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What is Vaginitis?

Vaginitis is an inflammation of the woman's vagina. Up to a third of women will show signs of vaginitis at some point in their lives. Vaginitis affects women of all ages, but is most common in reproductive ages. There are many possible factors and the type of treatment depends on the agent. In this chapter;



- Symptoms of vaginitis

- Types of treatment

- Explain how to reduce your risk.



A small amount of clear or cloudy white fluid flow through the woman's vagina is normal. This keeps the tissue wet and healthy. The vagina maintains a balance of various organisms, such as bacteria and fungi, so that it can function normally. Some factors can disrupt this normal balance of the vagina:

- Antibiotics

- Changes in hormone levels

- Pregnancy

- Breast-feeding

- Menopause

- Vaginal showers

- Spermicides (sperm killers used for contraception)

- Sexual intercourse

- Infection



A change in normal balance may allow fungi or bacteria to increase and cause vaginitis. This causes the epithelium of the vagina to become inflamed. Vaginitis can cause itching, foul odor, or plenty of discharge.



In case of any abnormal discharge, burning or itching, consult your doctor immediately.



Diagnosis

For the diagnosis of vaginitis, your doctor will take a sample of the discharge from your vagina; examine under the microscope or send to culture. Your doctor may also request other tests. To ensure the results of the tests are accurate, do not take a vaginal shower before seeing your doctor; Do not use any vaginal medication or spermicide.



Treatment

Treatment is done according to the causative agent of vaginitis. The treatment may be by oral pill or a cream, tablet or gel applied to the vagina. In some cases, your partner may also be treated.



Even if discharge or other symptoms disappear before you finish your medication, it is important that you follow your doctor's instructions exactly. Although the symptoms disappear, the infection may still be present. Stopping treatment early may cause symptoms to return. If symptoms recur after treatment is completed, see your doctor. A different treatment may be needed.



Types of Vaginitis



A. FUNGUS INFECTION:

Fungal infection is also known as candidiasis. It is one of the most common types of vaginal infection.



Active. It is formed by a fungus called Candida. This is found in a small number in the normal vagina. However, when the balance of bacteria and fungi in the vagina changes, the fungi can multiply and cause symptoms.



Some types of antibiotics increase your risk of yeast infection. Antibiotics kill normal vaginal bacteria that control fungi; thus, fungi can multiply excessively. If a woman is pregnant or has diabetes, she is more likely to have a yeast infection. Excessive growth of fungi can also occur if the immune system, which protects the body from diseases, does not work well. For example, fungal infections may be severe in women infected with human immunodeficiency virus (HIV). They may not even pass treatment or they may recur frequently. In many cases, the cause of fungal infection is unknown.



Symptoms. The most common symptoms of fungal infection are itching and burning of the area called the vulva outside the vagina. Burning can be worse when urinating or with sexual intercourse. Vulva may be red and swollen. Vaginal discharge is usually white, lumpy and does not smell. Some women with yeast infection notice an increase or change in discharge. Some people do not notice any currents.



Treatment. Fungal infections can be treated by placing medicine in the vagina or swallowing pills. In the majority of cases, the treatment of male sexual partners is not necessary. You should definitely see your doctor if:

- If you have a vaginal infection for the first time

- If your symptoms do not disappear after treatment

- If your vaginal discharge is yellow or green or smelly

- If you have a sexually transmitted disease (STD)



Sometimes a woman may actually think that she has a yeast infection when she has another problem. Just like fungi, there are several conditions that cause itching and burning. If there is another reason, if the woman is taking medication for yeast infection, it may be more difficult to find the main cause.



What can you do?



There are some things you can do to reduce the risk of vaginitis:



- Do not use feminine hygiene sprays or scented deodorant tampons.

- Don't try and hide a bad smell. This may be a symptom of infection that requires you to see your doctor immediately.

- Do not vaginal shower, do not wash the inside of the vagina. It is better to allow the vagina to clean itself.

- Use condoms during sexual intercourse.

- If you have been prescribed antibiotics for another type of infection, talk to your doctor about preventing fungal infections.



B. BACTERIAL VAGINOSIS



Active. Bacteria that cause bacterial vaginosis are naturally present in the vagina. Bacterial vaginosis is caused by excessive proliferation of these bacteria.



Symptoms. The most important symptom is increased discharge with a strong fishy odor. The smell may be more during your menstrual period or after sexual intercourse. The discharge is usually thin and dark or dull gray, but may also be greenish in color. Itching is not common, but may be present if there is too much discharge.



Treatment. A variety of different antibiotics can be used to treat bacterial vaginosis, but there are two most commonly used: metronidazole and clindamycin. They may be taken orally or may be placed in the vagina in the form of tablets, creams or gels.



