Differential Diagnosis for Significant Candida Infection under Large Skin Folds in Obese Patients
- Single most likely diagnosis:
- Intertrigo: This condition is characterized by inflammation of the skin folds, often due to fungal or bacterial infections, and is commonly seen in obese patients. The warm, moist environment under large skin folds creates an ideal setting for Candida overgrowth, making intertrigo the most likely diagnosis.
- Other Likely diagnoses:
- Cutaneous candidiasis: This is a fungal infection of the skin caused by Candida species. It thrives in warm, moist areas, which are often found under large skin folds in obese individuals.
- Erythrasma: A bacterial infection that also favors warm, moist environments, often presenting with similar symptoms to intertrigo and cutaneous candidiasis.
- Do Not Miss diagnoses:
- Necrotizing fasciitis: Although less common, this is a severe infection of the skin and subcutaneous tissue that can start in skin folds. It requires immediate medical attention due to its high mortality rate if left untreated.
- Cellulitis: A bacterial skin infection that can spread rapidly and become severe, especially in immunocompromised patients. It may initially present similarly to intertrigo or cutaneous candidiasis but requires prompt antibiotic treatment.
- Rare diagnoses:
- Lymphoma or other malignancies: In rare cases, persistent skin lesions or infections under skin folds could be a sign of an underlying malignancy, especially if they do not respond to typical treatments.
- Hiddenitis suppurativa: A chronic skin condition characterized by recurrent, painful abscesses and nodules in skin folds, which could potentially be confused with severe cases of intertrigo or cutaneous candidiasis.