Mycoses En Ville : L'essentiel.pdf

The Essentials (Part 1/2)

Causes of Mycoses:
- Warm, humid environments (swimming pools, saunas)
- Skin maceration: excessive sweating, insufficient drying, closed shoes, obesity, diaper rash
- Contact sports (judo)
- Skin wounds
- Certain medications (antibiotics, corticosteroids)
- General health: endocrine diseases (diabetes), immune deficiency
- Pregnancy

Skin Mycoses:

1. Dermatophytoses outside skin folds:
- Erythematous, scaly lesions with central healing and peripheral extension.
- Often itchy, contagious (wash towels at the start of treatment).
- Differential diagnosis: eczema or other inflammatory annular dermatoses.
- Treatment: topical antifungal for 3 weeks; oral terbinafine for 15 days if widespread.

2. Intertrigo mycoses:
- Circular, crumbly borders, fissured or macerated base.
- Affects skin folds (interdigital, inguinal).
- Treatment: topical antifungal 1-2 times/day for 3 weeks; oral terbinafine for 15 days if widespread or immune-compromised.

3. Pityriasis versicolor:
- Affects the trunk, causes light brown, slightly scaly plaques.
- Transient hypopigmentation post-inflammatory.
- Treatment: ketoconazole gel moussant twice a week for a month.

4. Candida albicans:
- Affects large skin folds (inguinal, intergluteal, sub-mammary, abdominal), interdigital folds.
- Treatment: topical antifungal cream for 3 weeks.

5. Mucosal candidoses:*
- Oral candidiasis (thrush) with glossitis, stomatitis, or black hairy tongue.
- Vulvovaginitis: erythematous mucous with white deposits, pruritus, milky discharge.
- Balanitis/urethritis: pruritic.
- Treatment: local (mouthwash, topical antifungal) or systemic (fluconazole) depending on severity and response to initial treatment.