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ukmla 2026

Candidiasis (Cutaneous)

Superficial Candida infection of skin folds, oral/genital mucosa — erythematous rash with satellite lesions in moist occluded areas

Review date
reviewed 2026-04-05
Reading time
4 min read
Author
Dr Kola Tytler MBBS CertHE MBA MSt MRCGP
Dermatologycommonacute
On this page
Condition details
Dermatology
common
4 min read
reviewed 2026-04-05
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About This Page

This is a clinician-written, evidence-based summary aligned to the 2026 MLA Content Map. It is intended for medical students and junior doctors preparing for the UKMLA. Always cross-reference with NICE guidance, local protocols, and clinical judgement.

Key points

  • C. albicans — commensal that becomes pathogenic with predisposing factors
  • Risk factors: diabetes, immunosuppression, antibiotics, obesity, inhaled corticosteroids (oral thrush)
  • Intertrigo: beefy-red erythema in skin folds with SATELLITE pustules/papules
  • Oral thrush: white removable plaques on erythematous base
  • Treatment: topical clotrimazole/nystatin. Oral fluconazole for extensive disease

Overview

Cutaneous candidiasis is a superficial infection caused by Candida species, most commonly C. albicans. Presentations include intertrigo (skin fold infection), oral candidiasis (thrush), angular cheilitis, vulvovaginal/balanitis, and paronychia. Hallmark is erythema with satellite lesions beyond the main rash border in warm, moist areas.

Epidemiology

Very common. Oral thrush affects ~5-7% of newborns and is common in elderly, denture wearers, and immunocompromised. Vulvovaginal candidiasis affects ~75% of women at some point. Risk factors: diabetes, antibiotics, immunosuppression, inhaled corticosteroids, pregnancy.

Clinical Features

Symptoms
Intertrigo: red, sore rash in skin folds
Oral thrush: white patches, sore mouth, altered taste
Vulvovaginal: itch, soreness, thick white discharge
Recurrent oral/genital candidiasis in young adult
Signs
Intertrigo: beefy-red erythema with satellite pustules/papules
Oral thrush: white curd-like plaques, removable, leaving erythematous base
Angular cheilitis: fissuring at mouth corners

Investigations

First-line
Clinical diagnosisUsually clinical — characteristic appearance
Swab MC&SIf diagnostic uncertainty
Second-line
Blood glucose / HbA1cScreen for diabetes if recurrent/extensive
HIV testConsider if recurrent oropharyngeal candidiasis in young adult

Management

NICE CKS — Candida
1
General measures
  • Optimise glycaemic control, review antibiotics/steroids
  • Keep skin folds dry
  • Rinse mouth after inhaled corticosteroid use
2
Topical antifungals
  • Skin: clotrimazole 1% cream BD for 2-4 weeks
  • Oral: nystatin suspension QDS for 7 days or miconazole oral gel
  • Vulvovaginal: clotrimazole 500 mg pessary stat or fluconazole 150 mg PO stat
3
Oral antifungal
  • Fluconazole 50 mg OD for 7-14 days (extensive)
  • Recurrent vulvovaginal (>=4/year): fluconazole 150 mg weekly for 6 months

Complications

  • Oesophageal candidiasis: Dysphagia — indicator for HIV
  • Invasive candidiasis: In immunocompromised/critically ill
UKMLA Exam Tips
  • 1Satellite lesions = hallmark of candidiasis — distinguishes from dermatophyte
  • 2Oral thrush in young adult = screen for HIV and diabetes
  • 3Inhaled corticosteroids + no mouth rinsing = oral thrush
  • 4Nystatin is NOT absorbed from GI tract — topical use only

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Verified Sources & References

NICE CKS — Candida: skin
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