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March 1976

Picture of the Month

Am J Dis Child. 1976;130(3):291-292. doi:10.1001/archpedi.1976.02120040069012

Denouement and Discussion 

Congenital Cutaneous Candidiasis 

Manifestations  Congenital cutaneous candidiasis appears at birth or shortly after as a diffuse maculopapular vesicular rash distributed over the face, neck, trunk, and limbs. Pustules are common and bullae occasionally occur. Pronounced desquamation follows the acute phase. There is no fever, other constitutional signs are lacking, and the infant thrives despite the extensive skin involvement. Oral thrush may occur, but it is uncommon. A direct smear from the cutaneous lesions mixed with a drop of 10% potassium hydroxide shows mycelia and yeasts. Cultures, carbohydrate assimilation, and fermentation tests identify the species of Candida. Agglutinating antibodies for Candida are present int he infant's serum and may be of fetal or maternal origin. In infants born by cesarean section, the mother's abdominal wound may bacome infeted with Candida and direct smear frequently shows mycelia and yeasts. Section of the cord and placenta stained with PAS also demonstrate an

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