Metronidazole may cause side effects in some patients when taken orally. They may cause nausea, vomiting and darkening of urine color, and may cause severe nausea and vomiting. Do not drink alcohol while using metronidazole, this combination



Often there is no need to treat a woman's sexual partner. However, if the woman has recurrent infections, treatment of the partner may be helpful.



Bacterial vaginosis frequently recurs. Long-term or repeated treatment may be required. In the majority of cases, treatment works in time. Sometimes if bacterial vaginosis occurs repeatedly, it may mean that you have an STD. Your doctor may test you for other infections.



C. TRICOMONIASIS



Active. Trichomoniasis is a condition created by the microscopic parasite Trichomonas vaginalis. It spreads through sexual intercourse. Women with trichomoniasis are at increased risk of infection with other STDs.



Symptoms. Symptoms of trichomoniasis include a yellow-gray or green vaginal discharge. The stream may have a fishy smell. Burning, irritation, redness and swelling of the vulva may occur. Sometimes it can be painful when urinating.



Treatment. Trichomoniasis is usually treated with a single oral dose of metronidazole. Do not drink alcohol for 24 hours after taking this medicine because it may cause nausea and vomiting. Sexual partners should be treated to prevent recurrence of infection.



D. ATROPHIC VAGINITIS: This is not caused by an infection, but may cause discharge and vaginal irritation. It can occur at any time when female hormone levels are reduced, such as during breastfeeding or after menopause. Symptoms include dryness and burning. Atrophic vaginitis is treated with estrogen, which can be administered as vaginal cream, ring or tablet. A water-soluble lubricant may also be useful during sexual intercourse.



As a result; Consult your doctor as soon as you see any abnormal discharge or signs of vaginitis, such as burning or itching. Although vaginitis causes discomfort, it can be treated almost any time after the agent is found.



Glossary



Bacterial Vaginosis: A type of vaginal infection caused by excessive proliferation of a group of organisms normally found in the vagina.



Candidiasis: A type of vaginitis caused by overgrowth of Candida (a fungus normally found in the vagina), also known as fungal infection or moniliasis.



Clindamycin: An antibiotic used to treat certain types of vaginitis, among many other types of infections.

Estrogen: A female hormone produced by the ovaries that stimulates the development of the inner layer of the uterus.



Human Immunodeficiency Virus (HIV): A virus that attacks specific cells of the body's donor system and creates acquired immunodeficiency syndrome (AIDS).



Metronidazole: An antibiotic used to treat some vaginal and abdominal infections.



Sexually Transmitted Disease (STD): refers to diseases spread by sexual contact. Chlamydia infection, gonorrhea, genital warts, herpes (syphilis), syphilis and acquired immunodeficiency syndrome (AIDS) are caused by human immunodeficiency virus (HIV) infection.



Spermicides: Chemicals that neutralize sperm. They are present in the form of creams, gels, foams and suppositories. Some condoms are covered with spermicides.



Vulva: Lips of the female external genitalia.


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Vaginal Fungal Infection

Vaginal yeast infection is a common disease that almost every woman encounters at least once in her life and, if left untreated, can cause more serious illnesses. Candida albicans is the most commonly isolated fungus among vaginal infections in women. Other Candida species, such as Torulopsis glabrata, may also be involved in approximately 10-15% of cases. 75% of women experience vaginal yeast infection at least once in their lifetime.

How is fungal infection transmitted?
Fungal infection is usually not transmitted elsewhere. Fungal cells in the woman's own normal vaginal flora multiply and become active when the body resistance decreases for various reasons and form vaginitis. It is thought that it can rarely be passed through sexual contact. Because it cannot be produced in male semen, it is not generally accepted by every doctor as a sexually transmitted disease. It is unlikely that it will be transmitted from the pool, sea, toilet or other goods used.

What are the symptoms of yeast infection?
The most important and most common symptom of vaginal yeast infection is itching, which increases especially at night and causes restlessness. It increases with itching especially hot effect. Most patients have burning in the external genitalia. When urinating, there is a severe burning sensation in areas where the urine touches and that area is red. Some patients may have pain and burning during sexual intercourse. Women avoid pain because of pain.
Different from the normal, odorless, sometimes thick and in mass, sometimes white or gray color, aqueous discharge is. But the presence of currents is not always a rule and may not always be currents. If present, it is white in color and has a milk or cheese cut. There is no bad smell in the discharge. The presence of odor should suggest the presence of a second infection accompanying candidiasis.
Redness and swelling of the vulva and vagina may occur. Fungal plaques can be found on the wall of the vagina.These are typical for candidiasis. Depending on the scratch, vulva skin may peel off and there may be minor bleeding.
How is vaginal fungal infection diagnosed? What are the examinations performed in vaginal fungal disease?
Vaginal examination is sufficient for the diagnosis of fungi. The presence of fungal plaques in the vagina by the doctor and the patient's complaints are sufficient for diagnosis. Peeling and small bleeding may occur on the vulva skin due to scratching, and these are also evaluated by the physician. Although the patient does not have any significant complaints, fungal cells can be seen in the smear test.


