What are the basic principles of treatment of candidiasis?

Candidiasis is a widespread disease that causes an increasing number of patients to visit a dermatologist. Read the causes and clinical manifestations of candidiasis in our previous articles. In addition to identifying the characteristic symptoms, it is important to choose the right treatment for candidiasis. The beginning of any treatment – this is the correct diagnosis. Read in our article aspects of the diagnosis of candidiasis, differential diagnosis, as well as the basic principles and methods of treatment of candidiasis.

Correct diagnostics – the first step in the successful treatment of candidiasis

In superficial forms of candidiasis, the diagnosis is based on the presence of a characteristic clinical picture in the patient and the detection of the fungus in the pathological material (skin scales, scrapings from the nails) during microscopic examination. The diagnosis can be considered reliable if pseudomycelium or true mycelium and budding cells are found.

Sowing on a nutrient medium is carried out to identify the type of yeast fungus of the genus Candida and to determine its sensitivity to antimycotic drugs. The isolation of the fungus culture alone has no diagnostic value, since it can be obtained by sowing scrapings from the skin and nails in healthy people.

Disease should be distinguished from such pathologies:

• seborrheic eczema;
• psoriasis;
• inguinal epidermophytosis;
• superficial trichophytosis;
• pseudomycosis;
• erythrasma (complicated form);
• with interdigital candidal erosion on the hands — from dyshidrotic eczema;
• on the feet — from mycosis caused by Trichophyton interdigitale and Trichophyton rubrum;
• for damage to nails and rollers — from onychia and paronychia of bacterial etiology, eczema and psoriasis;
• for balanoposthitis — from a similar disease of bacterial etiology.

How should I start treating candidiasis?

Limited, sometimes widespread forms of smooth skin lesions, especially those developed during treatment with antibacterial drugs, as a rule, are easily treated with topical antimycotic agents and may resolve without treatment after antibiotics are discontinued. Antimycotics of local and systemic action are prescribed as etiotropic therapy. In which cases systemic antimycotic agents are needed, and in which local treatment is sufficient, read on estet-portal.com.  In recent years, azole preparations with a wide spectrum of action, as well as polyene antibiotics, have been widely used in the treatment of candidiasis.

In case of candidiasis of smooth skin of large folds with acute inflammation, treatment should be started with the use of an aqueous solution of brilliant green (1 & ndash; 2%) in combination with powder and carried out for 2 & ndash; 3 days, then antimycotic drugs — until resolution of clinical manifestations.

The use of antimycotic agents in the treatment of candidiasis

With candidiasis of smooth skin of large, small folds and other areas of the skin, antifungal agents are used in the form of a cream, ointment and solution. Cream or ointment is applied in a thin layer on the lesions and rubbed 1-2 times a day. Duration of treatment — until the clinical manifestations resolve, then continue to apply the cream for another 7-10 days to prevent relapse.

In case of widespread processes on the skin and the ineffectiveness of local therapy, antimycotics of systemic action are prescribed. The duration of therapy is 2-4 weeks.

In case of candidiasis of the skin of the nail folds, an anti-inflammatory treatment of the nail fold is first carried out using applications with pure ichthyol, which are prescribed 1 time per day, until the inflammation is removed. Then, topical antimycotic agents are used, rubbing them under and around the roller. The procedures are carried out 2 times a day, in the evening it can be used under an occlusive dressing. It is effective to prescribe a combination of ointment (cream) with a solution, alternating them. In case of ineffectiveness of local therapy and in case of damage to the nail plates, antimycotics of systemic action are indicated.

Given the fact that candidiasis refers to opportunistic mycosis, it is first necessary to identify and, if possible, eliminate the pathogenetic factors of the disease (study of the immune and endocrine status, gastrointestinal tract and corrective therapy are shown).

Thus, the treatment of candidiasis consists of the treatment of comorbidities, as well as the use of antimycotic drugs of systemic and local action.