Fungal infections of the skin.

Infections of the skin by various species of the yeast Candida, commonly C. albicans, have become more frequent in recent years, and their recognition and treatment are important. These fungi are frequent commensals in animals and men, and are present in the alimentary tract and mucosa of many people. They may become pathogenic on the skin if local and general conditions become suitable. They prefer moist sites (Fig. 1), scaling cracked skin, and pockets between the nail fold and nail plate ; and skin contaminated with sugar from glycosuria or from which bacterial competition has been removed by the use of antibiotics. General conditions favouring growth include debility and serious illness, diabetes, antibiotic and steroid therapy, and rarely hypocalcaemia. Candida infection is recognized by the well-defined edge of the inflamed area, which is often undermined, and the adjacent skin may show small superficial pustules, which rupture and leave a tiny circle with a raised edge. Evaluation of mycological reports on scrapings can be difficult, and a positive culture is of little significance unless fungal elements are found on direct microscopy.