What are the factors that facilitate vaginal fungus?
· Broad spectrum antibiotics; They cause fungal formation by destroying vaginal PH and destroying benign bacteria (normal vaginal flora).
· Diabetes; Urine and vaginal secretion increases the amount of sugar facilitates fungal formation.
· Pregnancy; Fungus formation is facilitated by decreasing body resistance and changing vaginal PH due to pregnancy hormones.
· Impaired immune system; facilitates fungal formation.
· Birth control pills; change the vaginal flora and prepare the ground for fungal formation.
· Spiral; it can increase all genital infections as well as facilitate fungal formation.
· Use of nylon undergarments; They increase the moisture content of the vagina and external genitalia and help the fungus formation.
· Continuous use of sanitary napkins; Like nylon undergarments, they increase the moisture content and facilitate fungal formation.
· Use of genital organ perfumes, some toilet paper, perfumed condoms and vaginal tampon
· Obesity
· Presence of cervical sores
How Is Vaginal Fungal Treatment Done? What Are Fungicides?
Vaginal fungal infections are both very easy and difficult to treat. With treatment, complaints regress within a few days. The disease may recur in later stages in 5-25% of the patients. Recurrent candidiasis can be mentioned if the same picture repeats at least four times a year. This can be caused by the fungus moving deep into the vaginal intact tissue and remaining silent and unaffected by drugs.

Both systemic and locally effective drugs are used in the treatment. Vaginal suppositories and creams, oral antifungal agents are used in appropriate dosage and duration. Co-treatment is also recommended for recurrent infections.

In personal hygiene, the vagina is not washed with water, the use of liquid soaps with neutral pH ratings, the wearing of nylon garments, the laundry being cotton, boiling and ironing with steam iron, avoiding tight clothes, changing wet swimsuits after the pool and sea facilitate treatment.


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What is Fungal Treatment?

Fungal Treatment
Skin disease that occurs as a result of organisms entering the body is called fungus. The organism is located in the part of the aqueous or dry skin, itching conditions, causes the formation of redness. Deformation and color change are observed in the symptoms of fungal disease in nails.

Causes Fungal Disease?
It is an infectious disease. It can be transmitted by the use of articles such as towels, slippers, shoes that directly contact the skin of the person. In addition, communal areas such as pool, hammam, sauna can be transmitted from places.

Where Does Fungal Disease Occur?
Hand nails, feet, genital area, scalp are the most common microorganisms that cause fungal disease and are the parts where the symptoms are revealed.

How is Fungal Disease Treated?
Fungus in foot areas can cause serious illness in people with diabetes, so it should not be neglected. The treatment process of fungal disease, which can be confused with many skin diseases, is firstly taken by the history of the patient by a specialist doctor, then by the analysis and an accurate diagnosis. A clear diagnosis of fungal disease can be made and the most appropriate treatment process is determined. The use of medications, lotions and creams taken during the treatment process can eliminate symptoms. Because fungal disease is contagious, hygiene should be given great importance. Otherwise, it can be seen again.

What should be considered when fungal treatment?
As with any application that may affect health, the person must be examined by a doctor who specializes in skin and skin diseases before taking Fungal Treatment. Advancement of the Fungal Treatment process under the supervision of a specialist doctor is of great importance in terms of eliminating the possible side effects and risks associated with the treatment process.


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Common Problem of Women: Vaginal Infections

Many factors, from long-term antibiotic use to improper hygiene practices, allow the formation of infections by destroying the natural environment of the vagina. However, it is very easy to get rid of them kurtul

Lactobacilli, which predominate in the natural environment of the vagina, are benign hosts. These predominant microorganisms do not allow other disease-causing microorganisms to infect by forming a certain acidic environment. However, when this natural environment of the vagina is impaired due to pregnancy, frequent vaginal douching, antibiotic use, general immune system decline, fragrant tampon, vaginal spray usage, infections are created.

Vaginal infections are manifested by complaints such as intense discharge, itching, bad smell, painful sexual intercourse and burning while urinating. Treatment should be planned depending on the causative agent of the infection. It is possible to understand the type of infection by looking at the complaints that arise. Fungal infections are usually manifested by itching, white color, milk cuts or cheese breaks, while bacterial infections are more common with yellow-green or greyish currents, particularly with increased odor after sexual intercourse or menstrual periods.

