- A diagnosis of candidiasis (erosio interdigitalis
blastomycetica and paronychia) is rendered
- Nystatin ointment b.i.d. to interdigital web spaces
- Nystatin ointment mixed in equal parts with topical
corticosteroid triamcinolone 0.1% ointment b.i.d. to the proximal
- Skin care reviewed: to keep skin dry by wearing protective
gloves when exposing hands to water
- Follow up in 4 weeks
Follow-up evaluation strategy
- Erosions of the interdigital web spaces are completely
- Paronychia of multiple fingers is greatly improved; ongoing
treatment is recommended
Candidiasis typically affects mucosal sites and moist and/or
occluded areas of skin: groin, axilla, inframmary, infra-abdominal
pannus, glans penis (in uncircumcised males), and orogenital
Predisposing factors include obesity, diabetes, antibiotic or
corticosteroid treatments, immunosuppression, removable prostheses,
and chronic or frequent exposure to moisture, including saliva,
fecal and urinary incontinence.
Candidal superinfection may complicate pre-existing cutaneous
diseases, as abnormal skin may predispose to candidal overgrowth.
Failure of standard anticandidal treatment to fully clear symptoms
should raise suspicion for an underlying or coexisting disease.
Giannini PJ, Shetty KV. Diagnosis and management of oral
candidiasis. Otolaryn Clin N Amer. 2011;44:231-240.
Wolf R, Oumeish OY, Parish LC. Intertriginous eruption. Clinics