Candidiasis, Onychomycosis, and Tinea

Cutaneous CandidiasisOral CandidiasisPerlche Erosio Interdigitalis BlastomyceticaOnychomycosisTinea PedisTinea CorporisTinea ManuumFungal Folliculitis

Figure –

The white plaque on this patient's tongue can be easily removed to reveal inderlying erythema. This finding is characteristic of thrush.
 

Erosio Interdigitalis Blastomycetica

Maceration or scale between isolated web spaces of the fingers suggests erosio interdigitalis blastomycetica (interdigital candidiasis) (Figure). It most often occurs in the web space between the middle and ring fingers; sometimes the toes are affected. Erosio can spread and can be painful.

Long-term exposure to liquids and chronic maceration make those who do "wet work," such as launderers, bartenders, dishwashers, and homemakers, particularly susceptible. Exposure of the skin to irritants and moisture over a long period leads to breakdown of the skin barrier with subsequent colonization and growth of Candida. Rings can help retain moisture in the web space.

Erosio interdigitalis blastomycetica is also one of the cutaneous manifestations of diabetes. The immunosuppressive effect of corticosteroids can aggravate the condition.

References:

FOR MORE INFORMATION:

• Brodell RT, Elewski B. Superficial fungal infections. Errors to avoid in diagnosis and treatment. Postgrad Med. 1997;101(4):279-287.
• Loo DS. Onychomycosis in the elderly: drug treatment options. Drugs Aging. 2007;24:293-302.
• Tan JS, Joseph WS. Common fungal infections of the feet in patients with diabetes mellitus. Drugs Aging. 2004;21;101-112.
• Weinberg JM, Scheinfeld NS. Cutaneous infections in the elderly: diagnosis and management. Dermatol Ther. 2003;16:195-205.
• Weinberg JM, Vafaie J, Scheinfeld NS. Skin infections in the elderly. Dermatol Clin. 2004;22:51-61.