When evaluating the discharge character during the examination, the image of the vagina and cervix provides information about the causative agent of the infection. In cases where more than one factor is considered or the type of agent cannot be understood by examination, culture and microscopic examination of the samples are performed.

What is bacterial vaginosis?
The most common vaginal infection is defined as ‘bacterial vaginosis.. Normally not dominant, but for a variety of reasons, the rate of microorganisms that arise from the proliferation of this table with a malodorous white or grayish discharge, after the relationship with the increase in the amount of bad smell, symptoms such as menstrual periods appear. Bacterial vaginosis can be revealed by examining samples taken from vaginal discharge with liquids such as potassium hydroxide during the examination and treatment is planned accordingly. In bacterial vaginosis, antibiotics, the active ingredient of which is metronidazole, are used and treatments can last for one week.

Periodic treatment in resistant cases
Another common vaginal infection in women is candida type fungi. 75 percent of women have a fungal infection once in their lives, 50 percent of them encounter this situation more than once. Anti-mycotic drugs are used to treat fungal infection. In some patients, resistant microorganisms can develop and in this case it is necessary to determine the type of fungus and to direct the treatment accordingly. In resistant cases and frequent recurrent infections, periodic treatments should be applied.

Don't make this mistake
The most common mistake in the treatment of vaginal infections is to abandon the treatment. After the disappearance of the symptoms, infections are repeated in patients who discontinue treatment without completing the recommended dose and duration. The second treatment may not be able to benefit from the same drugs.

Parasites are also seen
Another common infection is parasites called ik trichomalacia.. This parasite, which is also evaluated in the category of sexually transmitted diseases, causes yellow-green, foamy discharge and may cause small bleeding in the vaginal wall or cervix. The patient may present with complaints such as pain, strain or burning during sexual intercourse. The appropriate treatment is the use of appropriate antibiotics.

Do not leave it stuffy and humid
Although the vagina prevents the ingress of liquids thanks to its natural structure, the chemicals used in the pools can disrupt the natural environment of the vagina. In addition, long-term wet swimsuit is also causing trouble. Shared toilet use can sometimes cause infections. To protect the natural environment, the vagina should not remain airless and wet. It is important to use cotton underwear and to change it frequently if daily pad is used.

Co-treatment may also be required.
One of the factors that disrupt the vagina's natural fl is to be with multiple partners, to have oral or rectal relationships. These conditions can increase the risk of infection. In bacterial and parasitic infections, and sometimes recurrent infections, the spouse is also recommended to be treated. Men can refuse treatment because they do not have any complaints, but the treatment of men also makes the treatment permanent and shortens the duration.


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Clinical Evaluation of Superficial Fungal Infections in Children

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Superficial fungal infections; dermatophytes and yeasts. Distribution of dermatophytes; country and geographical area, lifestyle, climatic conditions and migration varies depending on various reasons (1-3). Common fungal infections in children and adolescents; tinea capitis, tinea corporis, tinea pedis, mucocutaneous candidiasis, onychomycosis and pityriasis versicolor. Risk factors include being an infected family member or immunosuppressive factors such as human immunodeficiency virus (HIV) infection, chemotherapeutic use, long-term antibiotic and systemic corticosteroid use. Fungal infections in children are usually similar to adults, but are sometimes atypical and may cause difficulty in diagnosis. Fungal infections in children can be confused with many diseases such as seborrheic dermatitis, psoriasis, alopecia areata and trichotillomania. In immunocompromised people, systemic treatment is preferred over treatment instead of topical, and systemic treatment is also required for tinea capitis and onychomycosis (4).

This work; The aim of this study was to determine the prevalence, distribution, clinical variants, frequency and treatment approaches of superficial mycoses in children and adolescents with dermatophyte infection.


methods
Fifty-one patients diagnosed with superficial fungal infection in the pediatric dermatology outpatient clinic of Erciyes University, Faculty of Medicine, Department of Dermatology within the last year, who were diagnosed with the diagnosis, clinical appearance, direct microscopy, and in some cases, confirmed by fungal cultures. were evaluated retrospectively.

Records of all patients including age, sex, complaints, family history, concomitant diseases, duration of disease, clinical location and type of lesions, and treatment information were reviewed. Data were analyzed by Student's t-test and Chi-square test.


Results
Of the patients with superficial fungal infection, 33 (64.7%) were male and 18 (35.3%) were female. The mean age was 6.24 ± 4.4 (4 months-17 years) (Table 1).

