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This infection is usually caused by Candida albicans, whichis often present in body folds. Candidiasis is common in persons with diabetes and in obese persons. Other predisposing factors are the use of antibiotics, topical corticosteroids, or immunosuppressive drugs; poor nutrition; and immunosuppression.

Tinea pedis, or athlete's foot, is common in elderly persons. It manifests as maceration in the interdigital web folds and as scaly plaques on the plantar surfaces of the feet. A potassium hydroxide evaluation can establish the diagnosis. Tinea pedis is commonly associated with xerosis. It is best treated with a topical antifungal agent; treatment can be aided by a keratolytic such as lactic acid 12% cream.

Oral candidiasis, or thrush, is not uncommon in elderly persons. It can be related to poor dentition or immunosuppression, particularly as a result of oral corticosteroid use.

How safe is the use of high doses of niacin to foil urine drug screening tests?

Tinea corporis occurs most often on the torso of elderly persons. It commonly appears as an annular plaque with a rim of scaly erythema. Occasionally, tinea corporis manifests with polycyclic annuli or with nummular plaques, which mimic nummular dermatitis. The examination of a potassium hydroxide preparation can establish the diagnosis. Tinea corporis can be treated effectively with a topical antifungal agent.

The prevalence of onychomycosis increases with age; it is less than 1% in persons younger than 19 years and rises to about 18% in those who are 60 to 79 years. The infection is more common in men than in women. Among the predisposing factors are diabetes mellitus, psoriasis, a family history of onychomycosis, use of immunosuppressive drugs, and peripheral vascular disease.

A 73-year-old man presented with constant watering, irritation, and redness of the left eye. An outward turning of the left lower eyelid was noted. The palpebral conjunctiva exhibited hyperemia and thickening. Keratinization of the exposed conjunctiva indicated that this was a long-standing lower lid ectropion. Slit-lamp examination revealed superficial punctate keratopathy in the inferior one third of the cornea.

A 50-year-old man with end-stage renal disease secondary to long-standing hypertension had an elevated hematocrit and progressively increasing hemoglobin levels. For the past 7 years, he had been receiving hemodialysis 3 times a week. He denied headache, flushing, easy bruising, bleeding, nausea, vomiting, chest pain, dyspnea, and other symptoms. He was not receiving exogenous erythropoietin.

A 62-year-old woman is seen because of profuse vaginal bleeding that has led to anemia (hemoglobin, 4.5 g/dL). She has also noticed a lump in her navel.

LEBANON, N.H. -- Surgery for degenerative spondylolisthesis with spinal stenosis is significantly more effective against pain than usual nonsurgical care, though one-year outcomes appear equal for sciatica.

ST. LOUIS -- The appearance of passive personality traits in an older adult with signs of dementia may signal the presence of Lewy bodies rather than Alzheimer's disease, said investigators here.

STANFORD, Calif. -- Treating inborn urea-cycle disorders with intravenous phenylacetate and benzoate, an alternative way to remove toxic ammonia, has saved more than 80% of patients, mainly children, researchers here reported.

A prediction model and simple scoring form developed by Dutch rheumatologists can help physicians determine which early-arthritis patients are most likely to develop rheumatoid arthritis and should therefore receive prompt, aggressive treatment.

SEATTLE -- The drug temsirolimus (Torisel) prolongs survival in patients with metastatic renal cell carcinoma, researchers here reported today.

KING OF PRUSSIA, Pa. -- Despite reports linking rosiglitazone (Avandia) to increased risk of cardiac events, the data safety monitoring boards assessing that risk in three studies of the drug agreed that the trials should continue.

ABERDEEN, Scotland -- People with a family history of Parkinson's disease may be more susceptible to it after pesticide exposure or repeated blows to the head, European investigators reported.

BOSTON -- There's more evidence to support the inflammatory hypothesis of Alzheimer's disease, a finding that emerged from the Framingham Heart study cohort.

BOSTON -- Calcium and vitamin D intake from food and supplements may confer a moderately lower risk of breast cancer before menopause but not afterward, researchers here reported.