|Clinical Guidelines and Treatment Manual (Médecins Sans Frontières, 1993)|
|Chapter 4 - Skin conditions|
Erythema of the buttocks and perineum, sometimes "weeping". Caused by infection with Candida albicans.
- Clean with usual soap or an antiseptic (chloramine or chlorhexidine-cetrimide; preparation: see table 25).
- Apply gentian violet solution twice daily.
- Avoid damp clothing (leave buttocks bare).
- Intestinal thrush often co-exists:
Nystatin (PO): 4-600,000 IU/d divided in 3 doses x 10 days (vaginal tabs might be used for this purpose)
Highly contagious fungal infections. Prevalence is associated with the level of personal hygiene.
There are several different forms:
- Pityriasis versicolor with depigmented patches.
- Erythematous lesions in the skin folds (e.g. axillae and groin).
Associated with loss of hair. Highly contagious in families.
- Wash, dry and then apply whitfield's ointment twice a day.
- Use griseofulvin only in extensive cases (see below).
- Cut hair and then shave the head.
- Wash, dry and then apply gentian violet twice a day for several weeks.
- If treatment fails use:
Adult: 500 mg to 1 g/d divided in 3 doses
Child: 10 mg/kg/d divided in 3 doses
Treat for 10 days (sometimes treatment has to be continued for 1 month).
- Examine all the family.
- A short course of griseofulvin may be effective for adults:
griseofulvin: 1.5 g taken at the same time as a greasy meal.
However, there is a risk of digestive problems and vertigo.