Eighteen patients (35.3%) had scalp, five (9.8%) trunk, four (7.8%) tongue, four (7.8%) toenail, three (5.9%) both hands Fungal infection was observed in both the toenail and two (3.9%) hand nails. In others; three (5.9%) patients in the face area, three (5.9%) patients in the genital area, one (2%) patient in the upper extremity, two (3.9%) in the foot area and two (3.9%) in the dorsal area patients (Table 2). One patient had trunk and upper extremity involvement, the other had trunk and face involvement, and another had face, tongue, trunk and nail involvement.

In 10 patients with tinea capitis profunda (19.6%), tinea capitis superficialis eight (15.8%), tinea versicolor eight (15.8%), candidiasis eight (15.8%), tinea unguium eight (15.8%) ), tinea corporis two (3.9%), tinea pedis two (3.9%), tinea facial two (3.9%), tinea cruris one (2%) and tinea incognito in one (2%) (Table 3). Tinea incognitive patient was found to be the site of involvement. One of the children had tinea pedis and tinea unguium together. In this study, tinea capitis (35.3%) was found to be the most common clinical type of dermatophytosis.

In the family history of the patients, superficial fungal infection was found in 10 (19.6%) near first degree and two (3.9%) near second degree. The remaining 39 (76.5%) patients did not have a family history.

The most common symptom was pruritus. Concomitant diseases; Pulmonary tuberculosis, extrofia vesica, ectodermal dysplasia, epilepsy, growth retardation, hypospadias, obesity, diabetes, pachyonychia congenita, prematurity, rhinosinusitis, tinea amiantecea and telogen effluvium.

Twenty-one patients received systemic antimycotic treatment (terbinafine or itraconazole) and 30 patients received topical treatment in the whole patient group. Four of the patients in the systemic treatment group were tinea unguium and fourteen were tinea capitis. The other three patients who received systemic treatment were diagnosed as; Candidiasis, tinea incognito and tinea corporis were confirmed nail involvement confirmed by direct mycosis examination. Four were onychomycosis and four were tinea capitis (Table 3).

Four (44.4%) of nine patients with nail involvement were treated topically and five (56.6%) were treated with systemic antimycotics. All patients receiving topical treatment resulted in complete recovery, while four of the five patients receiving systemic treatment had complete recovery. One of them did not come to the controls. It was found that all patients with superficial tinea capitis superficialis received systemic antimycotic treatment, while four of the patients diagnosed with tinea capitis profunda received topical antimycotic treatment (Table 3). While the mean disease duration of the patients receiving systemic treatment at the time of admission to the outpatient clinic was 5881 days, the mean disease duration of those who preferred local treatment was 1738 days.


Discussion
Skin infections caused by dermatophytes and yeasts have become an important problem affecting children and adolescents over the years (3). Most of the patients were male patients aged 5-7 years. In the literature, it has been reported that tinea capitis infection is more common in men. In this study, tinea capitis was found in 13 patients in men and five patients in women, in line with previous information. In previous studies, tinea pedis and tinea unguium were reported to be more common in men than in women, whereas in our study two of the three children with tinea pedis were found to be women (5). This finding may be due to the insufficiency of the number of patients and suggests that more comprehensive studies are needed.

In our study, a history of superficial fungal infection and concomitant immunosuppression in a family of risk factors was also evaluated. It is known that prematurity increases both fungal infections and also predisposes to other infections and increases the use of antibiotics and leads to immunosuppression (6,7). The prevalence of opportunistic superficial fungal infections such as candida is increasing in diseases such as obesity and diabetes. In addition, superficial fungal infections are the most common skin infections detected in patients with diabetes. Fungal infections have been reported to occur in 10-60% of patients with diabetes (8). In epilepsy patients, the use of antibiotics is much higher in this population due to infections frequently accused in the etiology (9). In our patients, it was seen that there were concomitant diseases such as pulmonary tuberculosis, extrofia vesica, ectodermal dysplasia, epilepsy, growth retardation, hypospadias, obesity, diabetes, pachyonis congenita, prematurity and rhinosinusitis. Although none of the patients in our study had concomitant immunosuppressive diseases such as hereditary immunosuppressive disease or chemotherapy, frequent antibiotic use secondary to concomitant diseases was found to be a risk factor for the disease.

In this study, tinea capitis was found to be the most common type of superficial fungal infections in Kayseri. Similarly in the literature, tinea capitis infection is the most common fungal infection in the world in children and adolescents (4,10). The clinical types of tinea capitis and the distribution of agents vary from region to region in the world and in our country. Turkey's Aegean and Mediterranean regions in the western part of tinea capitis superficialis more frequent, although in Kayseri in central Anatolia, East Anatolia, we observed similar to the tinea capitis profunda more often. The reason for this is that the distribution of tinea capitis agents in Central Anatolia is similar to that of Eastern Anatolia (11). Because previous studies have shown that Trichophyton verrucosum is the most isolated agent from patients with tinea capitis in both Central and Eastern Anatolia (12,13).

