amplification of internal transcribed spacer (ITS) regions of ribosomal DNA utilizing panfungal ITS primers.
    [Show full text]
  • Medicinal Product No Longer Authorised
    European Medicines Agency EMEA/H/C/611 EUROPEAN PUBLIC ASSESSMENT REPORT (EPAR) POSACONAZOLE SP EPAR summary for the public This document is a summary of the European Public Assessment Report (EPAR). It explains how the Committee for Medicinal Products for Human Use (CHMP) assessed the studies performed, to reach their recommendations on how to use the medicine. If you need more information about your medical condition or your treatment, readauthorised the Package Leaflet (also part of the EPAR) or contact your doctor or pharmacist. If you want more information on the basis of the CHMP recommendations, read the Scientific Discussion (also part of the EPAR). What is Posaconazole SP? Posaconazole SP is an oral suspension that contains the active substance posaconazole (40 mg/ml). What is Posaconazole SP used for? Posaconazole SP is an antifungal medicine. It is used to treatlonger patients with the following diseases, when they cannot tolerate other antifungal medicines (amphotericin B, itraconazole or fluconazole) or have not improved after at least 7 days of treatment with other antifungal medicines: • invasive aspergillosis (a type of fungal infection due to Aspergillus), • fusariosis (another type of fungal infection nodue to Fusarium), • chromoblastomycosis and mycetoma (long-term fungal infections of the skin or the tissue just below the skin, usually caused by fungal spores infecting wounds due to thorns or splinters), • coccidioidomycosis (fungal infection of the lungs caused by breathing in spores). Posaconazole SP is also used to treat patients with oropharyngeal candidiasis or ‘thrush’, a fungal infection of the mouth and throat due to Candida. It is used in patients who have not been treated for this disease before.
    [Show full text]
  • Or Moisture-Associated Skin Damage, Due to Perspiration: Expert Consensus on Best Practice
    A Practical Approach to the Prevention and Management of Intertrigo, or Moisture-associated Skin Damage, due to Perspiration: Expert Consensus on Best Practice Consensus panel R. Gary Sibbald MD Professor, Medicine and Public Health University of Toronto Toronto, ON Judith Kelley RN, BSN, CWON Henry Ford Hospital – Main Campus Detroit, MI Karen Lou Kennedy-Evans RN, FNP, APRN-BC KL Kennedy LLC Tucson, AZ Chantal Labrecque RN, BSN, MSN CliniConseil Inc. Montreal, QC Nicola Waters RN, MSc, PhD(c) Assistant Professor, Nursing Mount Royal University A supplement of Calgary, AB The development of this consensus document has been supported by Coloplast. Editorial support was provided by Joanna Gorski of Prescriptum Health Care Communications Inc. This supplement is published by Wound Care Canada and is available at www.woundcarecanada.ca. All rights reserved. Contents may not be reproduced without written permission of the Canadian Association of Wound Care. © 2013. 2 Wound Care Canada – Supplement Volume 11, Number 2 · Fall 2013 Contents Introduction ................................................................... 4 Complications of Intertrigo ......................................11 Moisture-associated skin damage Secondary skin infection ...................................11 and intertrigo ................................................................. 4 Organisms in intertrigo ..............................11 Consensus Statements ................................................ 5 Specific types of infection .................................11
    [Show full text]
  • Immunotherapy in the Prevention and Treatment of Chronic Fungal Infections
    A chance for treatment - immunotherapy in the prevention and treatment of chronic fungal infections Frank L. van de Veerdonk Radboud Center for Infectious diseases (RCI) ESCMID eLibrary © by author Candida infections Mucocutaneous infections Invasive candidiasis Th ESCMIDT helper cells eLibraryPhagocytes © by author Chronic Candida infection 30% to 50% of individuals are colonized with Candida at any given moment, but only rarely causing mucosal infections Even more rarely are these infections chronic However, several clinical syndromes have been described with chronic CandidaESCMIDinfections eLibrary © by author Mucosal host defence against Candida ESCMID eLibrary Nature Microbiol. Reviews 2012 © by author Mucosal host defence against Candida ESCMID eLibrary Nature Microbiol. Reviews 2012 © by author Chronic Candida infections Hyper IgE syndrome (HIES) Dectin-1/CARD9 deficiency Chronic mucocutaneous candidiasis (STAT1 GOF, APECED, IL-17F, IL-17R) ESCMID eLibrary © by author Characteristics of Hyper IgE syndrome ESCMID eLibrary © by author Loss of function STAT3 mutation Heterozygous mutation in STAT3 ESCMIDDominant negative eLibrary © by author Cytokine signalling INTERLEUKIN-6/23 IL-6/IL-23 RECEPTOR STAT3 phosphorylation IL-17 ESCMID eLibrary PMN Levy and Loomis et al, NEJM 2007 © by author Th17 deficiency in HIES IL-17 ESCMID eLibrary IFNg van de Veerdonk et al, Clin Exp Immunol© 2010by author Chronic Candida infections Hyper IgE syndrome (HIES) Dectin-1/CARD9 deficiency Chronic mucocutaneous candidiasis ESCMID eLibrary © by author
    [Show full text]