What caused this burning, pruritic vulvar rash?

December 7, 2009

Candida infection causes pruritus, burning, and erythema in the vulvovaginal area.

Case 3:
A 33-year-old woman seeks medical attention because of a burning and itchy vulvar rash. She is not immunocompromised.


What is your clinical impression?

A. Tinea cruris.
B. Candidiasis.
C. Erythrasma.
D. Intertrigo.
E. Seborrhea.
F. Psoriasis.

Case 3: Candidiasis

Pruritus, burning, and erythema in the vulvovaginal area suggest Candida infection. About 75% of women experience at least 1 bout of vulvovaginal candidiasis, B, during their lifetime.1

Candida species are the most common cause of fungal infection in immunocompromised persons. Oropharyngeal colonization is found in 30% to 55% of healthy young adults, and Candida species may be detected in 40% to 65% of normal fecal flora.2

Most localized cutaneous Candida infections may be treated with any number of topical azole antifungal agents (eg, clotrimazole, econazole, ciclopirox, oxiconazole, sulconazole, miconazole, and ketoconazole) and nystatin. Allylamines have less activity. Reserve oral agents for vaginal or persistent infections.

References:

REFERENCES:1. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2006. MMWR. 2006;55(RR11):1-94.
2. Segal E. Candida, still number one-what do we know and where are we going from there? Mycoses. 2005;48(suppl 1):3-11.