Unlike adults, many previous studies have reported that onychomycosis is rare in children (14). In various studies conducted in different parts of the world, rates ranging from 0% to 2.6% have been found in children. In parallel with the study conducted by Lange et al. (15) in 2006, it was observed that onychomycosis was not as low as expected in children and adolescents. In our study, onychomycosis was found to be 15.8% of superficial mycoses diagnosed in children under 17 years of age. Therefore, when nail disorder is detected in children, it should be emphasized that onychomycosis should be considered at the forefront of diagnosis. In our study, because of the presence of superficial fungal infection in the family of 12 out of 51 patients, it was seen that family transmission was important in pediatric patients. If superficial fungal infection is detected in children and adolescents, we think that relapse can be prevented by questioning the presence of fungal infection in the family and providing appropriate treatment to family members with fungal infection.

Although the first treatment of superficial fungal infections is topical antifungals, systemic antifungal drugs should be preferred when severe or chronic. Terbinafine, itraconazole and fluconazole are oral antifungals that are effective in the treatment of superficial fungal infections (16). General strategy for the management of superficial fungal infections in children; the most appropriate treatment option, including systemic treatment, without considering the profit / loss ratio and avoiding systemic antifungals as much as possible, but without hesitation in the presence of appropriate indications. In children, drug transfer is easier because nail plate has a thinner structure than adults (17). In this study, 30 patients in the pediatric age group were treated with topical antifungal and 21 patients with systemic antifungals such as terbinafine or itraconazole. In addition to the diagnostic difficulties experienced by primary and secondary care physicians, systemic treatment is preferred in children due to unconfirmed use, possible systemic side effects and difficulty in use in children. it was thought that this could cause the disease duration to be much longer.


Result
Tinea capitis is the most common clinical type of superficial fungal infection in children and adolescents. Superficial dermatophyte infections are more common in male sex. We also believe that onychomycosis should be kept in mind in the differential diagnosis of nail disorder in children due to the high rate of onychomycosis in our patient group. In the majority of patients with onychomycosis, only topical treatment was sufficient. It is stated that family history is an important risk factor in superficial fungal infections, which is often missed by physicians. In the treatment approach, especially the experience of the physician and the correct determination of the predisposing factors such as additional disease are the guiding factors in choosing the most appropriate treatment for tinea capitis, tinea unguium and other superficial fungal infections.


Author Contributions
Ethics Committee Approval: Approval was obtained from Erciyes University Faculty of Medicine Ethics Committee, Informed Consent Form was obtained from all patients included in our study, Concept: Retrospective study, Design: Ragıp Ertaş, Demet Kartal, Serap Utaş, Data Collection and Processing : Ragıp Ertaş, Analysis or Interpretation: Serap Utaş, Ragıp Ertaş, Demet Kartal, Literature Search: Demet Kartal, Written by: Ragıp Ertaş, Referee Assessment: Reviewed by the editors' board, Conflict of Interest: No conflict of interest was declared by the authors. Financial Support: No financial support was received from any institution or person for our study.


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Fish smelling vaginal discharge will cause pain and burning if there is

Vaginal discharge causes how is it treated? Fish-scented discharge, which is common in women, is often among the unnatural currents. If you have a fish-smelling vaginal discharge, you're experiencing a bacterial infection. For the treatment of fish-smelling discharge you need to use antibacterial medication.
Fish-smelling vaginal discharge is one of the main reasons for women to consult a doctor. Vaginal discharge is a common problem in gynecology in general. However, not every vaginal discharge is a sign of disease. Vaginal discharge is vital for the correct wetness of the vagina, comfort in sexual intercourse, and the correct reproduction of the female reproductive organs. However, sometimes bacteria, sometimes fungus spores, and sometimes some medications may damage the moisture balance of the vagina and change the flora. In such a case, vaginal discharge may increase or have a bad smell and color. Among the vaginal discharge, the most common type of discharge experienced by women is fish-scented discharge. If you have a vaginal discharge that smells like fish, you are experiencing an unnatural vaginal discharge problem. This disease, which is called bacterial vaginosis, is accompanied by malodorous, abundant gray-white foam with a slightly yellowish vaginal discharge. The vaginal discharge typically has the smell of fish. Severe pain is also felt during sexual intercourse. Oral and vaginal antibacterial drugs should be used in the treatment of fish-smelling vaginal discharge.

What should be normal vaginal discharge and how to smell?

