Candidiasis of the Skin
Learn about Candidiasis of the Skin (Cutaneous Candidiasis), including clinical documentation, medical coding, and treatment for Candidal Intertrigo. Find information on diagnosis, symptoms, and management of yeast infection of the skin for healthcare professionals.
Fungal skin infection caused by Candida species, often in warm, moist areas.
Red, itchy rash, sometimes with pustules or white patches. May have satellite lesions.
Skin folds (groin, armpits, under breasts), diaper area, oral mucosa.
ICD-10 Code Families
Complete code families applicable to B37.2
When to use each related code
| Description | When to use |
|---|---|
| Yeast skin infection. | Skin rash with satellite lesions, warm moist areas. Intertrigo, diaper rash. |
| Fungal skin infection. | Ringworm, athletes foot, jock itch. Scaly, itchy rash, often circular. |
| Bacterial skin infection. | Impetigo, cellulitis. Red, swollen, painful, may have pus or crusting. |
Best-practice checklist
- ✓Document affected skin areas (e.g., intertriginous folds, nails).
- ✓Describe lesion morphology (e.g., erythema, maceration, pustules).
- ✓Note KOH prep results if performed.
- ✓Document associated symptoms (e.g., pruritus, burning).
- ✓Include risk factors (e.g., diabetes, obesity, antibiotic use).
Common pitfalls to avoid
Coding cutaneous candidiasis without specifying the affected body area can lead to claim rejection for lack of specificity. Use B37 codes with appropriate laterality and site.
Intertrigo, a common form of cutaneous candidiasis, may be overlooked. Accurate documentation and coding (L30.4) are crucial for appropriate reimbursement.
Failing to document and code underlying conditions like diabetes that predispose to candidiasis can impact risk adjustment and quality metrics.
Best-practice tips
- 01ICD-10 B37. Candidiasis CDI: Skin folds dry, aired. Compliance: Antifungal cream.
- 02SNOMED CT 111189009. Hygiene crucial. ICD-10 B37.4, B37.8, B37.9. Compliance: Avoid irritants.
- 03Rx: Antifungal powder for intertrigo. ICD-10: B37. CDI: Document location, severity.
- 04Manage comorbidities like diabetes. Candidiasis CDI: Impact, response to Rx. Compliance: HbA1c control.
- 05Loose clothing. ICD-10 B37.2. Candidiasis CDI: Infection resolved. Compliance: Follow-up care.
Step-by-step checklist
- 1
Confirm skin lesions: erythematous, satellite pustules, maceration
- 2
Check for intertriginous areas: skin folds, axillae, groin
- 3
KOH prep microscopy: pseudohyphae and budding yeast cells
- 4
Consider risk factors: diabetes, obesity, antibiotic use
Ready-to-paste narrative
Patient presents with clinical manifestations consistent with cutaneous candidiasis, also known as candidal intertrigo or yeast infection of the skin. Affected areas include [specify location, e.g., intertriginous folds of the groin, axillae, inframammary folds, or other affected skin areas]. The patient reports [symptoms, e.g., pruritus, burning sensation, erythema, satellite lesions, maceration]. Physical examination reveals [objective findings, e.g., erythematous plaques with well-defined borders, scaling, pustules, or other relevant clinical features]. Differential diagnosis includes intertrigo, seborrheic dermatitis, and psoriasis. Diagnosis of candidiasis is based on clinical presentation and may be confirmed with potassium hydroxide (KOH) preparation showing pseudohyphae and budding yeast. Treatment plan includes topical antifungal therapy with [specify medication, e.g., clotrimazole, miconazole, ketoconazole] applied to the affected area [frequency] for [duration]. Patient education provided on proper hygiene practices, including keeping the affected area clean and dry, and avoiding tight-fitting clothing. Follow-up appointment scheduled in [timeframe] to assess treatment response and adjust management as needed. ICD-10 code B37.2 (Candidiasis of skin and nails) is applicable. This documentation supports medical necessity for the prescribed treatment.
Common questions and answers
How can I differentiate between intertriginous candidiasis and other intertrigo types like bacterial or irritant dermatitis in clinical practice?+
Differentiating intertriginous candidiasis from other forms of intertrigo requires a careful assessment of clinical features and sometimes confirmatory testing. Candidal intertrigo typically presents as erythematous plaques with well-defined, scalloped borders, often accompanied by satellite papules and pustules. A key feature is the presence of maceration in skin folds, which can be exacerbated by moisture and friction. While bacterial intertrigo can also present with erythema and maceration, it may involve a foul odor and less distinct borders. Irritant dermatitis in intertriginous areas lacks satellite lesions and may appear more diffuse, with a history suggestive of friction or chemical exposure. KOH microscopy can confirm the presence of yeast in candidal intertrigo, providing a definitive diagnosis. Consider implementing a combination of clinical evaluation and KOH microscopy to accurately differentiate between these conditions. Explore how different diagnostic tools can assist in identifying various dermatological issues.
What are the most effective topical antifungal treatments for cutaneous candidiasis in immunocompetent adults, considering both efficacy and patient adherence?+
Several topical antifungal agents demonstrate efficacy against cutaneous candidiasis in immunocompetent adults. Azoles, such as clotrimazole, miconazole, and ketoconazole, are generally considered first-line treatment options. These agents are available in various formulations, including creams, lotions, and powders. Allylamines, like terbinafine and naftifine, also offer effective treatment, particularly for areas with hair involvement. When selecting a topical antifungal, consider patient adherence factors like application frequency and formulation preference. For example, once-daily application may improve compliance compared to multiple daily applications. Additionally, certain formulations may be more suitable for specific body areas. Creams are generally well-tolerated in most areas, while lotions may be preferred for hairy areas and powders for intertriginous folds. Learn more about individual patient considerations for optimal antifungal therapy selection and improved treatment outcomes.
When is oral antifungal therapy indicated for candidiasis of the skin, and what are the preferred agents and their potential adverse effects clinicians should monitor for?+
Oral antifungal therapy is usually reserved for cases of extensive cutaneous candidiasis, candidiasis involving the hair or nails, or cases refractory to topical treatment. Additionally, immunocompromised individuals may require systemic therapy. Fluconazole is a commonly preferred oral agent due to its good bioavailability and relatively low cost. Itraconazole and terbinafine are other options, particularly for infections resistant to fluconazole or involving the nails. Clinicians should monitor for potential adverse effects of oral antifungals, including gastrointestinal upset, hepatotoxicity, and drug interactions. Liver function tests should be considered, especially with prolonged use of itraconazole. Explore how to manage potential drug interactions and adverse events associated with oral antifungals. Consider implementing a comprehensive monitoring plan for patients on systemic antifungal therapy to ensure patient safety and optimal treatment outcomes.
Clinical accuracy: This information is provided for documentation and coding guidance and should not replace professional medical judgment.
Coding standard: ICD-10-CM, current FY guidelines.