CANDIDIASIS

• Candidia albicans is the most common causative agent. This yeast like fungus is normally found on the mucous membrane, skin, in the gastro intestinal tract and in the vagina. Under certain circumstances, it changes from a commensal organism to a pathogen. More widespread and systemic infections may occur in immune compromised individuals with the oesophagus most commonly affected

• Most common cause is candida albicans
• Apart from Candida albicans , few other species of candida like C. Tropicalis, C.dubliniensis, C.parapsilosis, C.guilliermondii, C.krusei, C.glabrata may be involved
• Risk factors: Immuno supression is the main risk factor for infection. Imbalance in local flora due to medications (antibiotics, steroids, cytostatic agents), immunosuppressive therapy , increased estrogen levels during pregnancy and congenital disorders like auto immune polyendocrinopathy-candidiasis-ectodermal dystrophy

• Paronychia – Inflammatory bogy swelling of posterior and lateral nail folds of digits of fingers. Commonly seen in house wives, maidservants, due to continuous wet job
• Intertriginous type –well defined peeling border around moist red macerated lesions and surrounded by satellite papules or pustules occur in body such as groin, inframammary, axillary, perianal and interdigital areas
• Oral Thrush – It present as curdy, white, easily detachable deposits on tongue or oral mucosa with underlying bright red and moist surface. It is also known as acute pseudomembranous candidiasis and is the most common form of candidiasis
• Perleche – sore angles of mouth
• Vulvovaginitis - frequently associated with itching and vaginal discharge. Vaginal mucosa shows erythema, Oedema and curdy white deposits. Candidial balanoposthitis occurs as a counter part in males

Differential diagnosis

• Tinea cruris
• Seborrhoeic dermatitis
• Flexural psoriasis
• Bacterial intertrigo

• KOH preparation – reveal budding yeasts with or without hyphae or pseudohyphae
• Gram stained smear gram positive organisms longer than bacteria
• Confirmed by culture on Sabouraud’s media- whitish mucoid colonies grow within 2 to 5 days

Internal medicines

• Panchatiktaka kashaya
• Nirgundyadi kashaya
• Vilwadi gutika
• Doosheevishari gutika
• Krimighna vati
• Haridrakhanda

Procedures

• Triphala / Ksheerivriksha( Nalpamara) Kashaya kshalana
• Tankana + Madhusnuhi -ext application
• Guggulumarichadi taila – ext application
• Neeli taila – ext application
• Rasottamadi lepa