In order to understand whether your vaginal discharge is a symptom of the disease, it is useful to first learn how normal vaginal discharge should be. Under normal conditions, your vaginal discharge should be clear and the egg should be like the flux. It is also important that there is no dominant smell. The amount of normal vaginal discharge does not cause you discomfort such as itching. It facilitates sexual intercourse and does not cause pain or pain.

The amount and color of normal vaginal discharge may vary in some special cases. The amount of vaginal discharge may increase during periods before menstrual bleeding, sexual arousal, pregnancy during which women are under hormonal effect. However, the smell should be normal and do not bother you.

How is diseased vaginal discharge?

If the discharge is dark yellow, green, brown, bloody, foamy and smelly, it is accompanied by pain, burning while urinating, and abnormal bleeding.

Fungal infections: Odorless, cheesy or milk white currents from the vagina are associated with fungal infection. Patients have complaints of burning and itching. Medicated treatment is essential.

Sexually transmitted infections (Trichomonas) Trichomonas vaginalis microorganism is transmitted by sexual intercourse, leading to vaginal infection. It is characterized by abundant vaginal discharge and vaginal burning, yellow or greenish, foamy, bad smelling, and itchy findings in the vulva. Antibiotics are used in the treatment.

Gardnerella discharge: Similar to trichomonas, fragrant yellowish green color. But it is not sparkling like trichomonas.

Can vaginal discharge be a sign of cancer?

Brown vaginal discharge: It occurs in sexually transmitted diseases such as cervical cancer, pelvic inflammatory diseases (PID), perimenopause, menopause, or gonorrhea.

Thrush - Candida albicans: Yeast infection caused by fungal species. It occurs in moist areas of the body such as the vagina and mouth.

Vaginal discharge may also be due to a tumor formation. The character of the stream is slimy in consistency and abundant, with fine lines of blood on it.

Uterine cancer; Apart from the infection, although it is rare, the bad smell of the blood flow should bring to mind cervical cancer. The malodor here is caused by tissue destruction.

Cancer of the ovarian ducts: Broth colored discharge and lower abdominal pain in patients.

Diagnosis of vaginal discharge?

In order to make the correct diagnosis in vaginal discharge, the organism that changes the shape, color and smell of the discharge in the vagina must be correctly identified. For this purpose, physician examination, imaging and discharge from the patient and tissue samples are analyzed in the laboratory. Vaginal culture and smear test are the most commonly used test methods for diagnosis. When the organism causing the vaginal discharge is fully identified, the treatment of the vaginal discharge is carried out with appropriate drugs.


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FOOT FUNGUS AND TREATMENT

Foot Ringworm (Tinea Pedis) Picture of Athlete's foot, also called tinea pedis

Fungal infection of the foot. Peeling, redness, itching,

burning and sometimes causes blisters and wounds.



The athlete's foot is a very common infection. Mushroom type shoes,

Produces easily in hot and humid environments such as socks swimming pools,

dressing rooms and public shower floors. It is the most common in summer and hot, humid climates.

It is more common in people who use tight shoes and use community baths and pools.


What Causes an Athlete's Foot?

Athlete's foot, hair, toenails and outer skin layers

it is caused by a microscopic fungus that lives in dead tissue.

There are at least four types of fungus that can cause the athlete's foot.

The most common trichophyton rubrum of these fungi.


What are the Athlete's Foot Symptoms?

Signs and symptoms of athlete's feet vary from person to person.

However, common symptoms include:

Peeling, cracking and scaling of feet

Redness, blisters or smoothing and disintegration of the skin

Itching, burning or both

Types of Athlete's Feet

Interdigital: Also called toe web infection, this is the most common type of athlete's foot.

It usually occurs between the two smallest toes. This shape of the athlete's foot

It may cause itching, burning and death, and infection can spread to the sole of the foot.

Moccasin: A small irritation, dryness, a moccasin-type infection of the athlete's foot

It may begin with itching or scaly skin. As it develops, the skin may thicken and crack.

This infection may cover the entire sole of the foot and may extend to the sides of the foot.

Vesicular: This is the least used type of athlete's foot. This is usually under the skin.

It starts with the appearance of sudden bubbles filled with liquid. Most often, blisters develop on the underside of the foot.

However, they may also appear between the toes, on the heel or on the foot.

Peeling, cracking and scaling of feet

Redness, blisters or smoothing and disintegration of the skin

Itching, burning or both


How is the Athlete's Foot Diagnosed?

Not all itchy feet have athlete's feet. The best way to diagnose infection,

scrubbing the skin and examining the balance under a microscope for evidence of fungus.


How is the Athlete's Foot Treated?

The athlete's foot is often treated with topical antifungal medication (a medication placed directly on the skin).

