Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion

Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion

Candidiasis Cutaneous

Candidiasis cutaneous is an infection caused by candida. The organism causes topically infections, but serious disease complications can result from the infection. Common sites of the infection include: oral thrush, infant diaper dermatitis, vaginal infections, groin, toes, fingers, axillae, and perianal area (Dunphy, Winland-Brown, Thomas, & Carter, 2015). Candida infection can be systemic infecting the lungs and gastrointestinal tract. Risk factors related to severe complications are secondary to immunocompromised patients following major surgery, immunocompromised patients, and infants.

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Incidence and Prevalence

Women are at greater risk for development of vaginal candidiasis. Vaginal candidiasis often affects women after antibiotic therapy because the medications disrupt normal flora. The most common type of infectious agent is candida albicans (Ferri, 2018). Neonates and elderly are at higher risk of the infection. Patients with obesity, diabetes, receiving glucocorticoids, maceration have a higher risk of infection (Wolff, Johnson, Saaverdra, & Roh, 2017). Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion.

Pathophysiology

Cutaneous candidiasis occurs in moist areas of the skin. The fungal infection has two subgroups: cutaneous and chronic (Ferri, 2018). Physical presentation of cutaneous presents with areas of erythema, inflammation and shiny lesions around the perimeter of the erythema. Microscopic presentation of lesions shows yeast forms and sausage-looking forms (Wolff et al., 2017). Areas of the skin affected by cutaneous candidiasis form on the vagina, penile skin, overlapping skin folds, abdomen, nails, oral cavity, axillae, buttocks, and perianal area.

Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion Chronic candidiasis is generally seen in hospitalized patients (Ferri, 2018). Gram stains of samples from the respiratory and gastrointestinal tract shows yeast cell formation. Areas of samples for chronic candidiasis from an endoscopy or lung biopsy will show cytokine secretion of T-cell subtypes (Campois et al., 2015).

Physical Assessment

            Physical assessment of cutaneous candidiasis presenting on the skin reveals white, flaky patches with surrounding inflammation and erythema Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion. The patient may complain the skin is itchy with pain from the inflammation.

Physical assessment of chronic candidiasis depends on the site of infection. Oral thrush will present with inflammation to the oral membrane with large white patches to the tongue and surrounding membranes. Patients may complain of burning, dry mouth, pain and dysphagia (Ferri, 2018). Diagnostic testing for chronic candidiasis includes cultures for a sputum sample and upper endoscopy with or without a sample.

Evidence-Based Treatment

Treatment for cutaneous candidiasis includes topical antifungal ointment or powder depending on the site of infection. Antifungal medications based on clinical guidelines for treatment are clotrimazole, econazole, and miconazole (Ferri, 2018). Patients with candidiasis of the finger/toenails will present with dystrophic nails with surrounding nail bed erythema with possible nail bed loss. Oral or topical antifungals are indicated depending on the severity of infection in the nail/toe beds. Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion.

Treatment for chronic and reoccurring candidiasis is with use of oral antifungals. Nystatin swish and swallow is used in treatment of oral thrush. Many candidiasis responds to fluconazole single dose in conjunction with a topical antifungal ointment (Ferri, 2018). High doses of fluconazole are indicated in patients with reoccurring infection by oral of intravenous route Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion.

Patient Education

Patients with topical infections should be educated to keep the area clean and dry for prevention and during treatment for candidiasis. Patients should be educated to complete all medications as instructed and to follow-up with provider in two weeks or before if symptoms worsen. Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion.

References

Camporis, T. G., Zucoloto, A. Z., Araujo, E. J., Svidizinski, T. I., Alemeida, R. S., Quirino, F. S.,

Haranp, R. M., & Felipe, I. (2015). Immunological and histopathological characterization

of cutaneous candidiasis. Journal of Medical Microbiology, 64, 810-817. doi: 10.1099/

jmm0.000095.

Dunphy, L. M., Winland-Brown, J. E., Porter, B. O. & Thomas, D. J. (2015) Primary Care: The

art and science of advanced practice nursing. Philadelphia, PA: F. A. Davis Company.

Ferri, F. F. (2018). Ferri’s Clinical Advisor 2018: 5 Books in 1. Philadelphia, PA: Elsevier.

Wolff, K., Johnson, R. A., Saavedra, A. P., & Roh, E. K. (2017). Fitzpatrick’s Color Atlas and

Synopsis of Clinical Dermatology. United States of America: McGraw Hill Education. Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion