Should i scratch thrush

A short course of a potent topical steroid ointment, tapering to a lower potency and reduced frequency of application, should relieve the symptoms of irritant contact dermatitis. Common symptoms of genital and flexural psoriasis are itching, fissuring, burning and pain.

Clinical appearance in the genitals is different from the usual psoriatic skin, with little or no scaling and a shiny erythematous surface. The cases are triggered post-acute infection or exposure to chemicals, including some medications. Candida infection classically presents with erythema and a thick white discharge. Non-albicans candida infections can present with less erythema and less discharge, and may be sore rather than itchy. Vulval skin may have deep-seated candida infection with a long-term itch.

It is not considered a sexually-transmitted infection. The diagnosis is by microscopy and culture, and sensitivity should be requested for non-albicans species, as these may be resistant to azoles. Repeat culture should be done for recurring symptoms to confirm candidiasis.

If swabs do not reveal candida and the diagnosis is unknown, skin biopsy is indicated to exclude a deep-seated candida infection within the skin. However, single dose azole vaginal cream is not effective for recurrent infections. Recurrent C albicans may need long courses of treatment, for weeks or even months. Non-albicans species may respond to Nystatin vaginal cream or boric acid mg vaginal pessaries for 14 to 28 days.

This is a common presentation. Establishing the diagnosis is the most important first step. Angie needs a vaginal and a vulval swab for microscopy and culture, to establish whether she has candida and whether it is C albicans or C non-albicans.

Whether or not she has candida on initial testing, the test should be repeated next time she has symptoms. This can sometimes be best addressed by giving the patient a take-home swab for self-testing when symptoms recur, along with advice to make an appointment to discuss the result.

Recurrent candida needs longer courses of both oral and topical antifungal treatment. Non-albicans species are often resistant to azoles and should have resistance testing if there is no response to initial treatment. Women who have recurrent candida should also be tested for diabetes, especially if they are post-menopausal. Some presentations should also be tested for HIV, depending on relevant history.

Tinea presents with itch and the presence of a red lesion with a well-defined scaly margin and central clearing in the perineum, pubic region, groin, buttocks or upper thigh. Topical azole cream for two to four weeks is effective for treatment of tinea.

Herpes simplex presents with pain and multiple small blisters in a crop close together, which may coalesce into larger single erosion and small shallow erosions.

The herpes simplex infection is caused by Herpes simplex virus 1 or 2, and is diagnosed by Herpes simplex PCR not serology. Treatment is with valaciclovir or famciclovir, with the dose dependent on whether the outbreak is initial or recurrent. Syphilis can often be silent, but the patient may notice a single painless ulcer in the primary phase, with a maculopapular rash involving the palms and soles in the secondary stage. The infection is caused by Treponema pallidum and can be diagnosed by swab from the ulcer for PCR, as well as serology at any time.

Positive serology always warrants treatment if there is no history of previous treatment, or there is a risk of reinfection.

Penicillin is the drug of choice for treatment of syphilis. Scabies usually presents with itch due to local or generalised irritation, which is worse at night. Genital lesions are often papular, rather than linear, burrows. The diagnosis is by direct observation of the burrows, papules and follicles on breast, genitalia, wrists and finger webs.

The whole family, all household members and sexual partners should be treated. Clothes, towels and bedding should be washed. The treatment should be repeated in one week.

Pubic lice: This itchy infection is caused by Pthiris pubis crab louse and transmitted by close body contact. Eggs of the lice are cemented to pubic hair, but this is less common these days due to the current fashion for pubic hair removal. The crab louse may be seen in pubic hair and the nits can be observed attached to pubic hair. Red spots on the skin may result from louse bite. The whole family, household members and sexual partners should be treated and clothes, towels and bedding should be washed.

Beware the person with delusional parasitosis, who returns with repetitive complaints that the parasite is still present. This person needs psychiatric help rather than topical treatments and should be referred appropriately.

Lichens are the skin lesions which are best biopsied to establish a definitive diagnosis prior to commencing steroid creams.

The skin is thickened and pale. The diagnosis is usually clinical, but biopsy can confirm the tentative diagnosis. To treat, oral antihistamine and moderate potency topical steroid ointment are used daily for two to three weeks, and then tapered off. Lichen sclerosus is a visual diagnosis made on areas of whiteness, atrophy or hyperkeratosis, and purpura.

The most abnormal-looking area should be biopsied to exclude VIN. When it comes to thrush, there is no evidence to suggest that tablets are better than cream for treatment, but my preference is to recommend the tablets to avoid the potential for the development of a secondary dermatitis. And if you are experiencing repeated episodes of thrush, which is defined as four episodes a year, then tablets are a must. And while I could blog about thrush for pages and pages, I want to highlight a recent update published in The Australian and New Zealand Journal of Obstetrics and Gynaecology.

This article examined the evidence for the various treatment recommendations, with the suggestion that a month course of oral tablet antifungal treatment can result in a more lasting cure than the standard 6 months of treatment.

The results will be sent electronically to your GP or Specialist and they can then contact you with the results and discuss the best treatment option. This is a service that I offer to my patients as a matter of routine. Your doctor will wash down the area with antiseptic, inject some local anaesthetic and wait for that to work.

Then a small sample of the skin — typically 4mm — is removed and placed into a specimen collection pot to be sent for examination under a microscope. A suture, or stitch is put in place to close the small hole in the skin and to help healing. The suture dissolves in approximately 10 days. Treatment starts by removing any causes of dermatitis. Uncomplicated thrush is common. Thrush is caused by a fungal infection Candida albicans that lives in the vagina, often without causing symptoms.

Why some women develop symptoms is unclear. It is uncommon before her first menstrual cycle and after menopause when periods cease , so hormones are likely implicated. Many have thrush at a particular time of the month, specifically before menstruation. It also often occurs following a course of antibiotics and is common in women with diabetes. Medications are available without a prescription so many women treat themselves.

Treatment consists of antifungal creams or vaginal tablets, which are put inside the vagina with a special applicator. There is also the choice of oral tablets, which are more expensive and not recommended for pregnant women. This is because they may be suffering from an entirely different infection , which requires different treatment. Recurrent thrush refers to four or more diagnosed episodes of vaginal thrush within 12 months. Because the four episodes have to be identified with a swab test, research into this area is difficult and costly.

Compared with research into uncomplicated thrush, the published studies for recurrent thrush are few and of poorer quality. No research so far has found a cure that works for all women.