Consultant. Vol. 50 No. 12

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Dermclinic
A Photo Quiz to Hone Dermatologic Skills

Why hasn't this tender lesion responded to antibiotic?

By DAVID L. KAPLAN, MD—Series Editor
University of Missouri Kansas City, University of Kansas | December 13, 2010

Dr Kaplan is clinical assistant professor of dermatology at the University of Missouri Kansas City School of Medicine and at the University of Kansas School of Medicine. He practices adult and pediatric dermatology in Overland Park, Kan.

Case 2: Candidiasis

A fungal culture that grew Candida albicans confirmed candidiasis, C. Consider candidiasis in patients who do not respond to antibiotic therapy for suspected impetigo; a candidal infection can mimic the bacterial disease. This patient’s lesion resolved after short-term oral antifungal therapy. In contrast to the rapid eruption of this patient’s lesion, actinic keratosis, squamous cell carcinoma, and seborrheic keratosis grow slowly.

Poll Results

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by susan kweskin | March 29, 2013 3:11 PM EDT

Thank you for your comments, Dr Shenoi...... you'll find the answer to your third question in the answer section to this quiz. Dr Kaplan wrote:

A fungal culture that grew Candida albicans confirmed candidiasis. Consider candidiasis in patients who do not respond to antibiotic therapy for suspected impetigo; a candidal infection can mimic the bacterial disease. This patient's lesion resolved after short-term oral antifungal therapy. In contrast to the rapid eruption of this patient's lesion, actinic keratosis, squamous cell carcinoma, and seborrheic keratosis grow slowly.

by shrutakirthi shenoi | March 25, 2013 10:33 AM EDT

1.It is very unlikely that anyone considers candidiasis in this case.

2.Doing a KOH for a tender crusted lesion is also unlikely.

3.Did the patient respond to antifungals?

by robert caudill | April 23, 2011 8:42 AM EDT

IMHO a biopsy is mandatoryt; ie Candida may be a superinfection of underlying dermal carcinoma. rgc

by DIEGO FALLON | March 12, 2011 1:16 PM EST

WOW ATTORNEY AND PA...WHAT A COMBO...WHAT IS MEDICINE BECOMING...THIS IS SIMPLE THINKING AFTER A FEW YEARS IN PRACTICE.WHO WAS TALKING ABOUT MEDICOLEGAL THINGS.I SUPERVISE PA FOR MANY YEARS .I TRY TEACHING THINKING SKILLS,ESPECIALLY IF THEY ARE ATTORNEYS. D.FALLON MD ABIM.

by DIEGO FALLON | March 12, 2011 1:09 PM EST

I SEE LESION AS OF ONLY 10 DAYS DURATION,NO RESPONSE TO ANTIBIOTICS,CRUSTED AND TENDER=CANDIDIASIS AS BEST CHOICE.GOOD CASE. SKIN CANCER AND AK:NOT GOOD CHOICES DUE TO THE WAY IT LOOKS AND THE TIMING.D.FALLON IM/GERIAT.

Article Comment Pages: 1 2 3 4 Next

TOPIC INDEX

Developmental/Genetic

Nutritional/Metabolic

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Why hasn't this tender lesion responded to antibiotic?

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