DERMATOLOGYORAL THRUSHSYMPTOMS/EXAM
■ Oral thrush is a Candidainfection consisting of patches of white material
covering an erythematous base on the buccal mucosa, tongue, palate, or
tonsils. Typically, these lesions are easy to remove, revealing an underlying
erythematous base.
■ This infection is most common in newborns during the first week of life. In
adultsimmunosuppressionshould be considered in the absence of dentures
or antibiotic use.
TREATMENT
■ Nystatinsuspension applied to the oral mucosa 4–5 times/day. Clotrima-
zole troches dissolved in the mouth can be used in adults. In severe cases,
systemic antifungals may be necessary.
A Mexican immigrant complains of tender, swollen, red nodules on the
lower legs. What rash is suggested by this description? What’s the next step?
Erythema nodosum. Patient needs further evaluation (start with a
review of systems) for causes of erythema nodosum, including tuberculosis and
coccidiomycosis.FIGURE 17.3. Kerion with occipital boggy swelling and hair loss.
(Courtesy of Anne W. Lucky, MD as reproduced, with permission, from Knoop KJ, Stack LB,
Storrow AB.Atlas of Emergency Medicine, 2nd ed. New York: McGraw-Hill, 2002:445.)