The topic here is primary varicella.
In other words, chicken pox.
Take a look at the child here.
We have vesicles that
are taking place.
Seen less frequently now that
most children are vaccinated.
It can be seen adults
and that is horrible.
And dew drops on rose petals perhaps is
how you want to think of these vesicles.
So imagine in the morning that there
is dew drops that are on rose petals
and this then represents the weeping
vesicle that you’d find in chicken pox.
VZV pneumonia that
may take place.
Candidiasis, your patient is almost
always going to be immunocompromised.
But candida is a
normal skin commensal.
It can become pathologic
when overgrown though
and that’s where things
and those involved with a lot of wet work,
on other words, bartenders are predisposed.
You can have that candida, which
is in between your mucosal areas.
So we call this intertriginous,
in the body folds.
Think of your groin area, please.
If it’s thrush,
then you’re thinking about
the candida, unfortunately,
then creating an infection
in the oral cavity.
Creamy white papule,
plaques in the oral mucosa in which
that can be easily scraped off.
Oral thrush, you’ve
heard of before.
Or may result in perleche,
fissuring and erythema
in the oral commissures.
Candidiasis is your topic.
If you take a look at the tongue
in this particular patient,
you’ll notice that the
tongue is extremely white
and that if once scraped off comes off as
opposed to something called leukoplakia.
Leuokoplakia might be one in which
the squamous cells of the tongue
that are undergoing hyperplasia and
therefore with the tongue depressor,
there is no way that that white
substance is going to come off.
This however is oral thrush.
And on the right, you’ll notice
here underneath the nail bed
that we have white-like appearance
as well for the most part.
whenever there’s candidiasis, you should
be thinking about immunocompromise
and wherever candida is located,
what you’re going to find superficially
is going to be that white-like substance,
let it be the tongue, let
it be the esophagus,
let it be obviously if you have
candidal or fungal type of vaginosis,
there also you’re going
to find white-like --
Well there, if you do a pelvic exam, it
may very well look like cottage cheese.
Management: Topic azoles, topical
nystatin powder or cream.
And if it’s in the mouth, then you’re
thinking about nystatin mouth wash
or clotrimazole troches.
If you were then to
take a look at this,
yeast overgrowth can be
indentified on KOH examination.
What are you going to find?
Pseudohyphae are indicative
of pathologic overgrowth.
So let’s say that you are
you do a KOH examination, and
therefore you’ll find pseudohyphae
because these yeast might
then be elongated.
It wouldn't be a true
hyphae, but a pseudohyphae,
which then confirms that your patient
is suffering from candidiasis.