A 48-year-old woman with noninsulin dependent diabetes and controlled schizophrenia was initially seen in the emergency department for a groin rash of 1 year's duration. She was given clotrimazole cream, to be used topically twice a day, and discharged. Two weeks later she returned to the emergency department with an exacerbation of her eruption. She was seen by the dermatology service, and was noted to have extensive erythema and maceration of the vulva, perineum, and inner thighs. Satellite pustules were noted and potassium hydroxide preparation revealed pseudohyphae. Her serum glucose concentration was elevated at 17.6 mmol/L (normal, 3.3 to 5.5 mmol/L).
She was admitted to the hospital because of her worsening skin condition and elevated blood glucose level. She was treated with oral ketoconazole, 200 mg twice a day, topical soaks, and aeration. Her blood glucose level was gradually brought under control using insulin on a sliding scale. She improved
Coldiron BM, Manders SM. Persistent Candida Intertrigo Treated With Fluconazole. Arch Dermatol. 1991;127(2):165-166. doi:10.1001/archderm.1991.01680020021002