Diagnostic Approach to Candidiasis

Clinical Presentation and Diagnosis

Typical cutaneous candidiasis presents as blanchable erythematous plaques with satellite lesions in intertriginous areas, often with pruritus, according to the Infectious Diseases Society of America 1
Topical azoles (clotrimazole 1% cream twice daily) or polyenes (nystatin) for 7-14 days are recommended for simple cutaneous candidiasis, and keeping the area dry is critically important for treatment success, as suggested by the Clinical Infectious Diseases guidelines 1, 2
Oral fluconazole 150-200 mg daily for 7-14 days may be considered if topical treatment fails, as per the treatment guidelines 3

The American College of Physicians recommends initiating systemic antifungal therapy immediately if systemic candidiasis is suspected, with fluconazole as the treatment of choice for C. albicans 1
For non-albicans species or unknown species pending culture, consideration of amphotericin B is recommended, as treatment response to fluconazole is unknown for many non-albicans species, according to the Clinical Infectious Diseases guidelines 1, 2