Candidiasis: reflections on the problems of clinical assessment and treatment.

Abstract

Over a period of eight years 256 cases of suspected candidacies were investigated in private dermatological office practice by direct microscopic and cultural methods. Laboratory investigation cannot define the limits of disease with precision and the significance of the laboratory findings can only be made by the clinician, who cannot delegate responsibility for the final diagnosis. The majority of cases of intertriginous candidacies appeared to be secondary to intertriginous (seborrhoeic) dermatitis, diabetes, pregnancy or neoplasia, and primary candidiasis without a predisposing factor was not common. Gandidal balanitis was the clinical state most frequently associated with previously undiagnosed diabetes. Because of the inadequate response of intertriginous candidiasis to topical polyene antibiotics and the frequency of a co-existing dermatitis, it was felt that hydroxyquinoline (e.g. vioform)—steroid preparations are the best available method of treatment.