Tinea Versicolor and Candidiasis (Pityriasis Versicolor)

Tinea Versicolor and Candidiasis (Pityriasis Versicolor)

It is a mild, superficial infection of the skin, usually of the trunk.

a) Causative organism

The disease is caused by yeast, pityrosporum orbiculare which is a normal flora of skin, (pityrosporum orbiculare) and which accounts for the high recurrence rate after treatment and initial cure.

b) Clinical finding (sign and symptoms)

-Lesion are asymptomatic, but a few patents note mild itching
-The lesions are various types color hypo pigmented or with, whitish or brown scales macules on surface that vary 4-5 mm in diameter
-The lesions initially do not look scaly, but powdery scales may be readily obtained by scraping the area
-Lesion may appear on the trunk, upper arms, neck, face and groin

c) Management and nursing intervention

-Topical treatment like selenium sulfide or clotrimazole shampoo lwhich may be applied from neck to waist daily and left on for 5 -15 minutes for 7 days. Thism treatment is repeated weekly for a month and monthly for maintenance.

-Ketoconazole shampoo may also be used weekly

-3% salicylic acid in rubbing alcohol and sodium thiosulfate is also used to remove scaly substance from skin

-To prevent relapse sulfur – salicylic acid soap or shampoo or zinc pyrithrone containing shampoo used on a continuing basis may be effective prophylaxis

-Ketoconazole 200 mg daily orally for one week or 400 mg as single oral dose, apparently results in short term cure of 90% cases

-Advice the patient to take daily baths

-Iron under wears and T-shirts

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Candidiasis

a) Epidemiology

Candidiasis is a fungal infection caused by Candida albicans. This organism is frequently a normal inhabitant of mouth, throat, large intestine and vagina. It propagates in areas that are moist and warm, such as in mucous membranes and folds of tissues. Oral candidiasis is commonly encountered among denture wearers in the debilitated, diabet and patient with anemia.

The disease will occur also in those patient under going chemotherapy, local radiation treatment and patients who are using corticosteroid and anti biotic. Candidiasis is often one of the manifestations of HIV/AIDS.

b) Mode of transmission

Oral candidiasis occurs spontaneously in the mouth from normal flora due to prolonged use of antibiotic or immunosuppressive thrapy or HIV infection.

c) Clinical manifestation of oral candidiasis (oral thrush)

Oral candidiasis is manifested by the appearance of adherent white plaque on tongue and inner surface of cheek In advanced diseased esophageal involvement is the most frequent type of invasive mucosal disease. The lesion is found around oral and pharyngeal mucosa, particularly on the mouth and tongue, if scraped raw bleeding area seen. The lesions are usually painless, but fissuring at the corner of the mouth can be painful. The lesions can characteristically be scraped off.

Candidal Vuluvovugintis

Present as an irritable eryhema associated with a copious which white curdy discharge. Pregnant and diabetic women are at risk.

Management of candidal vulvuovagnitis

1. Fluconazol or traconazol can be given. Short course enough for immine competent
2. Clotrimazol vaginal tablet 100mg tab per vagina for 3 to 6 days
3. Miconazol vaginal also can be used for 3 days
4. Ketconazol 200 mg can be used for one week

d) Diagnosis and lab Finding

Diagnosis is made clinically and/, by microscopic examination of scraping from the affected area and by endoscope with biopsy and culture.

e) Management of oral candidasis and nursing intervention

Therapy depends upon the severity of disease, if a patient is able to swallow and take adequate amounts of fluid orally:


-Fluconazole 100 mg/d for 10-14 days, if the patient is more ill or has developed esophagitis while taking fluconazole.

-Relapse is common when there is underlying HIV infection.

-Mouth care will be given frequently

-Ketoconazole 200-400 mg with break fast for 7-14 days

-Clotrimazole 10 Mg dissolved orally five times daily

-0.12% chlorhexidine or half – strength hydrogen peroxide mouth rinses may provide local relief
-Nystatin powder (100,000 units /g) applies to dentures three or four times daily for several weeks may help denture wears.

-Tell the patient to take mouth care always after meal

-Also Nystatin suspension swish and swallow BID or prn

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Tinea Versicolor and Candidiasis (Pityriasis Versicolor) 2018-12-25T23:38:00-08:00 Rating: 4.5 Diposkan Oleh: David Maharoni