In severe cases may require oral medications (those who take the mouth).

The feet should be kept clean and dry as fungi develop in humid environments.


How to Prevent Athlete's Feet?

Steps to prevent athlete's shoes, shower sandals in public shower areas,

shoes that allow the feet to breathe; and daily washing of the feet with soap and water.

It can help prevent the athlete's feet by drying the feet thoroughly and using a fine foot powder.


Jock Itch

The jock spoon, also called tinea cruris, is a common skin infection caused by a fungus called tinea.

The fungus grows in warm and moist areas of the body, and as a result infection can affect the genitals, inner thighs and hips.

Infections are more common in summer or in warm, wet climates.


Jock itch usually looks like an itchy red, itchy rash.

Is Jock Itch Infectious?

Jock itching is only mildly contagious. The condition can be transmitted from person to person by direct contact or indirectly from fungal-bearing objects.


What are the Symptoms of Jock Itch?

Symptoms of itching in Jock include:


Itching, chafing or burning in the groin or thigh

A round, red, fluffy rash with high edges

Redness in the groin or thigh

Skin peeling, peeling or cracking

How is Jock Itch Diagnosed?

In most cases, itching of the rash can be diagnosed based on the appearance and location of the rashes.

If you do not know for certain that the condition is itching, consult your doctor.

The doctor will ask for your symptoms and medical history and will perform a physical exam.

Microscopic examination of skin scales may confirm the diagnosis.


How Jock Itching Is Treated

In most cases, the treatment of jock itch involves keeping the affected area clean and dry, and administering topical antifungal drugs.

Jock itch usually responds to over-the-counter antifungal creams and sprays.

However, prescription antifungal creams are sometimes necessary. During Jock itch treatment, make sure:


Wash and dry the affected area with a clean towel

Apply antifungal cream, powder or sprays as required.

Change clothes - especially underwear - every day

ringworm

Fungus is also a worm, also called tinea corporis, but the fungal infection of the skin.

It can occur anywhere on the body and looks like a circular, red, flat wound.

It is usually accompanied by scaly skin. When the middle skin appears normal, the outside of the wounds can be removed.

Ringworm may look like a wolf, but it is usually not serious.


Is ringworm contagious?

Ringworm can spread by direct contact with infected people or animals.

It can also spread on clothing or furniture. Heat and moisture can help spread the infection.


What are the symptoms of ringworm?

Ringworm sometimes looks like a red, round, flat wound that comes with scaly skin.

There may be one or more patchworms on the skin and patches or red rashes may overlap.

It is possible to have ringworm without common red ring rashes.


How is Ringworm Diagnosed?

A doctor can diagnose ringworm based on the appearance of rashes or reported symptoms.

He will ask questions about exposure to humans or animals with ringworms.

The doctor can take skin scrapings or samples from the infected area and look under the microscope to confirm the diagnosis.


How is ringworm treated?

Ringworm treatment usually consists of antifungal drugs applied to the skin.

Many ringworm infections respond well to over-the-counter creams, including:


Lamisil

Micatin, Monistat-Derm

Lotrimin Restaurant Reviews, Mycelex

Prescription topical or oral medications may be prescribed for more severe ringworm cases.


Yeast Infections

Yeast infections of the skin are called cutaneous candidiasis and are caused by fungal-like fungi called candida.

When the yeast on the skin grows more actively and the skin is red, lime and itchy

spill. Yeast infections are not contagious.


Yeast infections can affect almost all skin surfaces of the body,

however, it most likely occurs in hot, damp, wrinkled areas, including underarms and groin.

Candida infection is particularly common among people who are obese or have diabetes. People taking antibiotics are also at risk.


Candida can cause redness in babies and may cause nail infections.

Oral thrush is a form of candida infection found in the mouth. Candida also causes vaginal yeast infections.


What are the symptoms of a yeast infection?

Symptoms of yeast infection in skin folds include:


Rash

Patches emitting clear liquids

Acne-like bumps

Itching or burning


Symptoms of yeast infection in nail beds are:

Swelling

ache

Pus

White or yellow nail separating from nail bed

Symptoms of thrush (oral yeast infection) include:


White spots on tongue and on cheeks

ache

Symptoms of vaginal yeast infection include:


White or yellow discharge from the vagina

Itching

Redness of the vagina outer area

burning

How are Yeast Infections Diagnosed?

When diagnosing a yeast infection, your doctor will need to take a medical history and perform a physical examination.

Your doctor may scrape the skin under the microscope to confirm the diagnosis.


36AXX
pH-D Feminine Health, First Woman Owned Boric Acid Vaginal Suppositories, Made in USA, Bottle of 72 (600mg)