Indian Journal of Dermatology, Venereology and Leprology, Vol. 72, No. 5, September-October, 2006, pp. 386-387
Letter To Editor
Candidal intertrigo: Treatment with filter paper soaked in Castellani's paint
Sundaram ShanmugaV, Srinivas CR, Thirumurthy M
Department of Dermatology, PSG Hospitals, Peelamedu, Coimbatore - 641 004
Correspondence Address:Department of Dermatology, PSG Hospitals, Peelamedu, Coimbatore - 641 004, Tamil Nadu
Code Number: dv06132
Candidal intertrigo involving predominantly the fourth and fifth interdigital space of the foot is common among people involved in wet work and wearing occlusive footwear. The infection improves with topical antifungals but recurs unless the precipitating factors are avoided. Since it is essential to keep the area dry, various methods such as using cork or a gauze piece rolled and kept between the toes are tried.
Castellani's paint is an excellent preparation for tinea cruris and moniliasis of intertriginous areas. We soaked regular blotting paper with Castellani's paint and allowed it to dry. The magenta-colored blotting paper was cut into strips and placed in the interdigital space and taped [Figure - 1] once daily at bedtime for five days. Although any antifungal lotion could have been studied we chose Castellani's paint since it is colored and visual appreciation of the skin staining and release of the drug into water was essential for the study.
Candidal intertrigo was confirmed in four patients by Gram's staining. All the patients improved with treatment. The blotting paper was used to ensure dryness of the interdigital space and Castellani's paint to control the infection. It was observed that the treatment site was discolored by the use of magenta-colored paper, thus confirming the release of the dye. To further confirm that the dye is released the air-dried paper which was stored for one day was placed in a test-tube with water and held in the palms to raise the temperature of the water. The water turned magenta confirming the release of the dye from the paper. To further ensure that the blotting property of the paper is retained following soaking with the paint and drying, 3 ml of water was placed in a 5 ml measuring cylinder. A blotting paper strip measuring 10 x 1 cm was immersed into the cylinder till it touched the bottom. The level of water was observed before immersion of the paper and following removal of paper. The experiment was repeated with paper soaked in the paint.
The water level reduced by 0.1 ml both with treated and untreated blotting paper, thus confirming that the blotting property is retained by the paper even after soaking it with Castellani's paint.
We recommend that blotting paper soaked in an antifungal solution and dried, can be used to deliver the drug and also dry the affected interdigital space. As mentioned earlier, we used the paint to visualize the drug on the paper and its release over the treated site. The same treatment is likely to be effective even with the currently used colorless antifungal solutions.
Copyright 2006 - Indian Journal of Dermatology, Venereology and Leprology
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