​Dermatology - Genital Candidiasis

​Dermatology - Genital Candidiasis
Candidal infection of the nonkeratinized genital mucosa, such as the vulva, vagina, and preputial sac of the penis, occurs when there is an excessive proliferation of Candida spp. in the natural flora of the mucocutaneous region. More than 20% of women have vaginal colonization, and the majority of cases of vaginal candidiasis occur in individuals who are in good health.
Approximately 75% of women go through at least one occurrence, whereas 40-45% experience two or more occurrences. Diabetes mellitus and HIV illness are considered risk factors.


The patient presents with pruritus, vaginal discharge, vaginal pain, vulvar burning, dyspareunia, and external dysuria. The onset of symptoms typically occurs suddenly, generally during the week preceding menstruation. An relationship may exist between candidal intertrigo of the inguinal folds and perineum.
Abnormalities
Lesions manifest as erosions accompanied by edema, erythema, and a curdlike material that can be easily removed. Pustules may be present on the side of the vulva and the surrounding skin. Vaginal lesions are white patches that can be easily removed from the mucous membrane. In chronic situations, the patches may seem shiny and thin.
Subcorneal pustules with fringed, uneven borders may be present at the periphery.


The diagnosis is made through clinical examination and verified by doing a potassium hydroxide (KOH) preparation of a sample taken from the mucosal surface. The differential diagnosis include trichomoniasis (produced by T. vaginalis), bacterial vaginosis, lichen planus, and lichen sclerosus et atrophicus.


Administer azole creams and suppositories, or administer oral fluconazole or itraconazole. If there are recurrences, it is important to test and treat sexual partners accordingly.